VA doctor: We care, and we innovate
The nation should be proud of how we serve
When I share with someone that I work at the Veterans Health Administration, I often get one of two responses: “Oh, I’ve heard the care isn’t that good there.” Or, “What’s the latest on the scandal going on at the VA?”
Perhaps this is the inevitable conclusion for someone only reading news headlines about the Department of Veterans Affairs, but I am honored to be a VA doctor.
The other day, I was in a Lyft car (I am writing from San Francisco, after all) chatting with the driver when I mentioned I work at the VA. He immediately opened up and shared that he was an Iraq War veteran and told me all about his primary care doctor at the VA and the support he received as he transitioned back to civilian life. He thanked me for my service to the veterans. I thanked him for his service to our country. This is the VA that I know, the VA that our country should be proud of.
There are many reasons to take pride in the VA:
It has been a leader in research and discovery for decades. For example, cardiac pacemakers and CT scan technology were pioneered at the VA.
VA hospitals are an integral component of teaching at prestigious academic medical centers. More than 40,000 medical residents and 20,000 medical students, myself included, receive training at a VA hospital each year.
My VA hospital has a strong affiliation with the University of CaliforniaSan Francisco, one of the top medical schools in the country. It should be no surprise then, that the VA’s clinical care is on par with or better than our counterparts. A recent large meta analysis done by the RAND Corporation showed that the VA often performs better than or similarly to other systems of care with regards to safety and effectiveness of care.
As a VA doctor, I work in the largest integrated health system in the nation. I take care of patients in a system that allows me to access a patient’s electronic medical record across specialties and VA clinical sites nationwide. At the VA, I can access a patient’s previous doctors’ visits with just a few clicks, and directly instant message or email his VA providers with questions because we are all on the same computer network.
In a non-integrated system, this process entails wasted time on hold with various offices, unread faxes or, worse, no attempt to obtain old information at all.
A final point about quality of care: One of the most frustrating aspects of being a doctor is not being able to solve the social problems of my patients. The VA gives me more options to tackle this than other systems. The VA can provide special resources to our population, which I learn about all the time from our social workers and nurse care coordinators.
Just the other day, I was able to discharge a patient to the Metropolitan Fresh Start House, which provides homeless veterans with substance addiction, housing, food and structured recovery programs.
Nevertheless, there have been real access issues at the VA, highlighted by the Arizona appointment scandal in
2014. In response, Congress passed Veterans CHOICE, a program that allows veterans who live more than
40 miles from a VA, or who are unable to get an appointment within 30 days, to obtain care with a non-VA provider.
Additionally, the VA has increased transparency of wait times for appointments — something that many other public and private hospitals have yet to do. There is promise in this new system, but CHOICE won’t solve all access issues. Our patients face a shortage of all doctors, not just VA doctors, especially in rural communities.
My job reminds me every day of the sacrifices made by the men and women who have served us in the military. There is a sense of gratitude and mission unique to this special population. We all feel it, from the patients to their families to the doctors and staff.
It is my hope that as CHOICE evolves and people learn more about the VA system, the headlines will also start to reflect the VA that I know.