The VA folks you have encountered are all rank-and-file types and none of them top brass, correct?
I won't say that I've ever encountered any of the top brass, but I have had a number of interactions with managers of various levels. In one case, a manager apologized to me for slow service, explaining that although he was authorized to have twelve clerks, upper management had only given him five, and he'd not been able to pry the other seven loose from whatever else they were doing. And once, I was complaining about how far behind a department had gotten, I was asked by a suit to discuss the issue. It turned out that this department was under investigation for exactly that, and they needed my testimony to help find out just what was happening and why. I even got a call, once, from the manager in charge of a small community clinic because I'd complained about a complete lack of common sense in their phlebotomist. (He'd insisted on taking blood samples from orders that were several years old but not signed off, even though I had paperwork with me showing exactly what tests I needed.) The next time I came in, the phlebotomist told me how sorry he was and that it wouldn't happen again.