The quality of health care for veterans may be closely watched this election year due to frequent presidential promises to take care of those who served in the military.
Some doctors at the Zablocki Veterans Affairs Medical Center in Milwaukee say they're proud of the cancer treatment they're able to offer, and satisfaction at Zablocki apparently remains high. But a nurses union says a recent announcement threatens to weaken services for vets who may be in crisis.
A 2018 law supported by President Donald Trump allows a sizable increase in the number of military vets who are able to use a private health care provider, and then bill the VA. Dr. Elizabeth Gore is section chief of radiation oncology at the Milwaukee VA, and a professor at the Medical College of Wisconsin. Gore says she's well aware of that law, which is called the Mission Act.
"I know many veterans were very pleased with the Mission Act. It gave them opportunity to get care closer to home. I think sometimes that's completely appropriate, and we help coordinate that for patients. Other times, it's very, very difficult because we know they don't necessarily get the same level of care. It becomes disjointed, and it's not as timely, and it's hard to provide follow-up," Gore told WUWM.
Being an oncologist, Gore is especially concerned about patients with cancer, particularly lung cancer. She says the VA is doing more screening and finding more cases.
"It's probably lifestyle. There's a higher percentage of veterans who smoke. And the majority of patients with lung cancer unfortunately are smokers," Gore said.
By spotting the cancer early, Gore says the VA is better able to use a multi-disciplinary team to come up with a treatment plan.
Sometimes the treatment involves surgery. That's where Dr. Paul Linsky comes in. He's a general thoracic (chest) surgeon at the VA, as well as an assistant professor at the Medical College. Linsky says he's been able to specialize on the lungs.
"There are very good studies that have shown your outcome, if you have lung cancer, is improved by having your surgery done by a person that all of their clinical practice is general thoracic surgery," Linsky said.
Linsky says he doesn't also have to perform heart surgery or other types of operations. He says being able to focus on one thing has taught him a lot, including about blood vessels.
"Lung anatomy is variable. There's a lot of different patterns you have to be aware of. Because if you take the wrong vessel, it changes your operation," he said.
Linsky also praises the VA for having many medical staff who are veterans. He says they take care of their own.
Since most of the older veterans are male, Milwaukee VA doctors say prostate cancer is another type of ailment they often see. Palmyra resident John Stayton served in the Army during the early 1970s. He went through 44 sessions of radiation on his prostate last summer, and has been told he is now cancer-free.
"I can't say enough for these people. They're your friend, first-name basis, respectful. Any issues that you have, they'll listen, get you to the right person. The whole radiation department was just great. I could name all their names, but it would take up too much time," Stayton enthused.
Stayton says he didn't go to the VA when he was working because he had health insurance through his employer. Now retired, he says he'll continue to go to the VA, as needed.
"You don't have to have a whole chest full of ribbons or medals and stuff to get extra treatment. You are all treated the same here, and you are treated nicely, " Stayton said.
A few months ago, U.S. VA Secretary Robert Wilkie told WUWM that the patient satisfaction rate at the Milwaukee VA is 91%.
But some observers say the rating could sink if the VA goes ahead with an announced plan to change telephone triage staffing. The announcement says the Milwaukee phone triage unit would be consolidated with those services offered at the VA in Madison.
That concerns a member of the Wisconsin Federation of Nurses and Health Professionals. Dawn Potis has been a registered nurse at the VA for 19 years. Since 2005, she has worked on the day shift in the Milwaukee triage unit — a round the clock nurse advice line for veterans.
“They call in with urgent, emergent symptoms. They call in with suicidal thoughts, homicidal thoughts. It can be mental health issues. We get every kind of call you can imagine, but we get them where they need to go," Potis said.
She says it's important to have an experienced RN answering every call, citing an instance where a vet called complaining of back pain.
"You learn as an RN to ask questions to answer other questions. Come to find out, he was suicidal," Potis said.
She doubts the Madison unit would have that level of expertise. The VA responds that Madison already took triage line calls for the second and third shift, holidays and weekends, and that there is always a nurse on the line or available.
Support for Innovation reporting is provided by Dr. Lawrence and Mrs. Hannah Goodman.
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