“Our veterans have stepped up and served our country, so physicians want to be able to step in and serve them.”
ment, and nobody asks questions. But those who serve our country have to go through so many loopholes. We treat our veterans like they are at the bottom of the list, and it’s not right,” she said. “I want them to know they can have a physician in their own location and get treated quickly and be on their way to getting better.” A retired U.S. Army veteran, San An- tonio pulmonologist John R. Holcomb, MD, had no second thoughts about sign- ing up, even though he anticipates the same kind of administrative difficulties and payment uncertainties he experi- ences with the Medicaid program. He says VA is the safety net for many
For information about the audit, visit
va.gov/health/access-audit.asp. In Texas — which at 1.7 million has the second-largest veteran population in the country behind California — wait times ranged from 37 days in San Anto- nio to 85 days in the Rio Grande Valley for new patient primary care appoint- ments and up to 145 days for specialty care. (See “Average Texas VA Appoint- ment Wait Times,” opposite page.) VA has turned to private-sector phy- sicians in the past, mostly for specialty care. While ready and willing to help, however, physicians say the current system inadvertently creates more frag- mented care for veterans. They ask that the nation’s leaders clear existing bu-
reaucratic landmines — slow payment and lack of interaction between VA and the private sector, for instance — so they can get veterans the timely care they need.
Baytown general and colorectal sur-
geon Monira Hamid-Kundi, MD, was among the first physicians to sign up on TMA’s registry of private doctors willing to care for veterans. (See “Enlist Now!” below.) She often sees veterans in the emergency department “because they have nowhere else to go.” But VA rules typically require her to transfer patients to VA clinics or hospitals, which, despite their condition, takes days. “I see people sitting in [Washington] D.C. and they can go anywhere for treat-
veterans in the same way Medicaid is the safety net for a similar population without military service. The veterans on the long waiting lists typically have a lot of unmet needs, no pension because they weren’t in military service long enough to retire, no secondary insurance through a steady job, and nowhere else to turn for care. “We are going to sign up. That’s what
we do. We sign up for Medicaid, and that has similar problems. And if they [VA] want us to treat veterans, we will sign up for that, as well,” Dr. Holcomb said.
Calling community physicians Amid the crisis, organized medicine strongly called on leaders at VA and in Washington, D.C., to pave a smoother path for veterans to more swiftly access outside care and for physicians to eas- ily provide it. At press time in late July, Congress answered that call with a $17 billion fix that awaited President Barack Obama’s expected signature.
“Our veterans have stepped up and Enlist now!
Amid the ongoing crisis, more than 350 member physicians have signed up for TMA’s registry of private-sector doctors will- ing to see veteran patients. You can join, too, by visiting www
.texmed.org/profile/veteran. Access to the registry is limited to TMA members.
34 TEXAS MEDICINE September 2014
served our country, so physicians want to be able to step in and serve them,” TMA President Austin King, MD, wrote to the president in June and again in July. “This is an access-to-health care crisis. … Any further delay is unconscio- nable.”
TMA helped lead the charge for feder- al action at the American Medical Asso- ciation’s Annual Meeting in June. AMA’s House of Delegates voted overwhelming- ly to ask that President Obama “take im- mediate action to provide timely access
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