This was written by Robert A. McDonald, U.S. secretary of the Department of Veterans Affairs; Patrick Gallagher, chancellor of the University of Pittsburgh; and Jeffrey Romoff, president and CEO of UPMC.
The Department of Veterans Affairs is indispensable to the future health care needs of America. Those who would tear down the VA do a terrible disservice to veterans, to future health care providers and to our country’s citizens. Nowhere would the impact be felt more keenly than in Western Pennsylvania, which is home to some 500,000 veterans and their dependents, and is the birthplace of the Veterans of Foreign Wars.
As the largest fully-integrated health care system in the nation, the VA stands upon three pillars that enable holistic health care: education, essential to build and maintain the proficiency of care; research, leading to advances in diagnosis, treatment and rehabilitation; and delivery of clinical care.
In 1946, General Omar Bradley, secretary of what was then the Veterans Administration, signed a landmark agreement with the nation’s academic medical centers.
The VA benefited by securing first-rate clinical care for veterans, and affiliated medical schools gained a method of training health care providers — for the entire nation — and a means to engage in groundbreaking research.
Dually appointed university/VA physicians have since become the backbone of tertiary care in the VA’s clinical, education and research missions.
The VA is now affiliated with over 1,800 health professional schools, including many of the best medical schools in the nation. As we approach the 70th anniversary of Gen. Bradley’s historic agreement, we must recommit ourselves to ensuring that VA-affiliate relationships remain strong to meet 21st-century health care challenges, even in the face of regulatory and legal barriers that have threatened the strength of these essential partnerships in recent years.
The longstanding academic affiliation between our VA Pittsburgh Healthcare System with the University of Pittsburgh and UPMC highlights what can be achieved through these collaborations.
More than 100 University of Pittsburgh and UPMC/VAPHS joint faculty are principal investigators in 350-plus essential and groundbreaking research projects that will benefit future generations of patients, and contribute almost $31 million to the local economy. These include studies related to traumatic brain injury, post-traumatic stress, sleep disorders, cancer, regenerative medicine, health disparities and women’s health, among others.
Almost 1,000 interns, residents, nursing students and advanced fellowship trainees from Pitt and UPMC rotate through the VA hospital and clinics, assisting in the care of about 70,000 unique veteran patients annually.
In fact, the VA trains more health care professionals nationwide than any other system — 120,000 a year, including 62,000 medical students and residents, 23,000 nursing students and 33,000 students in other health fields. An estimated 70 percent of all U.S. doctors have trained in a VA facility; it’s the nation’s second largest financial contributor to graduate medical education.
The VA is also increasing veterans’ access to excellent clinical care, completing seven million more appointments this year than last — 2.5 million at the VA, 4.5 million in the community.
Since April 2014, net staffing has risen by more than 12,000, including more than 1,000 new physicians and more than 3,700 medical center staff.
Some of that success is due to programs like the call center established by UPMC and VAPHS in 2014 to refer veterans to UPMC clinics for care. In just a year, nearly 2,000 veterans received UPMC appointments, with wait times averaging less than a week.
Advances in health care that were developed through VA research initiatives include pioneering modern electronic medical records; developing the implantable cardiac pacemaker; conducting the first successful liver transplants (with Dr. Thomas Starzl, then at the University of Colorado); creating the nicotine patch to help smokers quit; crafting artificial limbs that move naturally when stimulated by electrical brain impulses; and identifying genetic risk factors for schizophrenia and Alzheimer’s disease, among many other accomplishments made possible by combining VA commitment and resources with the expertise and creativity of academic experts.
A number of these accomplishments reflect collaborations between VA facilities in Oakland and Pitt, such as the Human Engineering Resource Laboratories, a Pitt/VA venture that applies advanced engineering to mobility issues for people with disabilities, and the VA-funded Geriatric Research Education and Clinical Center at VAPHS, which focuses on biomedical, clinical and health services research regarding care of the elderly.
These efforts are critically important for the future of American health care, which is facing an aging population and a corresponding increase in health care needs, as well as a reduction in the medical workforce that could lead to a shortage of 46,000 to 90,000 physicians in 10 years.
Those who fully understand the value of VA affiliations to research, education and training, and clinical care also understand something else: It is not only veterans, but all Americans who benefit from the VA.