So far 2014 has not been the year the federal government played its best hand in health care. An embarrassing lack of foresight and preparation was exposed when the Affordable Care Act (ACA) was launched, and more recently a frightening degree of neglect was suggested when a CNN report alleged at least 40 veterans died as the result of lengthy wait times those vets endured for appointments at the Phoenix Veterans Affairs Health Care System. The aftermath of the ACA launch saw the departure of Kathleen Sebelius, and the recent debacle at the Phoenix VA sparked the resignation of Robert Petzel, undersecretary for health in the Department of Veterans Affairs. Good riddance to both—perhaps. But what effect does their exits have on veterans who are affected by a disability? So far as we know, no one received a better wheelchair or prosthetic limb. All we know is that someone was not playing heads up ball. Or someone didn’t care.

It’s difficult to blame President Obama for this. He has a lot on his plate. Nonetheless, these two breakdowns in execution of policy happened on his watch. The irony of the tragedy at the Phoenix VA is amplified by the fact that at the Veterans of Foreign Wars convention in 2009, President Obama is reported to have said, “We’re going to … cut those backlogs, slash those wait times, deliver your benefits sooner.”

Don’t say it unless you can make it happen. Not only in your office, but in the offices and hallways and living rooms of everyone who will help make your words real for someone.

As therapists who provide care and resources for individuals affected by disabilities, we need to remind ourselves that what happens when we are charged to provide services to a client—regardless of whether many of those services must be delegated to others—will carry consequences that will be ascribed to us. Good or bad. This is why we strive for LMNs that are bulletproof, and this is why we must sweat the details of how, when, and where a mobility device is delivered. It all happens on our watch.