Gender gap narrows

Number of female veterans getting health care increases

For a lot of years, women veterans felt unwelcome in Department of Veteran Affairs hospitals and clinics as if they weren real veterans, they complained. Reinforcing that impression was routine referrals to multiple health-care providers, in or out of VA, to get comprehensive primary care.

That is changing rapidly because of a commitment by the VA to improve women’s health services, to hire more gynecologists and other female health specialists and to close a gap in preventive health services and screenings, said Dr. Patricia Hayes, chief consultant for Women Health Services for Veterans Health Administration.

Hayes and her staff members have studies and data to show recent gains. They range from patient satisfaction surveys to numbers of staff physicians newly trained to provide for female health needs, and a new report showing a narrowing of gender disparities in preventive health care screening. In an interview, Hayes and Dr. Sally Haskell, her acting director for comprehensive women’s health, said challenges remain to reach full equality of access and services for women vets, particularly in VA community-based outpatient clinics. But the recent gains have been impressive and will continue, they say. In 2008, only 33 percent of VA health-care facilities offered comprehensive primary care to women. Today, women can get full primary care services at 90 percent of VA larger hospitals and medical centers and at almost 75 percent of its community-base outpatient clinics, Haskell said.

Four years ago, many female veterans visited VA clinics and were referred to larger hospitals, having then to travel hours to get basic primary care for things such as birth control and mammograms, Hayes said. Areas of the country where that still holds true have fallen sharply. From 2000 to 2009, the number of women veterans using VA health services almost doubled, to 293,000. During the next two years, it rose by another 44,000 to reach 337,000 by last October.

The Veterans Administration still needs to attract more female health specialists, Hayes said. But it has closed much of its previous gender gap for delivering primary care by improving capabilities of current staff members. “Since 2008, we have trained over 1,500 primary-care providers in this intensive training on comprehensive women health, Hayes said. “We designed what we call a mini-residency in women’s health, a 40-hour program, training 35 to 40 providers at a time. They learn things like birth control, abnormal bleeding but also mental health issues and PTSD in women and an overview of maternity care.

“These are folks (who) were trained in medical school or nurse practitioner school. But they have been seeing men for so long they felt rusty in their proficiency with women,” Hayes said.

Despite the gains, Hayes and Haskell said many women veterans still have misconceptions about the quality of VA health care and stay away. Many still believe, for example, that only combat vets can gain access. Yet women veterans who use VA care decide to stay with it, even if they have other health insurance. Like male veterans, females are rating VA health care as being better than care in the private sector.

Today, 17 percent of female veterans are enrolled in VA health care versus 20 percent of male veterans. But women returning from recent conflicts are using VA in much greater numbers previous generations.

“Word is getting out among women veterans that we have great care (and) a lot more systems and services in place to be comfortable using VA,” Hayes said.

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