Proposed system for delivering medical care to our women veterans of grave concern
by Emine Cay Masters, M.D
In order for women to receive adequate medical care, they need to have direct access to primary care, mental health, and gynecology care. These disciplines are considered the three fundamental pillars for delivering quality health care to women.
The number of women veterans utilizing VA healthcare will likely double in the next few years. Within the next 15 years, women are projected to represent 1 in every 7 enrollees versus 1 in every 16 today. In fact, the active duty military force today is 14% female. Most of the new women veterans entering VA care are under age 40 and of child-bearing age, thus creating a need for a significant shift in provision of healthcare to women veterans.
Women veterans have chronically been under served by the VA. Women veterans have higher physical and mental health burdens than their female non-veteran counterparts and medical burdens comparable to or worse than those of male veterans. Even while utilizing VA services, women have had to seek outside medical services more than have men, especially for women’s gynecological conditions.
My concern is that the Women Veterans Health Strategic Healthcare Group (a group composed of VA administrators far removed from direct patient care – none of whom are Gyn clinicians) has recently recommended that women veterans be limited to a single primary care provider who is supposed to take care of all her medical needs, including gender-specific gynecology care. This restrictive “gatekeeper” model was tried on a nationwide basis by the HMOs in the early 1990s, proved to be detrimental to patients’ well-being, and thus abandoned. Since then, women in the private sector, with or without health insurance, with Tricare coverage, even those enrolled in Medicaid welfare programs, not only have a primary care doctor, they have direct access to an Ob/Gyn for all their gynecological needs, from routine Pap smears to complex gynecology interventions. This is not fragmented care – it is the standard of care enjoyed by women outside the VA healthcare system. This same level of high-quality, focused, gender-specific care should also be provided to our women veterans who have served and sacrificed for our country.
The Women Veterans Health Strategic Healthcare Group has recommended that specialized mental health providers be assigned and co-located to ensure integration of adequate women’s mental health care as part of primary care. A specialized gynecology clinician should also be assigned and co-located in the women’s health clinic; otherwise, women veterans will continue to be deprived of the comprehensive and competent gender-specific care only a gynecology clinician can provide.
In summary, we need to let our Congressional leaders know, that just like the rest of the women in America experience, women veterans deserve the same direct access to a dedicated Gyn provider for all their gender-specific, female-related gynecology care.
ABOUT THE AUTHOR: Emine Cay Masters, M.D.. She is from North Carolina and can be reached via email at skymasters@charter.net
111th Congress- U.S. House Committee on Veterans Affairs
Bob Filner
Chairman Corrine Brown
2428 Rayburn House Office Bldg 2336 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515Vic Snyder / Steve Buyer
1330 Longworth House Office Bldg 2230 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515Cliff Stearns / Michael H. Michaud
2370 Rayburn House Office Bldg 1724 Longworth House Office Bldg
Washington DC 20515 Washington DC 20515Stephanie Herseth Sandlin /Jerry Moran
331 Cannon House Office Bldg 2202 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515Jeff Miller / Harry E. Mitchell
1535 Longworth House Office Bldg 2434 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515John J. Hall / Henry E. Brown, Jr.
1217 Longworth House Office Bldg 1124 Longworth House Office Bldg
Washington DC 20515 Washington DC 20515Ginny Brown-Waite / Phil Hare
414 Cannon House Office Bldg 2434 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515Shelley Berkley /Brian P. Bilbray
405 Cannon House Office Bldg 227 Cannon House Office Bldg
Washington DC 20515 Washington DC 20515John T. Salazar / Ciro D. Rodriguez
1531 Longworth House Office Bldg 2458 Rayburn House Office Bldg
Washington DC 20515 Washington DC 20515Michael R. Turner / Gus M. Bilirakis
1740 Longworth House Office Bldg 1630 Longworth House Office Bldg
Washington DC 20515 Washington DC 20515Joe Donnelly / Jerry McNerney
1218 Longworth House Office Bldg 312 Cannon House Office Bldg
Washington DC 20515 Washington DC 20515Doug Lamborn / Vern Buchanan
437 Cannon House Office Bldg 1516 Longworth House Office Bldg
Washington DC 20515 Washington DC 20515Zachary T. Space / Timothy J. Walz
315 Cannon House Office Bldg 1529 Longworth House Office Bldg
Washington DC 20515 Washington DC 20515Steve Scalise
1205 Longworth House Office Bldg
Washington DC 20515
111th Congress- U.S. Senate Committee on Veterans Affairs
Daniel K. Akaka / Richard Burr
Chairman Ranking Member
141 Hart Senate Bldg 217 Russell Senate Bldg
Washington DC 20510 Washington DC 20510John D. Rockefeller,IV / Patty Murray
531 Hart Senate Bldg 173 Russell Senate Bldg
Washington DC 20510 Washington DC 20510Sherrod Brown / Jon Tester
455 Russell Senate Bldg 204 Russell Senate Bldg
Washington DC 20510 Washington DC 20510Jim Webb / Bernard Sanders
144 Russell Senate Bldg 332 Dirksen Senate Bldg
Washington DC 20510 Washington DC 20510Arlen Specter / Johnny Isakson
711 Hart Senate Bldg 120 Russell Senate Bldg
Washington DC 20510 Washington DC 20510Lindsey Graham / Kay Bailey Hutchison
290 Russell Senate Bldg 284 Russell Senate Bldg
Washington DC 20510 Washington DC 20510Roger Wicker
487 Russell Senate Bldg
Washington DC 20510
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