An NYU Langone internal medicine specialist who served as a White House fellow at the US Department of Veteran's Affairs says the headline-grabbing failures of the VA health system's administration stand in sharp contrast to the highly rated care the system delivers.
In an editorial in The New England Journal of Medicine online June 5, Dave Chokshi, MD, MS, an assistant professor at NYU Langone Medical Center, says the paradox has created a watershed moment to reform and refocus the way the entire system is structured, staffed, and managed, while also building on its clinical excellence.
"With so much public attention focused on the VA's mandate to provide medical care, the time is right to broaden the discussion from access and correcting gaps in the system to actively thinking about how do we design a better VA system that best serves our nation's veterans' medical needs," says Dr. Chokshi.
In the commentary, Chokshi writes that persistent and systemic care-access problems, with long wait times for appointments and scheduling scams, contrast sharply with the documented experience of most veterans who, once in the hands of caregivers, achieve above-average health outcomes and receive high-quality clinical care backed up by laudable patient-satisfaction surveys and scores comparable to private health facilities.
Dr. Chokshi suggests key reforms he says will build on the VA's historic inpatient strengths, including:
Dr. Chokshi says he was motivated to weigh into the current debate because the VA responded well to a previous "crisis of confidence" in the 1990s by transforming itself into a quality system for clinical care and averting threats of privatization. "Now it needs to protect the best elements of its infrastructure, build aroundholistic care of each veteran, while embarking on another round of reforms," he adds.
|Contact: David March|
NYU Langone Medical Center / New York University School of Medicine