Many VA hospitals are affiliated with medical schools. Indeed, VA hospitals provide training opportunities every year for thousands of doctors who have just finished medical school. Senior doctors at VA hospitals often perform valuable research. However, as should be the case in any healthcare facility, taking care of patients must always come first. Doing what is right for the patient musttake precedence over training or research – or anything else for that matter.
Unfortunately, it appears that the best interests of the patient are not always the priority. This disturbing story out of the San Diego VA is a disturbing example, https://inewsource.org/2019/02/01/congressional-hearing-san-diego-veterans-2019/. Liver biopsies are not risk-free procedures, yet it appears that veterans were subjected to these procedures for no valid medical reason. While this doctor’s research efforts might (or might not) advance medical knowledge, one must never experiment on patients without their truly informed consent. Sadly, this appears to be exactly what was happening at the San Diego VA. It was very wrong, unconscionable.
One of the “dirty secrets” of medical training and research is that the standards at VA hospitals are often different than those at the connected teaching hospital, which is often literally next door. When they cross the street to the VA hospital, residents and fellows – doctors in training – have a much freer hand. The supervising doctors often never appear in the medical record. We see this repeatedly. It’s not surprising that the same sort of attitude might be seen about medical research. A doctor would not even consider doing unnecessary dangerous procedures at the teaching hospital to advance his or her research. But across the street at the VA – well, that’s a different kettle of fish.
Both regarding the training of doctors and medical research, what bothers me is the basic contempt for VA patients. Contempt is a harsh word and I don’t use it lightly. When you treat one group of individuals (veterans) markedly more unfavorably than others (private patients),it’s hard to call it anything else.
VA medical facilities exist to treat our veterans. They deserve the same respect and consideration they would get at a non-VA hospital. It’s really that simple.