VA Hospitals Run by Military Officers, ‘Exit Oaths’ Among Bills Proposed by Florida Congressman

July 28, 2021Hannah Ray Lambert
medical centers

A veteran checks out at the front desk of a prosthetic clinic in Las Vegas, April 19, 2018. US Air Force photo by Airman 1st Class Andrew D. Sarver.

A US congressman from Florida wants active-duty military members to run Department of Veterans Affairs medical centers in a pilot program, asserting they would likely provide better, more efficient care.

Republican Rep. Brian Mast, a veteran of the war in Afghanistan and a double amputee, introduced three bills on July 14 that addressed veterans’ issues, including directing the VA and Defense Department to consider creating a pilot program in which senior military officers would direct VA hospitals.

“Hardly a day goes by when I don’t hear from a veteran who needs help cutting through the red tape at the VA,” Mast wrote in a statement announcing the bills. “The bureaucracy is often incredibly difficult to navigate, which leads to delays in care, and that is unacceptable.” 

In a press conference, Mast said VA medical centers often struggled with vacancies in leadership that could be resolved by assigning officers to serve as directors for set periods. He pointed to his own positive experience recovering at Walter Reed National Military Medical Center, a facility run jointly by civilians and active-duty military personnel, after an improvised explosive device blast.

Brian Mast press conference
Veterans flank US Rep. Brian Mast during a press conference, July 14, 2021, in which he announced three bills addressing veterans’ issues. Screenshot via YouTube.

Marine veteran Brent Barkett is a consultant who helps insurance companies and health systems employ strategies to improve patient outcomes. Military personnel have the leadership qualities to run VA hospitals effectively, he told Coffee or Die Magazine.

“They will be guided on a mission, and there will be metrics that they have to meet,” Barkett said.

Representation matters, too, and that’s clearest at the patient-provider level, Barkett said. Studies have shown that quality of care is impacted when civilian mental health providers lack the knowledge and cultural competency to treat military members and veterans. Putting military leaders in charge of overall operations at VA hospitals could be critical to cutting through bureaucracy and getting results, Barkett said.

“If you don’t have somebody who represents who you are in that leadership position, there’s no empathy,” Barkett said. 

medical centers
Brent Barkett, left, keeps this picture of his platoon mates at Al Taqaddum Air Base in 2005 on his desk at all times. Barkett is finishing his doctor of public health program at Johns Hopkins and wants to focus his efforts on helping other veterans. Photo courtesy of Brent Barkett.

A second piece of legislation would allow members of Congress to open satellite offices within VA medical centers to meet with constituents. Mast and several other lawmakers previously opened small offices in VA hospitals around 2018 with the goal of being more accessible to constituents and giving veterans a “one-stop-shop to address any issues they may be having.”

The VA evicted them in 2019, arguing the department needed the offices for clinical space, according to NPR. Mast, however, believes it was personal.

“They don’t want to have that day-to-day oversight, of lighting a fire under their butt, and that’s exactly why it needs to exist,” Mast said.

Currently, the West Palm Beach VA is working to allow him to reopen his satellite office in the medical center, the congressman said, but he wants to make it easier for other lawmakers going forward.

Mast introduced a similar bill in 2019 with broad bipartisan support, but it never advanced. Barkett sees the bill as good public relations but doubts it would improve VA operations.

“The optics of it look good, but the feasibility of it to effect change is not there,” Barkett said. “How are [lawmakers] spending their time there? And are they qualified to audit the VA?”

medical centers
A man walks in front of the Department of Veterans Affairs headquarters building in Washington, DC, May 28, 2020. US Air Force photo by Master Sgt. Stephen J. Caruso.

Mast’s third bill would ask military members separating from service to take an Oath of Exit not to harm themselves and to support their fellow veterans. As with the first satellite-office bill, Mast unsuccessfully pursued an Oath of Exit bill in 2017.

The usefulness of such oaths is hotly debated. Barkett said he didn’t know of any studies that have formally tracked outcomes in veteran populations.

“Anecdotally, it works some of the time, and it depends on what population you use it with,” he said.

A study from the Journal of Affective Disorders published around the same time Mast introduced his bill found crisis-response planning — providing individuals with checklists to follow during times of intense distress — was more effective than no-suicide contracts among high-risk active-duty soldiers. The VA does not recommend such contracts.

Read Next: New System Allows Vets To See Patient Satisfaction Ratings for VA Hospitals

Hannah Ray Lambert
Hannah Ray Lambert

Hannah Ray Lambert is a former staff writer for Coffee or Die who previously covered everything from murder trials to high school trap shooting teams. She spent several months getting tear gassed during the 2020-2021 civil unrest in Portland, Oregon. When she’s not working, Hannah enjoys hiking, reading, and talking about authors and books on her podcast Between Lewis and Lovecraft.

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