VA Outflanked by Women’s Rising Ranks, Needs

No one’s quite ready for them, but female veterans have arrived in the Department of Veterans Affairs’ hundreds of hospitals and clinics. A system long geared toward treating an aging male population is scrambling to care for thousands of female veterans. They are younger, too. Most of the women who served in the recent wars are younger than age 40.

In the last budget year, the VA saw 281,000 female veterans, a 12 percent increase from two years earlier.

The northern Indiana VA system has seen similar trends. In the budget year 2009, the Northern Indiana VA Medical Center in Fort Wayne saw 1,635 female veterans – a 14 percent increase from 2008, according to spokesman Tim Twiss.

Nationally, women represent one in 16 veterans in the system, but in 15 years women are projected to represent one in seven.

This increase has forced changes in the VA’s culture, in addition to its medical system. Not only have VA facilities, including Fort Wayne’s, had to get equipment such as gynecological exam tables, they’ve had to create a place where women feel comfortable.

But change is not happening fast enough for some women in the VA’s system.

Retired Staff Sgt. Karen Boudriault, 49, of Waterboro, Maine, spent 26 years in the military before retiring in 2007. She said she was far from amused when she went into a VA facility in Manchester, N.H., for a post-Iraq deployment physical, and the phlebotomist drew blood to test her prostate – a gland women don’t have.

“I pretty much quit using them after they drew blood to check my prostate. I just didn’t trust them,” Boudriault said. “I didn’t trust the quality of care.”

Reflecting another common complaint, congressional investigators in July said that VA hospitals weren’t always providing privacy to female veterans when they bathed and received exams. Investigators found that many VA facilities had gynecological tables that faced the door – including one that opened in view from the waiting room. It also found instances where women had to walk through a waiting area to get to the restroom, even though VA policy requires these restrooms be placed next to an examination room.

Some female veterans have complained that they were turned away from appointments when they showed up with children. In response, VA Secretary Eric Shinseki told a congressional panel in October he issued a directive allowing patients to bring children along for appointments, unless they were seeking mental health care or were in intensive care.

There have been complaints about the inconvenience of having to go outside the VA for many female-specific tests or procedures – even though the VA picks up the tab. That includes all obstetrical services.

In northern Indiana, VA outpatient clinics in Muncie and Goshen have been remodeled with convenient restrooms near examination rooms, thoughtfully placed gynecological tables and other features to address the privacy needs of women, Twiss said. A similar renovation is scheduled for a clinic in Peru.

“As we remodel anything, we keep in mind whether it will be used by females,” Twiss said. Women’s concerns are also monitored by a women’s health coordinator, he said.
As more female soldiers participate in dangerous security missions overseas, more are turning to the VA to help with their physical and mental health needs. When Fort Wayne’s 1st Battalion, 293rd Infantry deployed to Iraq in March 2008, for example, the 39 women in the unit found themselves training for combat roles usually reserved for men.

Tammy Duckworth, a VA assistant secretary who was a helicopter pilot in Iraq and lost both her legs and partial use of an arm in an attack, said the VA needs to continue to change its programs to better suit women’s needs.

She said the placement at each site of a women’s health coordinator has helped female patients.

“You have to service the most vulnerable member of your population, and if that is the young 18-year-old who experienced traumatic either PTSD or military sexual trauma, she should be able to get exactly the treatment that she needs from VA,” Duckworth said. “If we cater to her and she has more requirements, what we do to cater to her is going to help all veterans overall.”

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