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dialogue

18

MAY / JUN 2015

I 

Healthcare Journal of new orleans  

‘‘

Q

Will there be any services that you might

not be able to handle ormight still be sent out?

A

The way the VA network of hospitals

works is that not all the hospitals are the

same. There are different levels of services,

groups of programs that we provide. They

are designed that way because if you dupli-

cate everything at every hospital it’s very

expensive. It’s one of the reasons that we

are efficient. So our network of hospitals

performs a lot like an ACO and we are able

to refer across hospitals and across clinics.

The goal is to be able to provide everything.

Do we need a transplant center at every

hospital? No. Do we need to do open heart

surgery at every hospital? No. But within a

geographic region the VAwill do just about

everything.

Q

Can you tell us a little about the work the

VA is doing with homeless veterans in New

Orleans?

A

The homeless program and what the VA

has been able to accomplish is, I think, one

of the most remarkable things in recent

American healthcare or even world health-

care. Part of understanding homelessness is

you have to understand that at some point

this platoon sergeant who was able to lead

a group of soldiers in battle is now living out

of his car with perhaps a spouse and chil-

dren. Maybe going from homeless shelter

to homeless shelter. You have to step back

from that and say, “Okay, how many things

went wrong for that to happen?” Employ-

ment? Did they have enough education to

be competitive? Were they healthy enough

to be able to work? Housing? When you

think about just those four cornerpieces if

youwill, bringing those together to solve the

homeless problem has been something the

VAhas led the way in. Our primary charge is

to make sure that veterans stay healthy, but

we’ve coordinated with the help of Hous-

ing and Urban Development the allocation

of housing vouchers andworking with local

city and state government for housing stock.

We’ve coordinated with the Department of

Labor for employment assistance for veter-

ans. So our program really is an integrator

of a number of services at the federal level,

at the state, and the local, city level.

The brilliant story here is that local leader-

ship, particularly our mayor, has been very

engaged and really brought together com-

munity partners in an integratedway to elim-

inate homelessness among veterans in the

city of New Orleans. It is my understanding

that it’s the first city to do that. It’s not going

to be the only city. There are some big chal-

lenges across the country, but I think we’ve

found a way that we can do it whenwe work

as a team and as a community. The goal of

course is to eliminate veteran homelessness

by the end of 2015. We are not only helping

the veterans to get the housing, but to sustain

it. Our retention rate right now, a year after

being housed, is roughly 95%, which is excel-

lent.The homeless question is an important

question not just because in our country we

should not ever have a veteran or anyAmeri-

can citizen who is without housing, but cer-

tainly not a veteran. It’s important because

it’s an end result of many systems that have

broken down. If we’re able to understand

that andmake the adjustments in a good GI

Bill that provides education support when

those young men and women come back

fromactive duty, and later good employment,

at least we can address the prevention issue

and keep veterans frombecoming homeless

in the future. The trick is not to give up right

now.We havemany veterans whomay be on

the verge of becoming homeless sowe need

to be vigilant and not rest on our laurels, and

strengthen our programs.

We are now looking at expanding our

homeless program in the Baton Rouge area,

because that’s a large market for us, and

strengthening our programhere. We have a

community resource and referral center that

is sort of a one-stop shop for homeless vet-

erans and now we’re looking at a new part-

nership with a teaching kitchen, which will

teach homeless veterans how to earn a living

by learning how to cook and get a certificate

“So we have to prepare ourselves to be able to

function. The good thing is that we are part of the

largest non-profit healthcare system in the world.

So we are able to draw from this large VA network

of 152 hospitals, draw from that expertise...”

European physicians

regularly use uroscopy to

determine illness.

c. 500

For Christians, disease is still widely believed to be a result of sin or evil spirits

leading to some rather random and seldom helpful treatments. Some lay physicians

did, however, use examination, palpation, percussion, and examination of feces,

urine, and semen, as well as dream interpretation in making diagnoses.

c. 1300

The first thermometer is

invented by Galileo Galilei

1592

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