Troubles have been mounting for months at the Central Alabama VA health system, and right now no clinical department is feeling the heat more acutely than radiology.

Last week the Montgomery Advertiser obtained leaked emails showing that, in early November, the chief radiologist asked referring doctors to order imaging exams only when “absolutely necessary.”

In the email thread that followed, “a podiatrist said it’s ‘asinine’ to assume that orthopedics, podiatry and rehabilitation medicine can function without patient scans,” according to the newspaper.

The article showed that the crisis has resulted from a critical staff shortage. Already down several radiologists, the department has had just one radiologist reading images for two hospitals serving more than 40,000 patients. The overworked radiologist said in the email thread that covering two hospitals while also tending to administrative duties presented an “impossible” workload.

This was the latest in a string of hits to the Central Alabama VA’s radiology department, whose staffing woes have involved not only unfilled radiologist positions but also openings for essential support staff, the newspaper reported.

Hires were recently made after it came to light that hundreds of x-rays had gone unread over the past few years. Meanwhile, the system arranged for read coverage by nearby VA facilities. But the staff shortage extends well beyond radiology, making it all the harder for human resources personnel to keep up.

The Advertiser obtained staffing reports showing a total of about 198 open positions as of mid-July, including 27 openings for doctors, 38 for registered nurses and 44 for other nursing jobs.

The Central Alabama VA’s publicized problems mirror laundry lists uncovered at VA hospitals across the country—long wait times for appointments, falsified schedules to conceal the long waits and so on, not to mention unread diagnostic images numbering in the hundreds and possibly thousands.

Observers are hopeful that the VA is on the road to recovery.

The Central Alabama VA’s director, James Talton, was fired in October, five months after President Barack Obama accepted the resignation of Eric Shinseki as VA secretary. Former Procter & Gamble head Robert McDonald, whom “60 Minutes” portrayed as a turnaround expert, was confirmed and sworn into the office in July.

“Right now, one of the biggest challenges we face is the shortage of clinicians and other healthcare professionals,” McDonald said in an address to the Institute of Medicine Oct. 20, adding that he’s been on a recruitment drive at medical schools around the country. “Audiences everywhere have been welcoming and interest is high.”

The VA’s media relations department did not respond to a request for comment on the situation in Central Alabama.