Academy Seeks Change in VA Policies

Veterans Health Administration policies about communication processes and prescriptions pose problems for veterans and their community-based family physicians, said the Academy in three recent letters.

AAFP Board Chair Mary Frank, M.D., of Mill Valley, Calif., wrote a letter to Secretary James Nicholson of the Department of Veterans Affairs seeking changes in the policies. She also wrote the heads of the American Legion and Veterans of Foreign Wars to rally support for the changes.

Communication Gap

According to Frank, a VHA directive requires providers to communicate the rationale for medication changes or refusal of medications to veterans, but it does not require communication about these issues with the veteran's community physician. "Our members have repeatedly expressed their frustration that as patients move within and out of the VA (Veterans Affairs) Clinic System, there is little, if any, communication from the VA health system and its physicians to community physicians who care for those patients," wrote Frank.

Such communication would result in better continuity of care for the patient, Frank said. She called for amending the directive "to encourage, if not require, VA physicians in such situations to communicate with the community physician as well as the veteran."

Prescription Block

Frank also identified a problem with prescriptions for veterans. In most situations, a VA pharmacy may fill a prescription written only by a VA physician, and a veteran with a prescription from a community physician needs to have a VA physician rewrite the prescription so the VA pharmacy will honor it, said Frank. "This is an unnecessary hassle for the veteran and a waste of resources in the health care system."

The Department of Defense allows military facility pharmacies to fill prescriptions from civilian physicians as long as the medicines are on the formulary and within amounts authorized for the facility, said Frank. "We believe it would be reasonable for the VA to have a policy similar to that of the Department of Defense, and we are working with key members of Congress to change the law in this regard." She sought the agencies' support for such a change.

Invitation to Meet

In the letters, Frank asked for representatives of the Department of Veterans Affairs, American Legion and Veterans of Foreign Wars to meet with AAFP representatives to explore these issues and discuss solutions that would benefit veterans and community physicians.