Women make up one of the fastest-growing groups of veterans, a trend bringing changes to the VA health system in Nebraska, Iowa and the rest of the nation.
Members of the VA medical staff in Nebraska and western Iowa are receiving refresher training on gynecological exams, proper nutrition during pregnancy, cervical cancer diagnosis and treatment, and other medical care that women need.
The increasing number of female veterans is one of the reasons that new medical clinics have opened in Bellevue and other communities, said Cindy Niemack-Brown, manager of women’s programs for the VA Nebraska-Western Iowa Health Care System.
Like Burns, many of the patients are in their 20s and have returned from military tours in Iraq or Afghanistan. They show up at VA clinics — long geared toward older men — toting kids and presenting medical needs that the VA isn’t used to seeing, whether it’s pelvic pain or a breast exam.
The VA health system for Nebraska and western Iowa is made up of the VA Medical Center in Omaha and seven outpatient clinics. There are about 13,000 female veterans in the region, and that number is expected to grow by as much as 10 percent over the next decade.
Nationally, women account for about 8 percent of the total veteran population and more than 5 percent of all veterans who use VA health care services. By 2020, the federal government estimates, women will make up nearly 11 percent of the veteran population and more than 9 percent of all VA patients.
Dr. Rachel Bonnema, a staff physician at the VA Medical Center in Omaha, said some primary care doctors at VA clinics haven’t seen many female patients over the years. Some doctors have not performed many pelvic exams or don’t know the newest treatments for ailments that affect women, such as uterine bleeding, she said. “They have gotten rusty.”
Bonnema, who serves on a federal committee on health care for female veterans, helps lead training for the Nebraska region’s primary care doctors. Training includes information on the latest treatments for menopause and recommendations on breast cancer screenings.
Burns, who lives in Lincoln, served for 11 months in Iraq as a combat medic with the Nebraska National Guard. The 28-year-old uses the VA clinic in Lincoln for all her medical care, including colds, flu, a dislocated shoulder and pelvic and breast exams.
She said her VA physician is a woman and is skilled in women’s health care. Burns said she’s glad the VA is providing training for doctors because pelvic exams and similar care are difficult enough for women, even when the physician is experienced.
“If they (didn’t) know what they were doing it would be horrible,’’ she said. “I wouldn’t want to go through it.”
Another problem: Women don’t always realize that they can seek care at VA hospitals.
Nationally, the VA is working to make sure female veterans are aware of its medical services.
Bonnema said some women think VA health care is only for older men, like their grandfathers and great-grandfathers who served in World War II, Korea or Vietnam.
Burns said she understands how female veterans could get that idea. When she sees mostly male veterans at her clinic, she sometimes feels out of place.
“It can be a little like, ‘I don’t fit in here,’” she said.
Niemack-Brown, the regional VA official for women’s programs, said her office is trying to reach out to female veterans. A $10,000 federal grant is funding a quarterly newsletter for women, providing details on VA medical services and clinics. VA staff members also are visiting National Guard units, churches and other organizations to provide information about how women can register for VA benefits.
“We want to get them in the door,” Niemack-Brown said.