State of Women Veterans: VA women’s health care more proactive in some areas of care than private sector

When I left active duty in 2005 and walked into a VA Medical Center for the first time, I wasn’t sure I belonged. I saw few other women, and it didn’t feel terribly welcoming. For the next decade or so, I stuck with private sector providers covered by insurance. Last year, I came back into the VA system – and am incredibly glad.

In the private sector, my primary care physician, gynecologist, and psychologist couldn’t see the same electronic medical record, so it was up to me to remember and communicate details about the care I was getting in other settings. Same with information about laboratory test results and medications: my records were scattered in multiple systems that weren’t interoperable. Even if other providers or services were in the same building, they didn’t always take my insurance, so I always had to worry whether procedures or tests would actually be covered or if I’d be left holding the bill.

Within VA, I actually get comprehensive and integrated care from a team. All my providers have access to my records, and they can easily collaborate if needed. I’m also confident that I’ll be getting high-quality, culturally competent, evidence-based care, even on gender-specific measures: in fiscal year 2014, 88 percent of VA patients get cervical cancer screenings versus 74-76 percent of patients in the private sector and only 60 percent of Medicaid patients. When it comes to breast cancer screening, 86 percent of VA patients get mammograms when recommended compared to 69-74 percent in the private sector.

VA has engaged in culture change campaigns to ensure all Veterans are treated with dignity and respect.

The number of women Veterans using VHA health care has more than doubled since 2000 to more than 500,000, and VA has been working diligently to better meet our needs. Comprehensive health services available to women Veterans today include primary, specialty, hospice/palliative, mental health, infertility, gynecology, and maternity care services, including seven days of newborn care. VA has trained over 3,000 designated women’s health providers through national Women’s Health Mini-Residency programs.

VA has also done research on the barriers to care that we face so we can work to overcome them. As a woman Veteran patient and as a VA employee, I know we have further improvements to make – to give one small example, it annoys me when clerks checking me in call for “Mr. Williams” or assume I’m there as a spouse and not a patient. Know that we have heard these concerns and are engaged in culture change campaigns to ensure all Veterans are treated with dignity and respect.

VA has also continued to roll out additional programs to ensure women Veterans get the best care. Here are two examples:

Maternity care coordination

In response to the increased number of women Veterans of reproductive age receiving care at the VA, a new role was created in 2012, the maternity care coordinator. VA currently has 129 maternity care coordinators (MCCs) who serve pregnant women Veterans in 141 health care systems and medical facilities nationwide by developing relationships with a variety of VA providers and offices as well as non-VA community providers and following pregnant women Veterans throughout pregnancy and into postpartum.

One 100 percent service connected female Veteran wrote to her local VA about her coordinator:

“I don’t know what I would have done without her by my side during my last pregnancy, but I can say it was miserable before she came along. My MCC is such an amazing person with so much dedication for what she does. … I am truly grateful for her position in the VA. She is the perfect match for the job. She has been such a blessing and made my second pregnancy much easier to handle with confidence from her help. I truly appreciate everything she has done for me and I am so thankful for her liaison services were put into this position. My MCC is a true asset to Women’s Health and the example for what a patient liaison service is all about.”

Pain management

The Phoenix VA has recently started an eight-week mindfulness-based group training program for pain management that is specifically tailored to the needs of women Veterans. Participants receive a 90-minute orientation that covers the differences between acute pain and chronic pain, validates the many adverse impacts of chronic pain on women’s lives, and provides education on mindfulness as an approach for enhancing function and quality of life despite pain. The “Breathe, It’ll Be OK” program is based on years of clinical research and practice regarding chronic pain, mindfulness-based approaches for chronic pain, and women’s health. It includes a focus on social relationships and unit support, as well as stretching, movement, self-pacing, control, and acceptance. A focus on training draws on Veterans’ military background to underscore the importance of developing a regular practice of mindfulness.

One participant said:

“I feel like I have a new lease on life. I’m 69 years old and have been living with chronic pain for over 40 years, as well as a history of trauma/MST. Since going to acupuncture at your clinic and being a part of this group and experiencing fellowship here, I’m looking at my upcoming birthday and thinking I have a new chapter to write.”

Need help getting access to VA health care? Contact the Women Veterans Call Center at 855-VA-WOMEN – it was created to provide women Veterans access to services for which they may be eligible and is staffed exclusively by women.

This is the seventh blog in an 11-week series on the State of Women Veterans. Visit the campaign page to read other entries.