VA has had more than a half-million claims filed under the new PACT Act legislation, which expands care and benefits for former servicemembers exposed to burn pits and other toxic substances during their service.
News
Military Surgeons Deployed to Combat Environments Face Moral Injury, Distress
A new VA study may be the first to examine moral injury and distress at the intersection of these populations—that is, military healthcare professionals, specifically surgeons
Current Issue
Deployed Servicemembers Had Lower Cancer Risks Than Those Who Weren’t
Despite concerns about exposure to hazardous material, military personnel who deployed to Southwest Asia actually had a lower risk of dying from cancer than their colleagues who were never deployed, according to a new study.
VA’s Clinical Quality, Safety as Good or Better Than at Outside Care
A new review has determined that care provided in the VA healthcare system is consistently as good as or better than non-VA care in terms of clinical quality and safety.
COVID-19
Mental Health of Veterans Before, During and After COVID-19 Pandemic
With work disruptions, social isolation and economic concerns, the pandemic understandably caused significant distress for many veterans.
Veterans Surviving COVID-19 at Much Higher Risk of Gastrointestinal Disorders
Survivors of COVID-19 are at heightened risk of developing gastrointestinal (GI) disorders within a year after infection compared with those who were never infected, according to a new study of veterans being treated by the VHA.
HCC Surveillance Rebounded at VA, Still Low
How did the first two years of the COVID-19 pandemic affect hepatocellular carcinoma (HCC) surveillance and factors associated with completion at the VA?
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
Savasana is my favorite
When this editorial charms (or lands with a thud) on the masthead page of the May 2023 edition of US Medicine, Pam and I will be back on the road again. These past few months hanging out in Virginia during Pam’s recovery have been challenging for both of us. We are not used to being this static, physically or existentially. I have been writing extensively during this period, which necessitates a protracted amount of time on my bum (I do my best work with pressure on my brain). This has caused my long-term affair with lower back pain to flare up with a vengeance. I am certainly not alone in this painful condition. Researchers suggest that 8 in 10 Americans will experience back pain at some point in their lives. When I retired from the Army, I noted back pain as an issue during my exit physical review. In response, every corner of my body seemed to be scanned and/or X-rayed. The Army concluded I had the well-used spine of a fifty-something soldier. In short, like so many other humans, I have classic musculoskeletal lower back pain.
VA Study Shows Low Use of Primary Care for Reproductive Health Services
The integration of reproductive health services into primary care practices is increasingly recognized as critical to the advancement of patient-centered care and improving reproductive outcomes.
Quality Care Reduces Breast Cancer Survival Rate Disparities Based on Race
Though non-Hispanic Black women are more likely to have tumors at a higher grade and later stage and be diagnosed with triple-negative breast cancer
Frailty in Older Veterans Associated With Greater Suicide Attempt Risk
Veterans who are 65 and older and have symptoms of frailty are at increased risk of attempting suicide, and those with lower levels of frailty were found to have greater risk of suicide death, according to a new study.
Decline in Cerebral Cortical Thickness Linked to PD Cognitive Decline
What effect does reduced cerebral cortical thickness have in Parkinson’s disease (PD)?
Fewer Parkinson’s Motor Issues 11 Years After Deep Brain Stimulation
More than a decade after deep brain stimulation (DBS), early-stage Parkinson’s disease (PD) patients appeared to have fewer motor complications than those treated only with medications, according to a new study.
Cognitive Impairment Can Affect Parkinson’s Gait Rehab
What is the effect of baseline cognition on gait outcomes after a treadmill training program for Parkinson’s disease (PD) patients?
Cardiorespiratory Fitness Linked to Lower Abnormal Glucose Risk
Cardiorespiratory fitness (CRF) can be a good predictor of chronic disease. The problem is the difficulty and impracticability of routinely measuring that in primary care settings.
Cardiac Autonomic Neuropathy Linked to Stroke in T2D
What is the association between cardiac autonomic neuropathy (CAN) with incident stroke among diabetes mellitus patients?
Time in Range Beneficial in Patients With Individualized A1c
Individualizing hemoglobin A1c treatment goals in older adults is important to balance risks in benefits, according to a new study.
Elevated Preoperative Glucose Level Linked to Adverse Effects in Hernia Repair
An estimated 1 in 10 Americans and 1 in 4 veterans has diabetes, not only putting them at increased risk for problems such as heart and kidney disease, but also making them more prone to complications such as infection and bleeding following surgery.
VA Stops All EHR Rollouts; Says It Plans a ‘Reset’ of Program
VA has called a halt to all future deployments of its new electronic health record (EHR) system in order to prioritize fixing issues at the five sites where the system is already deployed.
Genetics Play a Role in Severe PTSD in Some Deployed Soldiers
The risk for specific soldiers to have severe post-traumatic stress disorder (PTSD) appears to far predate their deployment. In fact, some military personnel are born with it, according to a new study.
At All Levels, Chief Medical Office Scavella Focused on Best Care for Veterans
For a VA physician, it can be a challenge to figure out the best treatment plan for a patient and implement it, and the victory comes when the veteran’s health and quality of life is improved.
Promotion Delays Affecting Military Readiness But Senator Won’t Budge
Delays in promotions directly impacts military readiness, DoD officials have said. But there isn’t much they can do about it as long as Sen. Tommy Tuberville (R-AL) is blocking the expedited promotion of more than 150 military generals and flag officers
Mental Health of Veterans Before, During and After COVID-19 Pandemic
With work disruptions, social isolation and economic concerns, the pandemic understandably caused significant distress for many veterans.
VA Slowly, Steadily Rolls New Pay, Hiring Authorities Those Could Increase Salaries for Some Staff
While VA is moving quickly to roll out new pay and hiring authorities, the impact might take time to trickle down to VA staff in non-supervisory roles or those whose salaries are not near the top of their profession’s pay cap.
Republicans Seek to Overturn VA Policy to Provide Abortion Services
Republicans in the House and Senate have reintroduced a resolution to reverse VA’s recent policy change that allows for limited abortion counseling and services at its facilities.
Outpatient Prolonged Exposure Therapy Is Effective for Combat-Related PTSD
Outpatient prolonged exposure therapy, a type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations, is a fast and effective treatment for combat-related post-traumatic stress disorder (PTSD) in active-duty military and veterans, according to a new study.
VAMCs Struggle to Find Mental Health Staffers for Primary Care
For years, VA has been working to integrate mental healthcare into primary care and requires facilities serving at least 5,000 veterans annually to have a mental health provider available within primary care settings.
Diabetes Drug Metformin Shows Promise for Reducing Incident Osteoarthritis
Metformin is recommended as first-line therapy for Type 2 diabetes at the VA and elsewhere. Among the benefits, according to the VA PBM, is that the drug, which has been in use for decades, is low-cost and safe to initiate in most patients, even those with moderate renal dysfunction.
VA Secretary McDonough: PACT Act Claims Numbers Still Too Small
VA has had more than a half-million claims filed under the new PACT Act legislation, which expands care and benefits for former servicemembers exposed to burn pits and other toxic substances during their service.
Military Surgeons Deployed to Combat Environments Face Moral Injury, Distress
A new VA study may be the first to examine moral injury and distress at the intersection of these populations—that is, military healthcare professionals, specifically surgeons
New Bill to Raise VA Physician Salary Cap Goes to Full Senate
The Senate VA Committee has advanced sweeping bipartisan legislation that would allow VA to raise the salary cap for physicians to above $400,000.
GOP Bill Calls for End of VA’s EHR Modernization Program; Democrats Vehemently Disagree, Calling Effort ‘Unsound’
A group of Republican lawmakers has introduced legislation that would end VA’s Electronic Health Record Modernization Program. The bill is a response to the frequently delayed and problem-ridden rollout of the department’s new EHR, which the bill’s authors say is fundamentally broken and doing more harm than good to veterans.
Factors Making PTSD More Likely After TBI
Why do some military servicemembers with traumatic brain injury (TBI) develop posttraumatic stress disorder (PTSD) symptoms, while others do not?
With More Than 250,000 Alzheimer’s Patients, VA Is a Market for New Drug
Now that the Food and Drug Administration has granted Fast Track approval for the new Alzheimer’s disease medication Leqembi, the issue of who will pay for it looms large.
Group Focuses on Telehealth Fraud at VA, DoD, Other Federal Agencies
While the pandemic has resulted in an explosion in the use of telehealth among federal health agencies, it also has created opportunities for fraud and waste, according to a recent joint report from six Offices of the Inspector General (OIGs).
Hurricanes, Sea Level Rise Endanger Hospitals on Atlantic, Gulf Coasts
In late September, Hurricane Ian, a deadly Category 4 storm, caused widespread damage, flooding, loss of power and evacuations from hospitals and nursing homes across Cuba and the U.S. Southeast, especially Florida and South Carolina.
VA Receives First Doses of Vaccine to Help Combat Monkeypox Outbreak
When the World Health Organization declared monkeypox a public health emergency on July 23, there were more than 4,000 reported cases in the United States. By mid-September, the number of reported U.S. cases had surpassed 24,000.
GAO: Claims Processor Misunderstanding Often Denied Agent Orange Benefits to Which Vietnam Vets Were Entitled
VA claims processors have consistently failed to understand the department’s own regulations when it comes to Vietnam veterans presenting with certain Agent Orange-related conditions, prematurely denying benefits for thousands, according to a Government Accountability Office (GAO) report.
Savasana is my favorite
When this editorial charms (or lands with a thud) on the masthead page of the May 2023 edition of US Medicine, Pam and I will be back on the road again. These past few months hanging out in Virginia during Pam’s recovery have been challenging for both of us. We are not used to being this static, physically or existentially. I have been writing extensively during this period, which necessitates a protracted amount of time on my bum (I do my best work with pressure on my brain). This has caused my long-term affair with lower back pain to flare up with a vengeance. I am certainly not alone in this painful condition. Researchers suggest that 8 in 10 Americans will experience back pain at some point in their lives. When I retired from the Army, I noted back pain as an issue during my exit physical review. In response, every corner of my body seemed to be scanned and/or X-rayed. The Army concluded I had the well-used spine of a fifty-something soldier. In short, like so many other humans, I have classic musculoskeletal lower back pain.
VA Study Shows Low Use of Primary Care for Reproductive Health Services
The integration of reproductive health services into primary care practices is increasingly recognized as critical to the advancement of patient-centered care and improving reproductive outcomes.
Quality Care Reduces Breast Cancer Survival Rate Disparities Based on Race
Though non-Hispanic Black women are more likely to have tumors at a higher grade and later stage and be diagnosed with triple-negative breast cancer
Frailty in Older Veterans Associated With Greater Suicide Attempt Risk
Veterans who are 65 and older and have symptoms of frailty are at increased risk of attempting suicide, and those with lower levels of frailty were found to have greater risk of suicide death, according to a new study.
Decline in Cerebral Cortical Thickness Linked to PD Cognitive Decline
What effect does reduced cerebral cortical thickness have in Parkinson’s disease (PD)?
Fewer Parkinson’s Motor Issues 11 Years After Deep Brain Stimulation
More than a decade after deep brain stimulation (DBS), early-stage Parkinson’s disease (PD) patients appeared to have fewer motor complications than those treated only with medications, according to a new study.
Cognitive Impairment Can Affect Parkinson’s Gait Rehab
What is the effect of baseline cognition on gait outcomes after a treadmill training program for Parkinson’s disease (PD) patients?
Cardiorespiratory Fitness Linked to Lower Abnormal Glucose Risk
Cardiorespiratory fitness (CRF) can be a good predictor of chronic disease. The problem is the difficulty and impracticability of routinely measuring that in primary care settings.
Cardiac Autonomic Neuropathy Linked to Stroke in T2D
What is the association between cardiac autonomic neuropathy (CAN) with incident stroke among diabetes mellitus patients?
Time in Range Beneficial in Patients With Individualized A1c
Individualizing hemoglobin A1c treatment goals in older adults is important to balance risks in benefits, according to a new study.
Elevated Preoperative Glucose Level Linked to Adverse Effects in Hernia Repair
An estimated 1 in 10 Americans and 1 in 4 veterans has diabetes, not only putting them at increased risk for problems such as heart and kidney disease, but also making them more prone to complications such as infection and bleeding following surgery.
VA Stops All EHR Rollouts; Says It Plans a ‘Reset’ of Program
VA has called a halt to all future deployments of its new electronic health record (EHR) system in order to prioritize fixing issues at the five sites where the system is already deployed.
Genetics Play a Role in Severe PTSD in Some Deployed Soldiers
The risk for specific soldiers to have severe post-traumatic stress disorder (PTSD) appears to far predate their deployment. In fact, some military personnel are born with it, according to a new study.
At All Levels, Chief Medical Office Scavella Focused on Best Care for Veterans
For a VA physician, it can be a challenge to figure out the best treatment plan for a patient and implement it, and the victory comes when the veteran’s health and quality of life is improved.
Promotion Delays Affecting Military Readiness But Senator Won’t Budge
Delays in promotions directly impacts military readiness, DoD officials have said. But there isn’t much they can do about it as long as Sen. Tommy Tuberville (R-AL) is blocking the expedited promotion of more than 150 military generals and flag officers
Mental Health of Veterans Before, During and After COVID-19 Pandemic
With work disruptions, social isolation and economic concerns, the pandemic understandably caused significant distress for many veterans.
VA Slowly, Steadily Rolls New Pay, Hiring Authorities Those Could Increase Salaries for Some Staff
While VA is moving quickly to roll out new pay and hiring authorities, the impact might take time to trickle down to VA staff in non-supervisory roles or those whose salaries are not near the top of their profession’s pay cap.
Republicans Seek to Overturn VA Policy to Provide Abortion Services
Republicans in the House and Senate have reintroduced a resolution to reverse VA’s recent policy change that allows for limited abortion counseling and services at its facilities.
Outpatient Prolonged Exposure Therapy Is Effective for Combat-Related PTSD
Outpatient prolonged exposure therapy, a type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations, is a fast and effective treatment for combat-related post-traumatic stress disorder (PTSD) in active-duty military and veterans, according to a new study.
VAMCs Struggle to Find Mental Health Staffers for Primary Care
For years, VA has been working to integrate mental healthcare into primary care and requires facilities serving at least 5,000 veterans annually to have a mental health provider available within primary care settings.
Diabetes Drug Metformin Shows Promise for Reducing Incident Osteoarthritis
Metformin is recommended as first-line therapy for Type 2 diabetes at the VA and elsewhere. Among the benefits, according to the VA PBM, is that the drug, which has been in use for decades, is low-cost and safe to initiate in most patients, even those with moderate renal dysfunction.
Sequential Electrical Stimulation Device Relieves Pain in Veterans Study
Despite changes in physical training routines and equipment designed to reduce musculoskeletal injuries in servicemembers and veterans, veterans experience back and joint pain at a higher rate than their contemporaries who have never served.
Veterans Surviving COVID-19 at Much Higher Risk of Gastrointestinal Disorders
Survivors of COVID-19 are at heightened risk of developing gastrointestinal (GI) disorders within a year after infection compared with those who were never infected, according to a new study of veterans being treated by the VHA.
Native Americans Diagnosed With More Severe HCC
Native Americans are among the racial/ethnic groups who are more likely to be diagnosed with more-severe hepatocellular carcinoma (HCC), according to a new study.
Advanced Liver Fibrosis Increases Risk of HCC Diagnosis
While it is well-understood that both nonalcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV) infection commonly result in hepatic fibrosis and might lead to cirrhosis, it has not been clear whether advanced fibrosis, determined by measurements of liver stiffness, increases the incidence of hepatocellular carcinoma in veterans.
HCC Surveillance Rebounded at VA, Still Low
How did the first two years of the COVID-19 pandemic affect hepatocellular carcinoma (HCC) surveillance and factors associated with completion at the VA?
Legislators Want More Accountability in VA’s New EHR Contract
VA is in the process of renegotiating its agreement with Oracle-Cerner over its new electronic health records (EHR) system, and legislators on both sides of the aisle are concerned that the new contract be more favorable to the VA and hold the EHR manufacturer more accountable for ongoing problems with the system.
VA Spent Millions on HPV-Related Cancer But No Vaccination Promotion
Vaccinations for Veterans, Servicemembers Half...
Stimulant Use Could Be a Key Factor in Heart Failure Development
Chronic heart failure affects an estimated 5% of veterans in the VA Health System, and annual mortality in heart failure patients is 15%
HIV Patients Have Worse Long-Term Survival Following Coronary Procedure
The burden of cardiovascular disease among HIV patients has tripled over the past few decades, and cardiovascular mortality has steadily risen.
VA Analysis Sought to Determine Best Approach for Treatment of Alcohol Misuse
A new study sought to determine that. Noting that psychosocial approaches are “the hallmark of treatment for harmful alcohol use,” the report in the journal Addiction added, “We aimed to compare the effectiveness of psychosocial therapy for harmful alcohol use using a network meta-analysis approach.”
Measuring Ability to Resist in Alcohol Abuse Treatment
While about half of patients with alcohol use disorder prefer non-abstinence based approaches to treatment, it is not clear when that approach is beneficial.
Substance Use Disorders Increasing Fastest Among Older Veterans
The past few years have seen significant increases in diagnoses for cannabis and stimulant use disorder at the VA, especially among older adults.
Ovbiagele Focuses on Disparities in Stroke Among Veterans, Others
Many factors play into why some populations have a higher risk of having and dying from a stroke: genetics, blood pressure, cholesterol, diabetes, access to healthy food, lifestyles that do not allow for regular exercise.
Tool Effective in Detecting Elder Abuse in Veterans Visiting EDs
A standardized tool designed for intermediate care technicians and nurses to screen high-risk older veterans in emergency departments for injury,
Survey Examines COVID-19 Vaccination Hesitancy Among U.S. Soldiers
Soldiers who agree with COVID-19 vaccination effectiveness, safety or importance, as well as soldiers who have an immediate supervisor who encourages them to get the COVID-19 vaccine, are more likely to get vaccinated, according to a new study.
More Treatment Failure Risk in Patients on Antidepressants and Montelukast
Montelukast, a prescription drug used to treat and prevent asthma, can affect antidepressant effectiveness, and initiating the asthma medication in patients already receiving antidepressant maintenance therapy is associated with an increased risk for treatment failure, according to a new study.
Intervention Improves COPD Patients’ Access to Pulmonary Care
Exposure to oil well fires, burn pits and sand and dust particles as well as the use of tobacco products puts veterans at increased risk of lung diseases, including chronic obstructive pulmonary disease (COPD).
Genetic Risk Factors for Alzheimer’s Found for Those of African Ancestry
VA researchers have discovered several new genetic variants associated with Alzheimer’s disease—the most common form of dementia—in people of African ancestry.
VA Employee Sues Over VA’s Decision to Provide Abortion Services
When VA announced in September that it would be allowing department clinicians to provide abortions and abortion counseling in response to the overturning of Roe v. Wade, it was widely anticipated that there would be lawsuits from state governments that restrict abortion access.
VA Disability Claims Rejected at Higher Rates for Black Veterans
Conley Monk Jr., a Black veteran who served in Vietnam, has spent much of the past 50 years trying to get the VA to accept his claims for disability benefits, housing assistance and education benefits.