Chief of Staff Talks Mental Health, Prevention, Staffing and More

By Chuck N Baker
Recently the Chief of Staff at the Department of Veterans Affairs (VA) sat down to talk about a number of health related topics. Below is the abbreviated interview with Dr. Ramu Komanduri:

Q: What is the role of the Chief of Staff?

A: I have a full responsibility ensuring safe, effective health care for our veterans. My goal is to be able to say a veteran can walk in any day and get the care they need as quickly as they can and make sure it’s the best, most effective care. We have been fortunate enough to be able to provide that type of care for the vast majority of veterans. The opportunity for me is to take care of veterans.

Q: Discuss the VA Mental Health Department.

A: We have a tremendous Mental Health Department. When you look at the foundation of services of the VA, Primary Care and Mental Health and certainly aspects of Rehabilitation are the most [active areas.] Suicide is a huge issue. I can tell you, look at the national figures, veterans make up about 8.5 percent of the population but they are 18 percent of the population that commit suicide. So, it is very critical. We focus on suicide prevention. One of the challenges we find is when you look at suicide as a risk factor, there are about 20 veterans a day dying by suicide. Out of that population, which is a horrible tragedy, 14 of them never come to the VA. When you look at the data, the veterans who come to the VA had a much lower rate of suicide than veterans not connected to the VA. Getting them enrolled in the VA and getting their health care at the VA is critical. So what we are now focused on is connecting the veterans that don’t come to the VA and help them get connected.

Q: One area that has recently gained more focus at the VA involves health care for women veterans.  Please comment.

A: Women veterans have really been a rapidly growing population in the VA. What we’ve done [at the North Las Vegas clinic] is we’ve established a women’s health center. And on top of that we’ve got in every primary health care center a specialized women’s health provider. Women can get [specialized] health care at each of the primary care centers. We really want to reach out to our female veterans and have more of them enrolled. We also have sub-specialists in mental healthcare for women. Tragically there are women who suffer from military sexual trauma or were traumatized in other ways, or have PTSD or other illnesses. We have also started a new program to address non-combat PTSD, which is open to both women and men.

Q: Is health care moving more in the direction of teleconferencing and computer communication?*

A: Yes. Veterans will say ‘Why would I need to drive to any location when the majority of my care can be monitored and done at home?”

Q: Does the clinic in North Las Vegas have staffing shortages?

A: We have a tremendous rapidly growing veterans population. In our community every week 150 new veterans enroll in our VA. We are blessed that veterans want to come to our VA. Along with other challenges, how do you keep up with the growth of hiring people? In this community especially, you don’t have enough health care professionals. It ranks among the lowest in the nation [for hiring] in both medicine and surgical sub-specialties, doctors, nurses, it’s very difficult [to hire enough] in this community …Academically we are building fellowship programs with UNLV and we’re working with Touro University also. We have a cardiology fellowship … What we’ve done to attract physicians is we offer loan repayment which is a very attractive program for certain disciplines [psychiatrists and psychologists] where they can pay off a good chunk of their educational loans, medical school loans, and help them to come to Las Vegas.

*(According to a report in a recent issue of DAV Magazine, veterans can now access their medical images and associated study reports online through the My HealtheVet portal. The new feature, “VA Medical Images and Reports,” allows veterans with a premium account to view, download and share copies of their X-rays, mammograms, MRIs and CT scans. For directions on downloading, go to www.myhealth.va.gov.)