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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