By Uriel Halbreich
We face fundamental deep-rooted problems.
The Buffalo News on June 10 reported that the city’s VA hospital is better than the worst facilities nationwide regarding waiting times. No wrongdoing was uncovered.
Lucky us Buffalonians – we are not the worst.
Rep. Brian Higgins, D-Buffalo, correctly commented on the “only” 1,500 Veterans Affairs patients here who were waiting to see the doctor for more than 30 days: “This is 1,500 too many.” This is a first, small step in the right direction, toward change.
The nationwide VA audit did not address the most important issues: What happens once the still-alive VA patient finally sees a health care provider? What is the care? What is the quality of care?
What happens beyond the paper trails? What happens with the people? Who assures that patients receive the best care available?
Are we confronting a case of “do not ask, do not tell?” Are we avoiding turning over a rock fearing the worms that we might find underneath?
I will illuminate a single, important point within my expertise: the mental well-being of veterans as well as people in active service.
Prior to moving to the United States in 1978, I served as the chief psychiatrist of the Israeli Navy. This was a period that, following the trauma of the 1973 Yom Kippur war, the Israeli army amended many operational concepts, many times under the influence of the U.S. Army.
In the area of trauma and post-traumatic stress disorder, these ideas were shaped by the Vietnam experience. Was the American concept meritorious? Is it the best clinical approach? It may be debatable.
Furthermore, in the lean and efficient Israeli army, we had a very elaborate personality screening system of every candidate for each unit. This has been tested, adjusted and retested according to each shred of new data as well as update of tasks. It assured “the right man for the right place.”
This tough, proactive screening not only improved performance but also contributed to low levels of PTSD. Do we have efficient and efficacious pre-trauma procedures here? We should.
The list of necessary actions is long, though doable, but first and foremost, to embark on the long road to excellence we should work on a change of attitudes from being content with being “not the worst” to being the best.
Uriel Halbreich, M.D., is professor of psychiatry and OB/GYN and the director of biobehavioral research at the University at Buffalo.