On a scale of 1 to America, I'm as free as a bald-headed eagle with a 10-foot wingspan.
I see Veteran's Day as a one-day break from my usual routine of criticizing everything that's happening in the U.S. Government. I take this day to think positively about our country and thank the efforts of our veterans and active duty members' personal sacrifices to keep America and other parts of the world free.
I'm also going to take this opportunity to reflect on my one-month Internal Medicine rotation at a Veterans Affairs hospital. Despite the criticism the VA receives for inefficiency and specific instances of monkey business, I observed some really great things happening at the VA Hospital in Washington DC.
CPRS
Stands for Computerized Patient Record System. Funded by taxpayer dollars, this electronic health record was launched in 1997 and is used by every VA hospital, clinic and nursing home (over 1,000 facilities.) Everything's on it- doctor's notes, lab results, imaging studies, medication orders- all the tools any provider needs. This is the best EHR system I've used so far on my clinical rotations, especially because it only takes a few days for a user to get a handle on it. Since doctors spend so much time behind the computer writing notes, reviewing records and updating medication orders, this EHR system is a salient positive aspect of the VA system.
Providers
The attending physicians at the VA are spectacular. They educate students, advocate for their patients, and practice medicine extremely effectively. Dr. Katherine Chretien, the GW Internal Medicine clerkship director, wrote an Op-Ed describing VA docs' motivation for working at the VA. She sums it up elegantly here: "Working at the Department of Veterans Affairs as a physician is like betting on the underdog team. Sometimes it seems the odds are stacked against you, but you still believe in what the team stands for. And you know that each win is a big one."
Another thing that happens effectively at the VA is interdisciplinary rounds, which is a daily meeting between case managers, social workers and doctors. The interdisciplinary team runs the list on the patient census to ensure that their patients have proper follow-up and placement in care facilities upon discharge. The social workers face many barriers with limited spots in nursing home/rehabilitation facilities, but their dedication to making things happen for the veterans is inspiring. The social workers and case managers are the people that are responsible for making sure that people stay out of the hospital as soon as they enter, and they do a good job at it.
Patients
The veterans we serve are what make the VA a special place. I was surprised by the diversity of the veteran population with white, black, Asian and Hispanic men and women comprising the veteran population. Despite the diversity, there's a distinct commonality among the patients, which was the degree of gratitude that each veteran expressed.
There is a tangible mutual respect between the healthcare provider and the veteran. As Dr. Chretien explains, providers feel a sense of fulfillment for serving patients that made a selfless sacrifice for our country. The veterans never failed to let us know that they were extremely grateful for their care and were extremely patient and pleasant people to work for. And they can tell a damn good story.
Wrap-up
Listening to a patient's story is the most important lesson I learned at the VA. I wouldn't have learned this if it weren't for a humanities project that medical students rotating at the VA were required to complete. Taking the time to hear about what patients think defines them eventually has an unmeasurable benefit in terms of rapport and compliance. I'd love to share with you a story that one of my patient's told me, but I'm waiting to hear back from her to obtain permission.
I miss working with vets on a daily basis, but I'm confident that I'll be back at the VA again soon. I truly believe that the quality of healthcare delivery at the DC VA is at the level of comprehensive care that every veteran deserves. I'm optimistic that our new Secretary of the VA will be able to standardize this across the country.
Here's some photos of me being an American.
I see Veteran's Day as a one-day break from my usual routine of criticizing everything that's happening in the U.S. Government. I take this day to think positively about our country and thank the efforts of our veterans and active duty members' personal sacrifices to keep America and other parts of the world free.
I'm also going to take this opportunity to reflect on my one-month Internal Medicine rotation at a Veterans Affairs hospital. Despite the criticism the VA receives for inefficiency and specific instances of monkey business, I observed some really great things happening at the VA Hospital in Washington DC.
CPRS
Stands for Computerized Patient Record System. Funded by taxpayer dollars, this electronic health record was launched in 1997 and is used by every VA hospital, clinic and nursing home (over 1,000 facilities.) Everything's on it- doctor's notes, lab results, imaging studies, medication orders- all the tools any provider needs. This is the best EHR system I've used so far on my clinical rotations, especially because it only takes a few days for a user to get a handle on it. Since doctors spend so much time behind the computer writing notes, reviewing records and updating medication orders, this EHR system is a salient positive aspect of the VA system.
Providers
The attending physicians at the VA are spectacular. They educate students, advocate for their patients, and practice medicine extremely effectively. Dr. Katherine Chretien, the GW Internal Medicine clerkship director, wrote an Op-Ed describing VA docs' motivation for working at the VA. She sums it up elegantly here: "Working at the Department of Veterans Affairs as a physician is like betting on the underdog team. Sometimes it seems the odds are stacked against you, but you still believe in what the team stands for. And you know that each win is a big one."
Another thing that happens effectively at the VA is interdisciplinary rounds, which is a daily meeting between case managers, social workers and doctors. The interdisciplinary team runs the list on the patient census to ensure that their patients have proper follow-up and placement in care facilities upon discharge. The social workers face many barriers with limited spots in nursing home/rehabilitation facilities, but their dedication to making things happen for the veterans is inspiring. The social workers and case managers are the people that are responsible for making sure that people stay out of the hospital as soon as they enter, and they do a good job at it.
Patients
The veterans we serve are what make the VA a special place. I was surprised by the diversity of the veteran population with white, black, Asian and Hispanic men and women comprising the veteran population. Despite the diversity, there's a distinct commonality among the patients, which was the degree of gratitude that each veteran expressed.
There is a tangible mutual respect between the healthcare provider and the veteran. As Dr. Chretien explains, providers feel a sense of fulfillment for serving patients that made a selfless sacrifice for our country. The veterans never failed to let us know that they were extremely grateful for their care and were extremely patient and pleasant people to work for. And they can tell a damn good story.
Wrap-up
Listening to a patient's story is the most important lesson I learned at the VA. I wouldn't have learned this if it weren't for a humanities project that medical students rotating at the VA were required to complete. Taking the time to hear about what patients think defines them eventually has an unmeasurable benefit in terms of rapport and compliance. I'd love to share with you a story that one of my patient's told me, but I'm waiting to hear back from her to obtain permission.
I miss working with vets on a daily basis, but I'm confident that I'll be back at the VA again soon. I truly believe that the quality of healthcare delivery at the DC VA is at the level of comprehensive care that every veteran deserves. I'm optimistic that our new Secretary of the VA will be able to standardize this across the country.
Here's some photos of me being an American.