One of the biggest – and most misunderstood – stories of 2014 was about the nation’s largest health care system, the Veterans Health Administration.
Revelations that managers at the VA were concealing long wait times led to the resignation of VA Secretary Eric Shinseki and has left the lasting impression that the VA does not deliver high-quality care.
The drumbeat of negative coverage has also made it difficult for the new VA secretary, Robert A. McDonald, to recruit more physicians, nurse practitioners and physicians’ assistants to ease the staffing shortage that caused the waits in the first place.
And this negative coverage also obscured the basic fact that the VA delivers some of the best – indeed, some of the only – coordinated health care in the entire country.
While many health systems and hospitals in the private sector talk about patient safety and teamwork, the VA actually delivers.
In many primary care clinics in the VA, a veteran going in to see his or her primary care physician will be treated by a team of nurses, nurse practitioners, licensed practical nurses, pharmacists, nutritionists and psychologists who actually hold daily huddles about their patients face to face.
A patient with diabetes, congestive heart failure and post-traumatic stress disorder may spend a half hour or more with his physician. Then he may sit down with a pharmacist for 45 minutes to review his complex medications before going to talk to a psychologist or social worker about his mental health issues.
The VA also has a system of nursing homes for veterans that has better staffing than many for-profit nursing homes.
And the VA has done pioneering research in patient safety, for example, dramatically reducing rates of one of the most vicious hospital superbugs, Methicillin-resistant Staphylococcus aureus (MRSA), throughout its 152 hospitals.
For physicians, nurse practitioners, psychologists, physical therapists, and other health care professionals, the VA offers two things the private sector seems unable to provide.
One is ready access to help in dealing with complex cases. A rehab physician told me she left her position at a prestigious northeastern teaching hospital and signed up with the VA because she could finally work on a real team with physical therapists and speech language pathologists.
The other advantage for health care providers at the VA is they don’t have to run a gauntlet of insurance company restrictions and denials. The government covers the costs, so the providers can actually tend to their patients.
According to many newspaper accounts, the staffs at the VA hospitals are demoralized. But the providers I’ve talked to over the past six months don’t seem that way at all. They’re energized to heal our nation’s veterans, and they appreciate the system of coordinated care that the VA has in place.
What demoralizes me is the failure of the media to cover this part of the story.
Bad news may sell better, but it does a disservice to the wonderful people who care for our veterans.