GUEST COMMENTARY: Health care that values relationships can make a difference | Guest Commentaries


Perspective helps you focus on what really matters.

As the names were called with honor and the bell rang, I felt a warm hand grasp mine and tighten. The elderly lady sitting next to me found comfort with connecting and, even though, we spoke no words to each other, I felt as though a name she knew was about to be called.

Truman VA Hospital holds quarterly memorial services to honor Veterans who have passed away during the previous quarter. Families and friends of the deceased are invited to attend the service, where we set time aside to honor their life and remember their service to our nation. Just prior to our last scheduled memorial service, I was feeling a little under the weather. So, I asked my assistant director to lead the event in my place. I normally open the event and welcome friends and families and talk about why we hold these memorial services. During the entire event, I remain upfront and a part of the service. However, this last time, I quietly took a seat in the fifth row and waited for the service to begin. It was another full house and I sat quietly as family and loved ones filled the chapel. At the top of the hour, the service began. As music was played, songs were sung and Veterans were honored, I could not help but be filled with a sense of family. See, my perspective changed that day.

The strength of the VA Healthcare System is that we build a lifelong relationship with our patients. It is a relationship that is built on prevention and not just treatment. On this day, I realized how valuable this relationship can be and how that value has meaning to our Veterans. Health care, as widely practiced in the United States, might more accurately be called “sick care.” Patients often avoid visiting their doctors until they have an acute or urgent concern. It is generally more difficult and expensive to address conditions later in their progression. This is only exacerbated with the complexity of military service connected conditions.

By shifting the focus to prevention and effective management of chronic conditions, providers can help patients avoid many conditions or keep them from advancing. Prevention reduces both the human and financial costs of illness. This is certainly desirable, but requires that multiple providers coordinate with one another to effectively identify and prevent conditions to which individual patients are susceptible.

In the private sector, this integration of care is rarely realized. Providers are seldom reimbursed for prevention and coordination-related tasks, which makes it costly for them to prioritize prevention over treatment.

The VA Healthcare System is perfectly suited to provide integrated care. Since it operates under a limited budget allocated by Congress, it has every reason to contain costs by keeping patients healthy. This means offering effective primary and preventive care and avoiding unneeded services. Unlike most private sector healthcare organizations, our providers are salaried employees. Earning a fixed salary protects providers from the pressure to focus on the number of billable encounters they are generating. Instead, they can prescribe only those services that patients truly need. It also encourages cooperation among providers who will be compensated for the time they spend working together to coordinate patient care

Prior to this day, my perspective was limited and, even though I knew this lifelong relationship was a key to VA’s success, I still only considered this relationship to be limited directly to health care services. As a member of the audience that day, I felt like I was among family. Sure, I work at Truman VA. I get my health care from Truman VA. But all the people who attended that quarterly memorial service were connected in some way to each other and Truman VA. We had built such a great relationship with them that, even after their loved ones had passed, they still chose to come back and allow us to honor their Veteran one last time.

As the service ended, I briefly spoke with the lady sitting next to me. During the service, she did not get up and place a candle up front. So, of course, I was curious about why she attended. She shared with me that her spouse had passed away more than nine months ago, but the lifelong relationship that Truman VA had built with him also connected her to a lifelong relationship with VA. That was why she continues to attend the services. That day, my perspective changed and, with her help, I was energized to focus on what really matters. VA Healthcare is about building a lifelong relationship and enabling Veterans to access VA throughout their entire life journey.

I have come to realize that this relationship is not only with our veterans. What matters is being truly effective and I believe to do this we must find community partners who share our same values and dedication to caring for Veterans. We want to establish and build strong relationships with our communities through partnerships and innovative endeavors. This is, of course, not limited to our health care community partners, although those relationships are highly valued. It is also with partners who care deeply about caring for those who have borne the battle and his/her widow and orphan.

Truman VA will remain a strong healthcare system with many capabilities and qualities. However, it is clear to me that VA is not the sole provider of benefits, services and resources to veterans and eligible beneficiaries. We will improve our ability to partner and work with those who provide benefits, services and resources to our veterans through improved collaboration, business practices and outreach. This will include the delivery of necessary benefits, services and resources that are accessible regardless of who provides them.

David Isaacks is a  Marine Corps veteran and Medical Center Director Harry S. Truman Memorial Veterans’ Hospital.



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GUEST COMMENTARY: Health care that values relationships can make a difference | Guest Commentaries

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