Seamus Caragher, a Harvard Medical School student, feels passionately about the responsibility of caring for the nation's veterans.
"When someone put the flag on their shoulder and joined the military for our country, I think you feel that extra little bit of desire to make sure you are there for them," said Caragher. "You feel that for all of your patients, but particularly those who have sacrificed so much for our country. In the room, it feels slightly different after they say, 'I was in Vietnam' or 'I served in Iraq.'"
In order to attract more interest in caring for our nation's veterans, Caragher and two of his pre-med classmates at Georgetown University, Andrew Frank and Michael McNamara, envisioned a "shadowing" program for aspiring doctors at Veterans Affairs medical centers.
The students took their idea to Capitol Hill, where it became a bill — the Veterans-Specific Education for Tomorrow's Health Professionals Act, or VET HP Act, which passed the U.S. House of Representatives in 2019. The program would help to create shadowing opportunities for those who may not be able to access them as easily as students who may have connections to the health-care community or those who attend schools outside of major cities.
The bill would also create a three-year pilot program at no less than five VA hospitals or clinics, prioritizing students in health professional shortage areas, first-generation college students, students referred by minority-serving institutions, and veterans. It now awaits consideration in the Senate.
Those who feel the pull to work with and care for veterans are in high demand across the country. For Veterans Affairs Secretary Robert Wilkie, the VA's hiring priorities are those in mental health and primary care roles, as they are in the greatest demand. Suicide prevention is also a major concern, as is care for those in rural areas. Incentives including bonuses, relocation expenses and salary bumps are all being used in this historically tight labor market.
The VA has also recently implemented the MISSION Act, allowing vets to seek care outside of the VA system in the private sector, which the VA says has helped 1.7 million veterans obtain care in less than a year.
The MISSION Act also requires the VA to release data on employment vacancies. In its most recent release, from the fourth quarter of 2019, the VA reports some 49,000 vacancies in its workforce, including about 2,500 primary care physicians, more than 700 psychologists, and 1,900 social workers — an important part of the care system for the nation's 19 million veterans.
The administration currently has 3,500 job postings on USAJobs.com. Those positions, according to Wilkie, would bring the VA to full employment as funded by congressional appropriations.
"We have critical needs," Wilkie said. "America is suffering from a shortage of doctors, nurses and critical specialists. ... By integrating the VA into the wider American health-care system, we hedge possibilities that we don't have the right services and the right numbers. That's the key, making sure we have as many choices as possible."
Wilkie said patient satisfaction rates are at all-time highs and wait times are as good as or better than those in the private sector. The VA press office points to veteran's access to care and health-care outcomes as the best indicators of adequate staffing, not vacancies.
"Staffing requirements are dynamic, and are updated constantly based on new business and workload, such as a growing mission, changes in state-of-the-art healthcare, partnerships with the community, changes in population, and evolving legislative mandates," Christina Mandreucci, the VA's press secretary, said in a statement.
The press office added that the VA is working to refine the MISSION Act personnel transparency reports, which include reporting vacancies, so they provide a clear picture of the department's staffing requirements.
The VA's vacancies have caught the attention of the House Committee on Veterans' Affairs, led by Rep. Mark Takano, D-Calif.
"These vacancies pose a significant challenge to meeting the standards of high quality care for our nation's veterans," Takano said, adding that the physician shortage extends well beyond the VA, with a projected 121,000 needed nationwide over the next few years.
"We have a huge opportunity here to train not only physicians and specialists, but nurses, health-care technicians and the array of professionals that we need to make sure that medical hospitals both within the VA system and the nation at large are adequately staffed," Takano said.
That's where Caragher, the Harvard medical student, is hopeful that his medical training, along with the potential impacts of the VET HP Act, will help to prepare the next wave of caregivers for our nation's veterans.
"It's really important to me that I'm not walking into the room unprepared to give of myself to people who have given so much for our country," he said.