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Tracy Gaudet, MD, director of the VA’s Office of
Patient-Centered Care and Cultural Transformation, has been inspired to change
her approach to medicine as well as transform care at the Veteran Affairs
Medical Clinics. Gaudet is in charge of the effort to establish the VA’s focus
on allowing veterans, whether ill or well, to enhance their health and thoroughly
achieve their overall well-being goals.
“Healthcare in the U.S. and the VA has operated on a ‘find
it, fix it’ reactive disease model,” Gaudet said in a recent interview. “What
we’re undertaking is truly a paradigm shift that promotes health and wellness.”
As compared to initiating with a patient’s suggested
complication or attempting to identify a condition early in its development,
Tracy Gaudet believes healthcare providers should begin by understanding the
veteran and their ambitions. She explains that medical staff at the VA shouldn’t
be asking, “what’s the matter?”, rather, they should be asking, “what matters
to you?”. The goal of complete health at the VA is to assist all veterans in
order to determine their basic health achievement goals and desires and to also
help them focus on all the areas of their lives that affect their health and
don’t allow them to reach those goals.
“It’s not just a ‘feel good’ program,” Gaudet noted, “but an
approach informed by evidence that makes use of all appropriate therapeutic
approaches as well as emphasizing self-care at all points along the spectrum of
health and disease.”
This approach often takes veterans out of the clinic. The
nine-week, peer-to-peer program emphasizes on guiding veterans through various
questions to encourage them to discuss why they want to be healthy, what they
want to accomplish and the kinds of relationships they want to have. According
to Tracy Gaudet, the results have been astounding. Many veterans have found
meaning and purpose in their lives again and connected to healthier lifestyles
through these new programs being available at Veterans Affairs clinics. Veterans
can then follow through with other available programs to help them reduce
stress like meditation or they can increase their overall fitness levels.
Additionally, as their health improves, the cost of caring for them drops. The
complete health approach encourages veterans to make continuous changes in
their health and life which may involve working on their closest relationships.
The Office of Patient-Centered Care and Cultural
Transformation (OPCC&CT) is directed to classify these innovative programs
throughout the VA and determine whether they can be implemented across the entire
system and facilitate their performance. It will also implement new programs on
a national basis.
Despite the operational and infrastructure challenges, the
VA has already established a majority of the fundamentals for the
transformation of care at the heart of the integrated, whole health approach.
Five existing facilities in Los Angeles, Dallas, Washington,
Birmingham, AL, and East Orange, NJ, have become Centers of Innovation,
combined with primary care and mental health services as well as alternative
programs, such as yoga, meditation, Qigong and Tai Chi. These centers have
already received a wide range of programs to address whole health. For example,
a Mindfulness Based Stress Reduction program found on the VA Greater Los
Angeles Healthcare System has assisted veterans to overcome pain and substance
abuse. The East Orange New Jersey Healthcare System has introduced a
demonstration kitchen and an outdoor program to support healthier eating and
engagement with nature, while the Washington center is bringing in virtual
online integrative health services and information.
The local El Paso Veterans Affairs Healthcare System also
has a variety of similar programs available for veterans and active duty
military members alike. As a part of the veteran’s Medical Benefits Package,
chiropractic services are now being required as an alternative treatment method
to relieve musculoskeletal injuries and conditions. Chiropractic care focuses
on restoring an individuals natural state of well being through the use of
spinal adjustments and manual manipulations to gradually rehabilitate patients
and improve their body’s optimal health. A chiropractor can carefully diagnose
the underlying cause of an individual’s symptoms and follow through with the
proper treatment to strengthen and improve the mobility of the joints by
aligning the spine and stretching the structures surrounding the spinal bones. Along
with a basic set of exercises, chiropractic treatment can ultimately improve
the overall health and wellness of many veterans as well as help them achieve
their desired physical and mental goals.
By Dr. Alex Jimenez
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