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I am writing to express my grave concerns regarding the proposed system for delivering medical care to our women veterans.

As you know, in order for women to receive adequate medical care, they need to have direct access to primary care, mental health, and gynecology care.  These disciplines are considered the three fundamental pillars for delivering quality health care to women.

The number of women veterans utilizing VA healthcare will likely double in the next few years.  Within the next 15 years, women are projected to represent 1 in every 7 enrollees versus  1 in every 16  today.  In fact, the active duty military force today is 14% female.   Most of the new women veterans entering VA care are under age 40 and  of child-bearing age, thus creating a need for a significant shift in  provision of healthcare to women veterans.

Women veterans have chronically been underserved by the VA. Women veterans have higher physical and mental health burdens that their female non-veteran counterparts and medical burdens comparable to or  worse that those of male veterans.  Even while utilizing VA services,  women have had to seek outside medical services more than have men,  especially for women's gynecological conditions.

My concern is that the Women Veterans Health Strategic Healthcare  Group (a group composed of VA administrators far removed from direct  patient care) has recently recommended that women veterans be limited  to a single primary care provider who is supposed to take care of all  her medical needs, including gender-specific gynecology care. Women in the private sector, with or without health insurance, with Tricare  coverage, even those enrolled in Medicaid welfare programs, not only  have a primary care doctor, they have direct access to an Ob/Gyn for  all their gynecological needs, from routine Pap smears to complex  gynecology interventions.  This is not fragmented care - it is the  standard of care enjoyed by women outside the VA healthcare system.   This same level of high-quality, focused, gender-specific care should  also be provided to our women veterans who have served and sacrificed  for our country.

The Women Veterans Health Strategic Healthcare Group has recommended  that specialized mental health providers by assigned and co-located  to ensure integration of adequate women's mental health care as part  of primary care.  A specialized gynecology clinician should also be assigned and co-located in the women's health clinic; otherwise,  women veterans will continue to be deprived of the comprehensive and  competent gender-specific care only a gynecology clinician can provide.

In summary, we need to let our Congressional leaders know, that just like the rest of the women in America experience, women veterans  deserve the same direct access to a dedicated Gyn provider for all  their gender-specific, female-related gynecology care.


Thanks for educating me on an issue that I rarely think about. I have certainly been aware of how women who serve in the military lack access to comprehensive care — mostly because of the military's restrictions on birth control and abortion. But I think I ignorantly assumed that veteran's issues were so disproportionately men that I assumed fighting for women's issues within that was unnecessary. So thank you for the reminder.

And I think that you have likely already done this, but certainly I would reach out to some of the congressional leaders who are notorious for fighting for women in the military — such as Dianne Feinstein. I also think this would be a great topic for an Op-Ed — perhaps you want to consider writing for your local paper. It's likely to be newsworthy precisely because it hasn't been over reported on.

Thanks for bringing it to our attention and good luck raising even more public awareness.

— Amy