Veteran: 'Buildings don’t give patient care, people give patient care'

Billings Gazette

by Cindy Uken

In less than six weeks, the $6.3 million Majestic Lane Clinic on Billings’ West End is scheduled to open to veterans.

The center will offer an array of specialty services, although some veterans are concerned it may not be properly staffed. Without adequate medical personnel, some veterans say the 70,000-square-foot facility will be a clinic in name only.

“Buildings don’t give patient care, people give patient care,” said Ed Saunders, adjutant of Billings Chapter 10 of Disabled American Veterans.

The potential for a woefully understaffed clinic is so grave that U.S. Sen. Jon Tester, D-Mont., fired off a blistering letter to VA Secretary Eric Shinseki this week taking issue with some of the VA’s employment policies, which hinders hiring, and the wages it pays nurses.

And Tester expressed his concern that the new clinic, which is adjacent to the Spring Creek Lane Clinic, will not be fully staffed. He said the new clinic will benefit thousands of area veterans who would otherwise have to travel to Fort Harrison near Helena, a 500-mile roundtrip from Billings, for surgery or other specialty treatments.

“My concern is that if the facility is not fully staffed, these benefits and services may not be fully realized,” Tester said, imploring Shinseki to ensure the clinic is “appropriately staffed.”

Tester, the state’s only member of the Senate Veterans Affairs Committee, told The Billings Gazette he knows it can be difficult to recruit medical professionals to Montana. But, he said, “I will keep pushing the VA to establish a plan to fill these new positions.”

Tester lobbied vigorously for the expansion.

Ground was broken in October 2012 on the Majestic Lane Clinic, which triples the size of the existing clinic. Once opened, it is expected to serve an estimated 12,000 veterans from Montana, Wyoming and North Dakota, about 2,000 more than are currently served.

It is designed to offer many of the services now available at Fort Harrison, Montana’s only VA hospital. Services expected to be offered are audiology, mental health, outpatient surgery, dental, physical, occupational therapy, speech therapy and eye care.

Thirty positions have been filled; VA Montana is still recruiting and hiring for about 20 more. Some of the positions filled are administrative, dentist, dental assistant, audiologist, RNs, associate chief of surgery, orthopedic surgeon, ophthalmologist and podiatrist.

Recruitment was underway for a social worker and Licensed Professional Mental Health Counselor. The application period has closed; the status of each is pending.

The clinic is still short an ophthalmologist, urologist, medical technologist, physical therapist and speech language pathologist and others.

Some of the first patients are expected to be those seeking behavioral health services. That is expected to pose few problems. There is one psychiatrist on staff and tele-health provides access to seven additional psychiatrists. Also on staff are an advanced nurse practitioner, substance use disorders specialist, psychologist, four psychotherapists and other behavioral health professionals.

A suicide prevention coordinator has just been hired at Fort Harrison and will cover the state. Plans call for a similar position in Billings in the near future.

Veterans have long expressed concern about staffing at the new facility, but never as vocally as they are now. Their concerns follow a nearly 90-minute tour that a delegation of Disabled American Veterans took last week. Their pointed questions about staffing and leadership failed to illicit the responses they hoped for.

They are specifically concerned that no single person has been identified as the one in charge. Duties have been doled out to at least three people locally, including a physician, a nurse and a health system specialist. Ultimately, the VA director in Helena is in charge.

“This doesn’t pass the common-sense test,” said Saunders, who also serves as public information officer for DAV Montana.

Veterans are also concerned about the lack of physical therapists, gynecologists and obstetricians, orthopedic specialists and geriatric specialists. The clinic has historically lacked obstetrics and gynecological capability, they said.

Women make up about 7 percent of the patient population at the existing facility. Last year, that translated into nearly 850 women. The number of female veterans receiving care at the clinic has increased nearly 7 percent over the past five years.

Christine Gregory, director of the VA Montana, is optimistic the positions will be filled. She has a team of people committed solely to recruitment. She is also banking on the partnerships VA Montana has with St. Vincent Healthcare and Billings Clinic to help provide necessary services.

To further help bridge the gap between the supply of medical professionals and the demand for services, Gregory said Project ARCH, or Access Received Closer to Home, a three-year pilot project launched in August 2011 that allows eligible veterans to receive care through a non-VA health care provider.

Based on personal experience with the VA system and “candid conversations” with VA medical staff, Saunders said, “I just can’t shake this hollow feeling I have that the Billings VA Clinic will have empty clinic space for many months to come. I remain cautiously optimistic.”