VA needs more primary care doctors

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Over the past month and a half, Americans have witnessed several failures within the Veterans Affairs Department. The story of mismanagement at the Phoenix VA hospital and other facilities within the VA system points to an administration in dire need of reform.

So, this week’s news of a compromise between Sen. Bernie Sanders (I-Vt.) and Rep. Jeff Miller (R-Fla.) is welcome. In the midst of the political wrangling that is to come over this compromise, a key issue of VA reform must be given the urgent attention it deserves.

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Bob McDonald, the incoming secretary of Veterans Affairs, will hopefully do all he can to make the VA work, but he is faced with enormous, often insurmountable, problems. In particular, few people are asking him how many primary care doctors he needs to fix the problem.

Not only do we need to be asking this question, but we need to be working hard to find a solution.

A May 30 cover story in The New York Times chronicled the heartbreak of primary care physicians struggling to manage a mountain of complex medical cases at VA facilities from coast to coast. The VA is in need of more primary care physicians. Falsified data at the Phoenix VA and wait times for veterans in desperate need of care are the tragic results of this gaping hole in the physician workforce at the VA. Recently, the VA estimated that it had about 400 unfilled vacancies for primary care doctors.

Through the Health Professional Educational Assistance Program, the VA currently provides for loan repayment and scholarships that fund the education and training of a range of health providers. Unfortunately, Educational Assistance Program benefits are limited and, as currently designed, the program does little to encourage primary care physicians to work at the VA. Furthermore, recent proposals to reform the VA do not go far enough to emphasize training VA doctors who are committed to the practice of primary care medicine.

That is why I am introducing The RDOCS-VA Act, legislation that will strengthen the Educational Assistance Program. Modeled after the successful Reserve Officers’ Training Corps (ROTC) program, RDOCS-VA will provide scholarships and stipends covering the full cost of attending medical school, in exchange for a five-year commitment to serve as primary care doctors at the VA. RDOCS-VA is designed to directly address the VA’s needs by requiring the annual creation of a minimum of 400 RDOCS-VA scholarships, with flexibility to award even more scholarships in the future. As a result, young American men and women will be going to medical school knowing that, upon graduation as medical officers, their all-important tour of duty will be as primary care physicians in the VA. 

Some might say that programs currently exist where new doctors can choose to pay off their debts through the national health service corps. However, these new doctors lack veterans-specific training. The VA needs primary care physicians trained to treat and manage the unique physical and emotional wounds our warriors bring home from war. Just as the military needs officers trained in cutting-edge tactics and technology, the VA needs primary care doctors who are ready to meet the challenges of veterans care, particularly the new medical challenges stemming from military service in 21st century combat areas.

Despite all the fine work that is done — day in and day out — at many VA hospitals (particularly the Seattle facility in my home state), the VA system finds itself at a defining moment in its history where any and all failures are intolerable.

Success in our mission to care for America’s veterans will be largely measured by a corps of new primary care physicians who are ready, willing and able to care for our warriors. Any systematic reform in the VA won’t be fully effective if the VA doesn’t have enough doctors.

 

McDermott has represented Washington’s 7th Congressional District since 1989. He sits on the Budget, and Ways and Means committees.