WASHINGTON — It has become a common complaint among OEF/OIF amputees moving from active-duty to veteran status: VA does not have the same level of technology or expertise as DoD facilities when it comes to prosthetic care. Veterans have told stories in congressional hearings of walking into VA prosthetic clinics with the latest generation of prosthetic fitted for them at Walter Reed and being told by VA staff that they had never seen that technology before.
The perception that VA is a step behind DoD in prosthetics expertise may be false, however, as both departments work closely together and with private industry to develop the latest prosthetics technology and train the next generation of prosthetists. The problem might only be an issue of timing.
The Training Gap
“VA is perceived as not providing the same thing as DoD, when in actuality we do,” explains Joe Miller, MD, VA’s national director of orthotic and prosthetic services. “We have access to all of the same technology, and we work very closely ensuring that both sets of clinicians are trained as much as possible.”
The disparity appears not in what training VA clinicians have, but in the speed they are trained. “DoD only has three sites and is typically able to get their staff trained faster,” Miller says. “VA has 78 [prosthetics] locations across the country. We have a much larger staff to train and work with.”
However, VA is attempting to get its staff trained as quickly as possible and on the latest generation of prosthetic technology. Whereas past models of training focused solely on the prosthetists, VA now includes physical therapists and the clinicians involved in prescribing the prosthetic. Clinicians train together so they all have a clear understanding of the product and its capabilities.
Sometimes VA is limited by the manufacturer’s capability to train; frequently a company only has one or two staff members that are qualified to train VA staff. Cost also is a limitation. Some training can be done online, and some can only be done locally, where the clinicians are based. While manufacturer’s staff sometimes can be coaxed into attending on-site group training sessions, frequently the VA staff must bear the expense of travel.
Currently, there is adequate funding for training VA staff, but fiscal realities suggest that level of funding will not last forever. “We’re hoping training dollars will continue,” Miller says. “Right now we’re very fortunate and trying to train as many as we can.”