VApicFrom The American Prospect new blog post

Despite Assurances, VA Secretary Pushes Toward Privatization

Secretary of the Department of Veterans’ Affairs, David Shulkin, has pledged not to privatize the Veterans Health Administration (VHA). He understands, he says, that the VHA’s ability to provide care that, as studies document, is superior to those in the private sector is because veterans are treated in an integrated system that meets all their health needs. In testimony to the House Committee on Appropriations Veterans Oversight Hearing on May 3, Shulkin argued that unlike the private sector, the VHA “defines health far more broadly as physical, psychological, social, and economic.” Such a “unique national resource … often cannot be found in the private sector.”

In spite of this some of Secretary Shulkin’s recent decisions are very troubling. In March, Shulkin announced that the VHA would begin providing emergency mental health services to veterans previously ineligible for them. While that coverage is long overdue, the VA’s budget will likely push some already enrolled patients out of the VHA system and onto private providers. At the same time, Shulkin has proposed outsourcing optometry and audiology care to the private sector. In both cases, the changes threaten to jeopardize the kind of integrated services the VHA provides.  Read More

Forum to Save the VA with Nancy Pelosi

Nancy Pelosi and Suzanne Gordon V event 041317

 

Yesterday, I spoke about my new book at a wonderful forum in San Francisco on “The Threats to Veterans Healthcare” with Congressional leader Nancy Pelosi.  The session was sponsored by the Veterans Healthcare Action Campaign.  Other speakers included Michael Blecker of Swords to Plowshares, veteran Edgar Escobar, and Major General Mike Myatt. Over two hundred people came to learn more about how they can participate in the fight against VHA privatization–as patients, VHA staff members, and as union activists.  In fact, so many came that the room was over-flowing.  In the comment period, veterans spoke out from the floor with amazing stories about the importance of VHA care.  To learn more about these issues, please order my new book The Battle for Veterans’ Healthcare and check out the website of Fighting for Veterans’ Healthcare, where you will find an excellent analysis of how Choice may dismantle the VA. For U.S. Representative Pelosi’s remarks and more on our panel, click here and to see the video of the event, here

SG at Podium

Thank You: The Magic Word in Healthcare Too!

New blog post in the BMJ

Suzanne Gordon: The power of thank you

suzanne_gordonI recently saw the power of thank you highlighted on two different occasions in healthcare settings.

On the first, I was following a team of physicians who were conducting patient rounds on the acute care of the elderly unit at the San Francisco VA Health Care System (SFVAHCS), Fort Miley. The group moving from room to room included medical students and residents, as well as a pharmacist and a social worker. The nurse assigned to care for the particular patient the team visited did not travel with the group through the wards. Instead, as the team fanned out around a patient’s bed, the nurse assigned to that patient—who was almost always in some other patient’s room—would interrupt his or her work and rush in to join the rounds. Whenever a nurse joined the group, the attending physician, Kathryn Eubank, briefly stopped the discussion and thanked the nurse for coming to join them.

Eubank also made sure to ask the nurse if she or he had any concerns or input to share with the team. When the nurse expressed a concern or shared important information, the attending physician thanked the nurse for this input. And when the group was finished, the attending physician again thanked the nurse for joining the rounds.  READ MORE

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Must Read!! Doctors at War

80140100810940MAlmost two years ago, Mark De Rond, an ethnographer at Cambridge University in England, sent a manuscript to the Culture and Politics of Health Care Work series at Cornell University Press. As co-editor of the series, I reviewed the manuscript — Doctors at War — which has just been published . It was done in the form of a of field notes describing De Rond’s months embedding with surgeons in a field hospital in Afghanistan during what is euphemistically dubbed – in the US at least – Operation Enduring Freedom. In other words the US war in Afghanistan, which is being waged not only by the US military but also by allies from other countries like the British, who, with the Americans ran Camp Bastion. The British Ministry of Defense (MOD) had asked De Rond to go to Afghanistan to study teamwork among British and American surgeons in the field hospital at Camp Bastion. As he describes it in the book, Camp Bastion was “the most successful trauma unit anywhere in the world.”

From the moment I began reading, I knew how important this book was and the contribution it could make not only to the healthcare literature but also to the literature of war. The MOD agreed that De Rond had a great deal to contribute to our understanding of how people work together under stress and encouraged him to not only write a report but to turn his work into a book. Then when the MOD saw the book, the tune changed and the MOD tried to block its publication. De Rond was forced to get a legal opinion in order to proceed with publication.

When you read this book – and please, if you have any interest in the folly of war and its human cost, you must read this book – you will understand why we loved it and the MOD hated it.

In it De Rond follows a British surgeon whom he calls Jesus and his colleagues in their daily round of trauma surgery. As he reports, between 2006 and July 2013, “just short of 20,00 casualties to the field hospital.” These not only included military personnel but locals who were injured. These physicians had to treat enemy combatants as well as civilians, many of them children – collateral damage of the war on terror.

Which has produced its own terror. Day after day, they wade elbows deep into the blood and guts, veins, and limbs, of what this elective war has wrought. We see not only the amazing feats of modern trauma surgery – which thanks to modern technology and the skill of these surgeons, nurses, and other battlefield hospital personnel, save people who would have died immediately in other wars. We also see the horrific wounds and trauma with which they will have to cope for the rest of their lives. After only a short stay in Afghanistan, De Rond himself has to deal with the trauma of what he witnessed.

I urge you all to read this important book, which as Chris Hedges says in his foreword to Doctors at War, “shines a light on a reality we are not supposed to see. It is a reality, especially in an age of endless techno war, we must confront if we are to recover the human.”