Backlog of orthopedic surgeries at VA Hospital begins to ease with Project ARCH

Billings Gazette

by Cindy Uken

The long, agonizing wait for a new left hip is over for a 77-year-old U.S. Air Force veteran who got snared in a backlog of orthopedic surgeries at the VA Hospital in Fort Harrison.

Bob Wombolt, a Korean War veteran, underwent hip replacement surgery Wednesday at Billings Clinic.

"I waited damned near two years for this," Wombolt said. "I am glad it's getting over with."

Wombolt is one of at least 300 Montana veterans who needed orthopedic surgery and were stuck on waiting lists while the Department of Veterans Affairs Montana Health Care System recruited a full-time surgeon.

The accumulation of veterans needing orthopedic surgery started to compound in March after Dr. Peter Wendt, the only surgeon who performed hip and knee replacement surgery, left the VA Hospital. The number of veterans needing orthopedic surgery outpaced Wendt's ability to keep up and his departure only exacerbated the problem.

If they wanted orthopedic surgery, Montana veterans without private insurance had to travel out of state for care or pay for it out of their pockets. Even that wasn't a solution. Some Montana veterans were told that VA facilities in Denver and Salt Lake City were too busy to accept Montana patients.

The logjam caught the attention of U.S. Sen. Jon Tester, D-Mont., and Veterans Affairs Secretary Eric Shinseki when the pair met with vocal veterans in July. The veterans did not mince words. Tester called the situation "completely unacceptable" and implored Shinseki to provide as much assistance and guidance as possible. Shinseki vowed that getting veterans access to quality health care would be a priority.

Since then, an orthopedic surgeon has been hired and will begin work at the VA Hospital in December.

In addition, VA Montana began a three-year pilot program called Project ARCH, Access Received Closer to Home. Billings was chosen as one of five sites nationwide for the pilot project. ARCH will contract with Billings medical providers, including Billings Clinic, St. Vincent Healthcare and OrthoMontana, to provide veterans with health care closer to home.

"No veteran in need of something as life-changing as orthopedic care should have to wait years for the surgery they need," Tester said. "The VA is finally making progress and giving Montana veterans the access to the quality care they deserve. We've got more work to do to fully live up to that promise, but getting a new orthopedic physician in place in Montana is an important hurdle to clear."

ARCH has helped to chip away at the backlog of orthopedic surgeries. By the end of October, Billings Clinic will have seen as many as 23 orthopedic surgery candidates.

"Bring 'em on. We've got the time, we've got the space, we've got the docs ready to go," said Chad Miller, director of orthopedics, sports and physical medicine, rehabilitation services and rheumatology at Billings Clinic. "We pride ourselves on good access here and making sure the patients get what they need."

It's a routine surgery that many have been denied for too long, Miller said. It can make these veterans functional and improve their quality of life. "That's important to us as an organization," he said.

The physicians at Ortho Montana, who are on the medical staff of St. Vincent Healthcare, have seen at least five patients and, so far, at least two of them have had their joint replacement surgery at St. Vincent, said Tiffany Garcia, the hospital's media relations coordinator.

David Richardson, 58, a paratrooper in the U.S. Army, was in agony. The severity of his pain made it nearly impossible to work. Through a series of appointments, X-rays and MRIs at the VA Clinic in Billings and the VA Medical Center in Sheridan, Wyo., Richardson knew he would need hip replacement surgery. It would likely be at the end of 2012 — and in Sheridan.

"All I can remember is that they said I'd be on a waiting list," Richardson said. "It was at the point that if I had to wait there was no way I could do my job. I would buckle. I didn't expect to go on welfare, but I couldn't make it to next year."

Richardson earns $8.80 an hour working as a sales associate at a local discount store where he spends the bulk of his work day on his feet. He needed the job and refused to wait more than a year. He called U.S. Sen. Max Baucus' office, learned about the ARCH program and underwent hip replacement surgery at Billings Clinic on Sept. 9, just days after the ARCH program took effect.

He was spared a lengthy wait, and the inconvenience and expense of having surgery 130 miles from home.

"He made noise at the right time," said his wife, Sharon Richardson.