Duke GIM Associate Professor of Medicine and Chief of Staff for the Durham VA Healthcare System, Ken Goldberg, MD, delivered Duke Medicine Grand rounds this past Friday. The title of his presentation was simply "The VA: how did we get here and where are we going?"
It's a large system.
Although most of his current work takes place as Chief of Staff at the Durham VA, Goldberg spoke more about the United States Department of Veteran Affairs on a national level. He presented the organizational chart showing its three administrative arms — cemeteries, benefits and health — each reporting to the Secretary of Veteran Affairs. Goldberg emphasized how very large the system is (380,000 employees) and how often decisions are not made locally. At least 9 different regulatory, or extensions of regulatory bodies, place pressure on VA performance.
Quality care at the VA
We also heard Goldberg's response to negative press in recent years about quality of care in the VA, data that refute those press reports. In fact, the VA, because of the electronic record had already achieved metrics for meaningful use and value-based care, metrics that were adapted for the Accountable Care Act because these were successful in the VA. Trust was undermined as the public only saw risk related to "socialized medicine." Yet looking at quality measures compared to non-VA hospitals, the VA is the same or better.
Dr. Goldberg aptly conveyed the VA mission, its services, recent drivers and academic affiliation. Those attending applauded the partnership with Duke where education and research also achieve excellence in their midst.
Finally, click here to view the VA transparency about access and quality.
See the full recording of Dr. Goldberg's presentation on the Duke Media Site here. (NetID and password required)