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VA hospitals and the nation’s top medical schools have been linked together since 1946 and since then VA health has benefited immensely from the research and teaching talents of these hospitals while also training 70 percent of the nation’s medical workforce.
Welcome to Standing Ready: An Inside Look at the Untold History of the VA's Medical Innovations. Join us as we elevate and highlight significant medical and scientific contributions of the nation's largest healthcare system.
Join us for interviews with VHA innovators and pioneers, exploring how VHA has changed the landscape of medicine over 75 years with topics on the history of prosthetic limbs, adaptive sports, how history has influenced VHA’s response to the COVID-19 pandemic, and more!
The Department of Veterans Affairs does not endorse or officially sanction any entities that may be discussed in this podcast, nor any media, products or services they may provide.
Unknown: Standing record the
podcast that gives you an inside
look at the Untold History of
the VA medical innovations with
your host, Katie della sensory
and Shawn Spitler.
Katie Delacenserie: All right,
everybody. Welcome back to
standing ready,
Shawn Spitler: Katie, I feel
like I'm having some deja vu,
you are
Katie Delacenserie: in fact
having some deja vu, Shawn.
That's because we did have a
episode in Season one dedicated
to academic affiliations. But it
is such an important topic and
so essential to really the
entire season, that is
absolutely worth revisiting. And
last year, the program turned 75
years old. So without academic
affiliations, you don't have a
lot of these innovations and
advancements that we have been
discussing throughout both of
our seasons of this show.
Shawn Spitler: So it actually
recorded this episode more than
a year ago, in fact, right. We
recorded this in February of
2021. And we spoke with Karen
Saunders and Stuart Gilman who
has since retired, but he was
kind of the unofficial historian
for the Office of Academic
affiliations. And, and I think
they're very interesting to
listen to. They're very
entertaining. They're energetic
about about this topic. So I
agree, we were going to kind of
create a bonus episode and
season one. And we said, you
know why this would actually be
a really good episode to put
inside of, of season two. So
here we are.
Katie Delacenserie: Yeah, I
think it's so important, because
without your academic
affiliations, you don't have
sort of these innovations that
VA has has come up with in these
last 75 years. And UVA runs the
largest medical training program
in the nation. And that is due
to, you know, it's a link
between medical schools and the
VA. So kind of delving into the
history of how this came, came
about and kind of looking at
this program in its 75th year is
really important. So I'm excited
to have this conversation. Yeah,
let's jump in. So the Office of
Academic affiliations,
officially celebrates its
birthday in January 1946. But
where do its broader origins
lie.
Unknown: The broader origins are
really lie with the foundation
of veteran's health
administration itself with the
founding of the Department of
Medicine and Surgery in the
Veterans Administration at the
time. And the challenge that was
facing America, as World War Two
was winding down was how to
provide health services to the
many, many veterans who are
going to be returning from
combat in Asia and, and Europe.
And the the status of the
Veterans Administration Health
Care System. Prior to that was
really entirely unsuited to meet
that need. They were
understaffed, the facilities
that existed were in the wrong
places. And, and they really
didn't have the tools they
needed to rapidly expand
capacity to meet this huge
influx. So a few things
happened. One was, they
identified the right leadership
to create this transition. And
General Omar Bradley was brought
in from the theater in Europe,
to oversee the modernization of
VA and prepare it for this. And
he brought with him the
physician who had developed
medical services for the war in
Europe, Major General Paul
Hawley. And together they came,
and were tasked to lead this
incredible transformation. And
they recognize that there were
several things that had to
happen to facilitate the
expansion of what would then
become the Department of
Medicine and Surgery, which
hadn't really even existed yet.
And they believed largely
through counsel from others who
had been thinking about this for
a while, that academic
affiliations could provide a
mechanism for rapid expansion of
the clinical workforce to be
able to meet veterans needs,
because they had, they had to
address quality and quantity and
medical schools had staff that
could be brought to us on a part
time basis, very quickly. But
they also recognize that the
faculty at the medical schools
were generally regarded by their
communities as excellent
physicians, and that that could
solve two problems. One was more
the Public Affairs problem of
how does the public have
confidence that this new VA that
was getting formed would have
the quality of care necessary.
But there was also just a
credentialing problem. How could
we fast track credentialing of
physicians? Well, if they've
already been vetted by
respectable organizations like
academic affiliates, what would
become academic affiliates that
would solve a lot of problems
for for us and onboarding them.
So they identified the strategy
of academic affiliations, they
had to do a few other things to
make that happen, they had to
create a new form of Civil
Service to rapidly onboard all
these physicians and title 38
was created. And and a little
more strategic was they needed
places for all of this veterans
care to occur. Since I've
already mentioned that all of
the most of the VA facilities
were in the wrong places, they
were in rural areas, not in the
urban areas we needed. And that
started a massive hospital
construction program, co
locating most of these new new
newly constructed VA hospitals
to be adjacent to academic
affiliates to facilitate this
interchange of faculty who would
be coming back and forth and
then the the physician residents
who would be providing a
substantial part of the the
workforce to leverage the
actions of the the supervising
faculty, so that we could
finally provide access of care
to folks and and that's what
policy memorandum number two was
trying to, to set as kind of
the, the policy basis for this
massive transformation for what
would become the Department of
Medicine and Surgery. It was,
you know, the academic
affiliation at that time, was
was the core strategy for
reinventing VA health care, it
wasn't a side hustle, while we
were also going to provide care,
it was the thing.
Katie Delacenserie: And to me it
you know, in China, I've talked
about this, it just seems like
such a natural thing. It just
seems like Well, yes, of course
he would partner with with
medical rules, right? Is there a
reason that didn't happen
before? Was there, you slowly
start to see, you know, it
develop, you know, in the 20s,
va, you know, establishes a
research office and starts, you
know, kind of getting more into
that. Was there sort of a fear
that, you know, veterans would
be experimented on, or is there
was there any hesitation on that
was?
Unknown: Yeah, that fear
exactly, General Heinz was the
administrator of the VA, just
prior to general Bradley, and
General Heinz had said he didn't
want veterans to be guinea pigs.
And he has largely been opposed
to having substantial academic
affiliations.
Katie Delacenserie: And by 1946,
you know, the legislation that
creates the Department of
Medicine and Surgery is signed
by Truman on January 3, and, you
know, days after that
Northwestern partners with
Heinz, and so it's a very, very
quick, so I get I see that on
the Veterans Administration
side, why they want to partner
with schools. You know, and it
just sort of seems like they're
that fit a need as well, for a
lot of medical schools like they
were looking for this to come
along, would you would you agree
with that?
Unknown: I'm not sure. They were
looking for it. But there were a
couple things happening at that
same time. One was, there was a,
there really was a huge sense of
patriotism, that, that the
schools and the faculty of the
schools felt they needed to be
able to do their part to assist
in the war effort. And, you
know, the physician that they
brought in two, to lead the
academic affiliations, who
became the first Chief Medical
Director was Dr. Paul Magnuson,
and he was not able to serve in
uniform and he really felt a
commitment that this was a way
he could contribute to the
effort. But there was also
another thing happening
throughout medicine, which was a
move towards residency training.
So prior to this, relatively few
physicians in America had been
residency trained, most people
would go into practice right out
of medical school, and an
interest in what was happening
and this was shared by Major
General Holly, as well as by Dr.
Magnuson. And the other leaders
of their professions was that
they, they believe that, that it
was advantageous for the nation
to incentivize physicians to
seek specialty residency
training and accredited
programs, and that this was a
kind of another goal that VA
could contribute to benefit the
nation was to help provide the
foundation for this, this new
level of professional
development.
Katie Delacenserie: And I think,
too, you know, you see, the
need, the needs of veterans in
1946 is, you know, across the
board, you know, you need just
general doctors, you know, you
need a lot of mental health
professionals and you need, you
know, people who specialize in
prosthetics and all of these
different things. And it's great
that that timing kind of
occurred when it did when all of
these disciplines were being
utilized. And we had the
pleasure to talk to Dr. Marie
Levin on the program earlier,
who began his residency at a VA
hospital in 1955. So it was
great for us to kind of get that
I know, he was he was there
almost as soon as this started.
So yeah, it's great to have that
recorded. And so kind of moving
forward, then in history. How
has the mission kind of changed
or expanded over time? And and
what are some of the landmarks
that move us forward in history
from 1946?
Unknown: Well, we've expanded
considerably, right. So I'd
mentioned before construction, I
think between 1946 and 1958, we
built 76 VA medical centers, if
you can imagine.
Katie Delacenserie: And it was
like slated to be the largest
hospital construction, you know,
project in history, I think at
the time,
Unknown: that was what that's
what they said, in 1946, was
we're about to start the largest
constructing the hospital, like
the largest construction program
in human history, wow. Something
like that. Yeah, they knew that
they were biting off a pretty
big, a pretty big bite. And, and
that was one of the, the amazing
skills, I think, that general
Bradley brought was he knew how
to organize systems to get
things done. And, and knew how
to juggle these plates, Bill
developing healthcare systems,
while creating physical plant
while having legislation be
crafted from thin air. You know,
he really was amazing, I think,
and that must have been one of
the reasons they they brought
him. But, you know, so the
academic affiliations happened,
you already referred to some
other things. At the same time,
they're developing the academic
affiliations with schools of
medicine, they're doing
foundational work in developing
the profession of clinical
psychology as we recognize it in
America. It existed before VA,
but VA provided huge impetus to
tightening up standards for
education and practice,
vocational rehab, advanced
considerably. And, and just to
mention, even what what the
concept of a hospital was one of
the things Dr. Holly contributed
was the incorporation of
psychiatric inpatient care in a
general medical surgical
hospital, that really wasn't a
thing in the United States. The
military started doing that and
field hospitals in Europe under
Holly's leadership, and he
insisted that there be what what
they called in the 40s neuro
psychiatric units within each VA
Medical Center. And and this
really revolutionized how mental
health was treated and its
interaction with with other
other health conditions and the
interaction of psychiatry,
psychology and other mental
health care with, with all other
health care. And, you know, in
the at that time, in the late
40s, they already had worked out
the blueprints of what a
standard, you know, hospital
should look like, and what's the
war the mental health unit
should be on and how it
interacted with the other units.
It was really a very
sophisticated thing. And, and so
even from that time, this
interaction and this, of what's
our system of care, with our
system of education, they were
really inextricable. They were
inextricably linked in those at
that time. And I and I think
that that's been a fundamental
theme of the history of
veteran's health. ministration
is so inextricably linked
academic mission is to what our
system of care is. And, and of
course, Dr. Sanders will be able
to talk about, I'm sure in a few
minutes about how that gets
manifested in 2021. Now, but but
there, you know, there had been
in this interval continued
growth of our affiliations in
terms of numbers of schools of
medicine and, and varieties of
affiliations with other types of
professional schools. There have
been an expansion of types of
specialties that we funded
there, a substantial expansion
of the budget that was devoted
to funding the education and
substantial effort at recruiting
staff and faculty to come. play
these roles of being direct care
providers, being clinical
supervisors, faculty, and
preceptors. And being
researchers, because we can't
also extract the research
mission from this because the
best clinical research happens
in places where you've, you've
got an academic learning and
practice environment.
Shawn Spitler: This season on
standing ready, we are looking
at the innovations that have
come out of academic
affiliations, we're looking at
things like the development of
the cardiac pacemaker, the first
successful liver transplant, the
nicotine patch. So just kind of
want to ask where these have
been possible without that
partnership with academic
affiliations?
Unknown: I personally think not.
Dr. Sanders, what do you what do
you think?
Absolutely not. I think the
things that we're most proud of
ended up as a direct result of
our academic affiliations, or
Nobel Prize winners, or research
enterprise, all are built on
that foundation of partnership.
And the educational programs
themselves, of course, are built
on this infrastructure of these
partnerships, these affiliation
agreements. And it's funny back
in 1946, and for gosh, probably
three decades after that, there
was no such thing as a written
agreement, right, there was no
signed document that says, we
have an affiliation, there was
just a handshake, yep, we'll
send your people over and they
can take care of my veterans,
right. So it was so much easier
back then. But now we have lots
of agreements and legal, you
know, legal things that must be
executed to have partners. But
the fact is that these are
integral to the VA system of
care at this point in time.
Katie Delacenserie: I think
handshakes could make
bureaucracy a lot easier. That's
just the way we like, Yep, we're
gonna send over some doctors.
That sounds good.
Unknown: Totally fine. Thank
you.
Shawn Spitler: And what do you
think, Bradley? Holly and
Magnuson would think or say
about the Office of Academic
affiliations today? Could they
have envisioned the advancements
that the program has made?
Unknown: It's been really hard
for me to kind of get into their
heads? Certainly for Bradley
and, and Holly Bradley wrote an
autobiography, Holly never wrote
much about himself. I, you know,
I think that there would be, I
think they would absolutely
remain committed to the academic
mission, being an integral part
to accomplish the clinical care
mission, that that would still
be obvious, and make perfect
sense to them. And I think they
would be really proud for what
grew out of the vision that they
were able to implement in an
incredibly short period of time.
I was gonna just agree with Stu,
on that point, that I think they
could absolutely recognize
today's VA, and how it came
about through what they executed
way back then. That that was the
infrastructure, they built the
infrastructure for today. And
they would recognize that,
Katie Delacenserie: yeah, I
would absolutely agree with
that. I think, you know, they're
coming in in the fall of 1945.
And they just have this huge,
you know, problem they need to
solve, how are we going to
provide care to 16 million
veterans and they, you know,
they're on very limited time to
be able to do that. So, I think
they, you know, they just saw a
problem and like, they had that
Battlefield mentality that they
had in the war and like, Okay,
we're gonna we're gonna move
ahead and we're gonna fix this
and, you know, if the
bureaucracy is standing in our
way, well, we're going to plow
right through that and yeah, I
think that for them, they would
just be so you thrilled and
honored that VA still providing
care to to its veterans in the
magnitude and scope that we are
today at. Yeah, I think I think
they would be impressed.
Unknown: I hate to let let this
this lookback go by without
mentioning title 38. And I think
we should talk a little bit
about that stew of how that
revolutionized that was equally
revolutionary in its own time,
by abandoning every construct in
civil service by saying, No, you
don't have to take an exam, you
are going, we're gonna see a
good professional, and we're
going to be able to hire them.
Without competition. I think
that was another just huge
infrastructure development, that
allowed VA to, you know,
actually just hire good
physicians, as we as we have. It
just abandoned the very
bureaucratic civil service
hiring mechanism, and just
created this whole other
supposedly easier system to do
it. And it was much easier. And
it still is much easier to not
have to compete for to compete
our jobs for health care
professionals.
Yeah, but they took it was quite
a fight for them to get that
they, the rumors are that
Bradley went to the mat and
threatened to resign if the
President wouldn't support the
legislation, and there was a lot
of opposition from government
employee unions and from
political opposition to this
innovation, which Yeah, so let's
see, what title 38 was able to
do then was to identify ways to
fast track recruitment and
appointment. It also, it also
permitted part time appointment
and allowed that flexibility for
faculty to circulate back and
forth in a more fluid way that
would be much more efficient,
and permit the, the expert
faculty from the affiliate, to
be able to come when they're
needed to be at the VA hospital.
So yeah, and of course, title
38, it's been expanded in a
variety of ways. And some other
ways, perhaps it's been whittled
away at but it is still
foundationally important to, to
be a and our modern ability to
Katie Delacenserie: function.
Care. And I'm so glad you
brought that up. Because, you
know, that was one of the
conditions that Bradley and
Holly were facing, you know, and
I believe Holly said something
like, you know, he was presented
a list of suitable candidates
that he could hire, and they
were all like, over 80 years old
or something like that. So
removing that requirement,
really allowed, you know, and
they they weren't quite, you
know, cutting edge, you know,
when you're near that old. So by
by getting rid of that you could
hire a younger doctor more
easily, who could provide, you
know, more modern care to
veterans?
Unknown: Well, I think that part
of the issue, even from the
Civil Service lists, or some
people weren't not, we're not
even licensed licensed
providers, substandard
providers, providers that
discipline Neri actions. So it
wasn't a very, you know, really
uplifting, VA. Yeah,
how bad was it? It was, it was
so bad that when General Holly
spoke to the American Medical
Association, he he said to them,
something along the lines of You
might not believe this when I
tell you today, but some day, VA
physicians will be good enough
that you'll allow them to be
members of the AMA. Now, that
goes back, there's a lot of weak
up, we could get into what the
AMA was in 1940, whatever, too.
But still, the general
reputation of the medical staff
of VA before this transformation
was not great. The public did
not have confidence in the VA to
meet the medical needs. And you
know, and some of that goes way
back even to the BAS ability to
fulfill a variety of other
benefits challenges earlier in,
in the century. So so this was
yeah, they have they had a lot
of work to do to get the medical
staff up to snuff in every
dimension imaginable.
Yeah, I was gonna say that the
amazing thing is I you know, I,
I did not rotate through VA as a
medical students, but I came up
to VA after I graduated as part
of my internship and residency
in Rhode Island. So this was the
late 70s. So this is only like,
you know, three decades after
all of this had happened, right?
By the late 70s. It's only 30
years later, one generation. And
already I was highly academic
professors, students, residents,
I a scholarly approach to care
evidence. i It's amazing that
that happened that fast. And I,
you know, I saw it with my own
eyes as an intern and resident,
this was already a different
place,
Katie Delacenserie: especially
as a historian who's been
looking at history in the
federal government for a while
there are very few times in the
history of the federal
government where something
happens that quickly that, is
that right? You know, that's not
to say that there needed to be
changes, and it needed to be,
you know, amended down the road,
but first for them in 1946, to
get something together that
quickly that made such an
impact. It's, it's, it's
unbelievable.
Shawn Spitler: So, Dr. Sanders,
as you reflect on the 75 years
of academic affiliations, can
you can you give us an overview
of what OA is today, since we're
kind of on that topic a little
bit. O AE is
Unknown: the VHA Office where
the academic mission of the
agency sits, we, we have a staff
of 60. Now, that's, that's
bigger than it's been in the
past. And I think, you know,
we've been growing over over the
decade or so that I've been
here. But I think we we are
organized around some certain
types of clinical professions.
We have a an entire clinical
section on medical and dental
education, we have a section
called nursing education, we
have a section called associated
health education, which has most
of the professions except for
medicine, and nursing. And then
we have a service line that
still runs, which is our
advanced fellowships and
professional development, which
are small programs, not
accredited programs that really
meet specific VA needs. So we're
organized around these clinical
service lines. But then, of
course, we have some
administrative support, you
know, sections that do budgeting
and finance and HR and, and
things like that. I think, you
know, in terms of our role in
the organization, we're we're
very much in the relationship
business, if I'd have to
summarize what we do. We're not
only, you know, invested in our
relationships with the education
stakeholders in VA itself, which
is our education community, the
trainees, the preceptors, the
supervisors, and the education
administration, staff out and
all the facilities around the
country, but we function as the
relationship office to outside
VA as well. We are we are have
relationships with professional
societies, like the Association
of American Medical Colleges, or
the American Psychological
Association with accrediting
bodies, like the media, the
association of the ACGME, the
ACC, Ma, you name it, so
accrediting bodies, member
organizations, specialty
societies. So we say I think,
very much connected to the pulse
of health professions education
across the country. And these
relationships, help these
organizations to know what's
going on in VA. And it also
helps us stay abreast of new
developments in health
professions education, you know,
licensing new levels of practice
new scopes of practice. So I
think we're a connector in a way
to the entire field of health
professions education. And I
think that has stood us in good
stead for the VA as a whole. And
for veteran care, certainly,
Katie Delacenserie: how would
you say, academic affiliations
has adapted during the COVID 19
pandemic? And what sort of
innovations have been spurred by
that and how has that been
handled?
Unknown: So I think we did
pretty good in terms of being
trying to be very flexible or a
federal bureaucracy. We we found
out right away that of course,
the move was to virtual care.
And the real questions we were
confronting right away, was, how
were the trainees intersect with
virtual care? How will they be
late be allowed to, you know,
deal with patients will how will
the supervision occur? Will
their supervisors have to be on
the calls with the trainees? Can
they just check in at times? I
think can they do virtual care
from home, once they do it from
the facility. What's the safest
options for our trainees and our
supervisors to provide continued
continuous veteran care. So we
were confronted very early with
some of these questions. And I
think we responded, we
immediately changed our
supervision rules to allow kind
of virtual and remote
supervision. We allow trainees
to telework from home if that
was the safest option, and to
provide veteran care from home.
We of course, the tried to
expedite telework training for
trainees. So they can only have
to read a one page handout
instead of taking a TMS module.
We dispensed with telework
agreements for our trainees
thinking that everybody knew
what they were they didn't have
to sign a telework agreement.
And apparently, there's a part
of a law that says in an
emergency, you can let people
telework without a signed
agreement. So we were just
looking for flexibility after
flexibility to preserve veteran
care, keep our trainees and
supervisors safe. And yet, you
know, continue to march forward
with making sure there was, you
know, no step unturned in the in
the process, I think we did a
relatively good job. We did
weekly COVID calls for a while
our stakeholders out in the
field were had a lot of
questions. So we started doing
weekly calls saying just call
in, ask your questions. If
there's an issue, we'll try to
solve them. And I think I'm
pretty proud of of our
responsiveness to the field, we
have made sure that our trainees
are on the list to get
vaccinated, that if they're at
the VA, they will get a shot
like any other provider. So
we've included them as part of
our workforce at every turn to
make sure they the they have a
good experience with VA. And of
course that our veteran care
continues.
Shawn Spitler: And do you think
as you know, over the next six
months to a year as as hopefully
the pandemic becomes less of a
thing? Will these will things go
back to normal? Or will we see
kind of a hybrid of what they
used to be and what they are
now?
Unknown: Well, I think that's a
great question. It's a $100
million question. I think that,
you know, things will go back,
but they're not going to go back
to what we call normal. I think
virtual care, I think we all
agree is here to stay, it's
convenient. I've had, I've had
virtual care, I've, I've had
video visits with my doctors, I
think they're convenient,
they're great. You can do a lot
with them, you can't do
everything, but you can do a
lot. And so I think they're here
to stay. And they're going to
need to be accommodated in our
trainee rules and regulations
going forward. And we need to
figure that out. And truthfully,
it's not just VA, of course,
it's the whole health
professional field that is going
to have to figure this out. What
are the right types of
supervisory structures and
requirements for trainees in
this grand new world? So do you
have any thoughts on that too?
Well, I agree with everything
you've said, what I what I point
out is that VA ends up doing
unexpectedly interesting and
important things as we go
through this process. Because
for example, in the starting in
the 80s, and well through the
90s the the most exposure that
many health professional
trainees had to working with an
electronic health record
happened when they were at their
VA learning experience. And and
I believe that that facilitated
the adoption of electronic
health records throughout. And I
think we're also going to be at
now where we are, as in this
leadership position of training
people how to provide care and
learn through telehealth, that
we've got a systematic way to do
it, we've got 120,000 Health
Professional trainees a year
coming through, and this is the
environment of care they're in
and they're gonna learn how to
do it. And we've, her office and
others are assuring that the
supervision is there. And the
facilities are committed to
providing excellent care through
these modalities. So I think
that'll be a kind of a
fascinating kind of sub thing
that VA does to fulfill the
education mission to benefit
veterans and the nation.
Katie Delacenserie: Yeah, and I,
you know, kind of reflecting on
this moment where we're, you
know, celebrating a 75th
anniversary, looking back, you
know, to 1946, when, you know,
we the VA and the nation kind of
faced this crisis about how they
were going to provide health
care, you know, and Shawn and I
have talked about this, how you
just can't help but draw
parallels to what's going on
today. And, you know, there's
this different type of crisis,
but we're still just sort of
like, you know, Moving forward
with this mission of how are we
going to provide health care to
our veterans? And to me it's
it's interesting to draw those
parallels between time. So what
what kind of excites you looking
forward to the next 75 years?
What excites you about the
future?
Unknown: I think that the
academic mission of VA has
always been forward looking. And
we have been at the forefront of
innovation in how care is
provided. And that means our
trainees are involved in
participating in those things
that's helped develop medical
specialties and other
professional areas that didn't
exist before. So we can we know
that VA has helped through our
academic mission contribute to
development of, you know,
addiction, psychiatry,
geriatrics, Polly trauma and
traumatic brain injury,
addiction medicine, and a
variety of other medical
specialties. We've been in the
forefront of funding,
innovations in training for
nursing with residencies, post
baccalaureate and nurse
practitioner residency is and
specialty training in a variety
of associated health
professions. And these
innovations continue to come VA
continues to be an innovative
system of care. And our
education mission is going to
continue to adapt, I can't say
what the news, you know what the
strategic goals will be, that
will be different in 10 years
from now, because we haven't
gotten to that time yet. But I
know that VA is going to be at
the forefront of advancing,
advancing those things. I
agree with through I think that,
you know, we are right at the
cutting edge of new professions,
new specialties, new levels of
training, and we're always
trying to push the envelope. And
yet sometimes were the ones
pulling the academic community
along with us. Because because
we really don't have anything to
lose. If our veterans need it,
why don't we try it, we do have
our own little experimental
laboratory, which is basically
this division that's do runs.
And it's our little skunkworks,
for testing things and testing
curricula and trying new ways of
teaching, folks. So I think that
we're going to continue to push
the envelope and see what VA and
veterans need to drive our
educational programs. So I think
that's what's really fun about
this is we get to have a very
large sandbox to play in.
Shawn Spitler: There's been a
lot of talk about Spanish flu, a
lot of talk about polio. But one
thing that we we see a little
less of a parallel is with the
AIDS epidemic. And I wondered if
you guys see any, any parallels
there or any way that in which
the VA and an academic
affiliations maybe dealt with
that, in that time in the 80s,
and maybe how that can inform
how we're dealing with things
today?
Unknown: Well, one of the things
that VA can do, that other
health care providing systems
cannot generally do is is
aggregate and analyze large
amounts of data across
geography. And I know that that
VA contributed substantially to
advancing understanding a system
of care for HIV as that illness
emerged, because in part, we
were able to work with more data
than many other folks had, and
and even better data in a lot of
cases than state Regional Health
Department's had. And, and I
believe that'll continue to be a
benefit that we have in
addressing condition like COVID,
because we've got a huge amount
of data even. Well, you know, I
don't know how extensive we can
make those relationships yet,
but the million veterans
genomics research program may
allow us to make some linkages
at a dramatic level to process
of care outcomes of care illness
and these things. And that's,
that's an opportunity that I
hope will be expressed. I know
that there are groups within VA
starting to work on these
things. Now. It's too early to
say what the fruits of that
labor is going to be. But I
believe that we've got because
of our National Integrated
Health Record the standardized
system of care standardized
benefits. We have opportunities
to learn really practical things
that really nobody else in the
country can and accomplish
through. That's a great answer.
Shawn Spitler: I agree that was
insightful and helpful. And I
hope to see the results of that
type of study. I think that kind
of stuff is really exciting and
innovative. That's, that's what
we're here to do a podcast
about. So that's all the time we
have. Thank you both for being
on the show.
Katie Delacenserie: Thanks very
much.
Unknown: Thanks for inviting us
to come talk with you about
this. It's our passion.
We appreciate it. Thank you so
much.