VA health care quality: The road to recovery

Despite the challenges of caring for the veterans of today's wars, the VA health system is getting high marks for quality.

By David Glendinning, AMNews staff. Dec. 10, 2007.

"We are not your father's VA," Jonathan B. Perlin, MD, PhD, who until recently headed the Dept. of Veterans Affairs health system, was fond of saying about today's department.

For decades, the quality of care in the VA health system was considered woefully sub-par. Enrollees complained of shoddy facilities, uncaring medical professionals and neglectful treatment. Its reputation suffered from such accounts as Oliver Stone's 1989 film "Born on the Fourth of July," which depicted the paralyzed protagonist's VA hospital setting as squalid and decaying.

Veterans, physicians and other experts tell a different story today. By many accounts, the quality-of-care picture at the more than 150 hospitals and nearly 900 outpatient clinics has changed dramatically since the mid-1990s. What was once the subject of embarrassment and ridicule is now held up as a model for health systems.

With its new reputation for having some of the best treatment available anywhere, the veterans system has been in high demand in recent years, said Martin F. Conatser, American Legion national commander. This demand, combined with the large influx of new Iraq and Afghanistan veterans, has strained the system's capabilities and led to access problems for new enrollees and long-time patients. "It's been a victim of its own success," Conatser said.

Investigators have found that veterans are having trouble enrolling in the system and receiving timely care once they do. Veterans, physicians and lawmakers have joined the chorus calling for major reforms to address an antiquated disability assessment process, staffing shortages and bureaucratic barriers to care.