Regional
(2010-03-12)
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"Women are sometimes greeted by nurses when it's time for their appointment [they're] called 'mister,'" says Erin Mulhall, deputy policy director for research at the New York-based Iraq and Afghanistan Veterans of America advocacy group. "The culture at the VA really needs to change when it comes to caring for female veterans, getting out of the mindset that it's just male patients that they're going to be seeing."
In Colorado, the state's VA health care system is putting its quality of coverage for female veterans under the microscope. And no detail is too big or too small.
Unanticipated Challenges
Wendy Thayer is 29 years old. She served in the Army and the Air Force National Guard and Reserves for a decade. And 6 years ago when she started going to the Grand Junction VA Medical Center for routine check ups, her petite frame and brown ponytail didn't fit the mold of a typical patient.
"I know when I first went there, there was more male dominance in the waiting area," says Thayer.
The VA medical system has traditionally been geared toward treating an aging male population. But that model is changing in Colorado. In 2001, just over 2,700 women were enrolled in the VA's Eastern Colorado Health Care system, which includes eight community clinics, a telehealth clinic and the Denver Medical Center, or hospital. By 2009 that figure jumped to more than 5,500.
Mary McCarthy is a nurse practitioner at Denver's VA Hospital. She's also a so-called "champion" at the facility who has specific training in women's health.
"They might be single, they might be single moms, they might be married with young children. So their needs are more and more around the contraceptive needs and the OB care," she says.
Although all women have access to champions like Mary McCarthy, not all clinics have them on staff. It's just one of the goals that this system is working on to ensure comprehensive care for its female patients.
"I've always loved women's health care, so I tend to be sort of nurturing and motherly toward my patients. But they love that," she says.
Nationally, the growing female veteran population has challenged the VA's health system in many ways--some of which have been unanticipated. A number of systems are grappling with fragmented care, which means women could spend hours driving to separate clinics for different medical appointments. Patient privacy has also been an issue. Until last year, women at Denver's Veterans Affairs Medical Center didn't have access to bathrooms that were close to their exam rooms, and some of the gynecological exam tables in rooms faced the door.
McCarthy says that's no longer the case.
"So we have a doorway, a door that's shut with locks if they want it locked," she says.
A New Women's Clinic
Right now some of the largest changes in Colorado's VA system are not that visible. Linda Rawers, Women's Program Manager for the VA's Eastern Colorado Health Care system says medical staff receive routine trainings so they can provide "up-to-the-minute" services for younger female patients. And all employees who greet people are trained to not make assumptions about who the patient is when a couple walks through the door.
"It may be the women that served, and it's really important to acknowledge that and not assume that it's the man checking in as a veteran," she says.
But the single largest improvement for women veterans in Colorado won't come for another four years. That's when a new $800 million dollar hospital will open its doors in Denver with a dedicated space for a women's clinic.
Rawers says the facility will be a welcome replacement to the current 60-year-old medical center, which as is bursting at the seams.
"One of the neat things is that our new place will have a separate and private check-in," she says. "It's going to be designed so different, so it will be a little bit quieter and a little bit more private."
And when it does open, Denver could still be among a minority of VA facilities to have dedicated space for a women's clinic. Right now there's an estimated 14 percent nationwide according to the Iraq and Afghanistan Veterans of America. Meanwhile, the VA expects the number of female veterans enrolled in the system to double in the next five years. As a result it's created a strategic group to guide veteran's health centers on women's health needs.
Funding the Future
The boom in female patients is something that Wendy Thayer now sees first hand. She's still a patient. But since her first appointment six years ago in western Colorado, she's moved to Denver to work as a check-in clerk at the VA Medical Center.
"Both Denver and Grand Junction have grown quite a bit in their women health care," she says.
And in the near term, it looks like federal funding could also increase. If President Obama's proposed budget for next year is approved, funding for women veteran's health care could grow by as much as 10 percent nationwide. © Copyright 2012, KUNC
