In 2014, the U.S. Department of Veterans Affairs was in crisis. The agency, which provides health care to approximately 9 million veterans at over 1,700 locations, had set a top-down goal to increase the percentage of veterans who were seen within 14 days of requesting an appointment. This mandate, as admirable as it was, clashed with the diminished capacity of the chronically underfunded organization, where in some parts of the country, underpaid physicians were burning out under the weight of rising caseloads.