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Change in the Department of Veterans Affairs: What should be done?

From the Neurology Service (Field Based), Department of Veterans Affairs and Departments of Neurology and Laboratory Medicine, Yale University School of Medicine.

Address correspondence and reprint requests to Dr. J. Booss, Director of Neurology Service (200), V.A. Connecticut Healthcare System, West Haven, CT 06516.

Health care in the Department of Veterans Affairs is undergoing the most dramatic change since the era following World War II. The Congress has supported the Undersecretary for Health in his guidance of this change. Traditional hospital-based, specialty-focused care has given way to outpatient and primary care focused health care. Administrative authority has been shifted to 22 Veterans Integrated Service Networks (VISNs). Research goals are being reoriented, and neurology resident allocation is being reduced. VA neurologists and neurology chairs must organize strong service lines in their own VA facilities and in their networks to provide care for veterans with neurologic diseases. VA neurologists must also emphasize their role in principal care and increase their involvement in outcomes research.

The opinions and recommendations contained in the present report are those of the author and do not represent the official policy of the Department of Veterans Affairs.

Received March 24, 1997. Accepted in final form April 21, 1997.

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