It's a huge undertaking to fix what some call "hopelessly broken."
More than 170 Veterans Affairs clinics across the country are undergoing a thorough review. Twenty-six of them are facing a full investigation.
"We had two days notice and team of five VA professionals came in," said Dr. Kevin Novak, Primary Care Association chief of staff.
Fewer than two months on the job, Novak watched and listened. For three days last week his team was grilled about everything from scheduling to staffing.
"(They wanted) to be sure they were doing it correctly and that there was no gaming of the system," he said. "They validated that things were being done here the way it should be and that we weren't hiding anything here."
Still, Novak said there were glaring deficiencies that needed improvement, including shifting administrative duties off neighbor island staff and off doctors so they can shift their time back to patients.
"What we need to focus on is building our base," Novak said.
The review found recruitment and retention to be a major problem. Novak said that just this month, they lost two full-time doctors, who were replaced by temporary fill-ins.
He said the VA is working with The University of Hawaii to grow locally. He wants the local population to go into the medical field an become doctors and nurses and stay local to care for their families.
The VA Pacific services some 24,000 vets from Molokai to the Marshall Islands, growing 5 percent every year with sign-in kiosks helping to cut back on long lines.
But the VA said some 13 percent of "no shows" are crimping its improved system, with outdated information frustrating staff, too.
"We can't take them out of the system here if they don't let us know," Novak said.
Then there's available parking -- or lack of it. The V.A. will begin adding more levels to the parking lot at Tripler -- 120 spots by 2017 -- and possibly leasing nearby lots.
The VA said each veteran is now assigned a Patient Aligned Care Team, composed of a doctor, nurse, tech and other staff.
There are expanded office hours on Saturdays, Tuesdays and Thursdays.
Eighteen months ago, the VA opened its satellite clinic on Fort Weaver Road.
The design for an 80,000-square-foot facility somewhere in the Ewa Plain called The Aloha Project is due next year.