Seeing our VA System from the inside

17 years ago

This past week I led a Congressional delegation to visit the Minneapolis Polytrauma Rehabilitation Center. The mission of Department of Veterans’ Affairs’ Polytrauma System of Care is to provide high quality medical care, rehabilitation, and support services for veterans and active duty service members who have sustained multiple injuries in service to our country.     Advances in battlefield medicine are saving lives that would have been lost in previous wars, but the injuries that our service members are sustaining are often more complex and require a lifetime of rehabilitation. The healing for these wounded heroes can be long and difficult, starting in the Department of Defense (DOD) medical system and then moving to the Department of Veterans’ Affairs (VA) or the private sector.
I have visited Walter Reed on many occasions to see the DOD side of this process. I went to Minneapolis to personally witness a more complete picture of VA’s role in polytrauma rehabilitation.
Returning service members with injuries to more than one physical area or organ system are able to utilize the Polytrauma System for care. Polytrauma can include combinations of traumatic brain injury, hearing loss, amputations, fractures, burns, and visual impairment. These are clearly difficult injuries that need substantial medical intervention and often require intensive work with specialists.
The system was designed to balance the need for highly specialized care with the need for service members to have local access to what can sometimes be lifelong rehabilitative care. So the system consists of four major regional Polytrauma Rehabilitation Centers, but also 21 Polytrauma Rehabilitation Network Sites and 76 Polytrauma Support Clinic Teams located at medical centers throughout the country.
During my visit to the Minneapolis Center, we visited a polytrauma unit, the rehabilitation gym, the prosthetics clinic, a transitional unit, and the Fisher House – a 10-room building where families of patients can stay. While there, we visited with one soldier who had suffered severe head trauma. He had spent ten months at the facility and was being released on the day of our visit. He and his family were very pleased with the care that he received: it was clear that the professionals at the center took their responsibilities extremely seriously and had provided excellent service.
We also had the opportunity to sit in on an amputee therapy session. One doctor offered us his perspective on improvements that he thought could be made to enhance rehabilitation for amputee patients: he told us that while VA does a lot of prosthetic research, more work should be done specifically on how prosthetics are connected to the patients. This will certainly be one area that I will be looking into further in my role as Chairman of the Subcommittee on Health for the Veterans Committee.
It was also clear from my visit that the VA polytrauma system is doing a good overall job of addressing the needs of our soldiers and veterans, but that gaps and challenges still remain.
One issue is that the goal of the Department of Defense (DOD) medical system is to stabilize a patient and determine whether he or she has the potential to return to service. By contrast, the VA health system focuses on longer term rehabilitation. So fundamentally, the two systems work on different schedules with different goals.
The problem for wounded warriors going through these systems is that it is often unclear when they should receive certain types of care, when they should begin rehabilitation, and which system should give care. This is caused by the complexity of the wounds of this war. For example, the stabilization and rehabilitation timeline for an injured or lost limb is not the same as the stabilization and rehabilitation period for traumatic brain injury.
Because VA and DOD have different expertise and injuries are so complex, it is critical that we maximize our resources and give our soldiers and veterans the best care available.
We must continue to improve upon the transition between the DOD and the VA so that our nation’s heroes do not suffer because of bureaucratic barriers.
I will continue to work with the VA and my colleagues on the Veterans Affairs Committee to improve our system and ensure that our returning service members can live their lives to the fullest.