Lancaster Physician Fall 2021 - 26

L A N CA S TERMED I CALSO C IET Y. O R G
Patient Advocacy
Coordinated Care and Communication:
Keys to High Quality Health Care and Optimal Outcomes for Veterans
DAVID W. BOWERS, MD, FAAFP
Innovative Healthcare Teams, LLC & retired physician
M
edical care delivery is complex and often fragmented. Given the
rapid pace of advances in diagnostic capabilities, therapeutic
interventions, and medical and surgical procedures, continuous
innovation and effort are required to deliver high quality care.
Effective communications within and between medical practices,
health systems, and patients are essential to maximize quality of care,
improve inefficiencies of care, and minimize medical errors.
The Veterans Administration (VA) health system is a nationwide,
federally funded provider. The VA provides ambulatory care in every
state in the U.S. through a broad network of primary care and specialty
outpatient clinics. Hospital inpatient physicians provide acute inpatient
and rehabilitation care services. Veterans who utilize the VA often have
relationships with non-VA providers of care.
Veterans who require referrals or consultations for service-connected
conditions as well as non-service-connected conditions that are not
available at their local VA (e.g., cardiothoracic surgery or neurosurgery)
are referred to larger, regional VA health systems or to community providers
for specialized care.
Veterans who have service-connected medical conditions receive
additional coverage for treatment of those conditions through the VA
health system. This coverage includes inpatient and outpatient treatment,
medications, and consultations outside the VA for services that are not
available through their local VA system.
For example, a veteran who sustained a traumatic brain injury related
to a bomb blast in the service may be under the care of a VA primary care
physician, a VA neurologist, and a community neurologist for specialized
seizure evaluation and treatment.
If a veteran has a service-connected condition, the care received at
the VA is a covered benefit, including medications and VA-initiated
community referrals, as indicated. The VA pharmacy has a medication
formulary, which is under the supervision of a multidisciplinary Pharmacy
Committee. Non-formulary medication requests are reviewed for
authorization by the Pharmacy.
I have been on both sides of VA / Community Provider communications
during my career. After completing my family medicine residency
in Lancaster and a two-year service commitment as an officer in the
National Health Service Corps, I joined a large private practice in Lititz
in 1983, which was formed in the late 1940s by three WW II veterans
LANCASTER 26
PHYSICIAN

Lancaster Physician Fall 2021

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