Tuesday, June 10, 2014

EXCLUSIVE: VA Hospitals Make Hispanic Veterans Wait Longer For Treatment, Says Former VA Doctor

Dr. Steven Coughlin
Dr. Steven Coughlin, the former Department of Veterans Affairs epidemiologist who in 2013 blew the whistle on VA's Office of Public Health for what he described as serious ethical problems with the agency's Gulf War research and more, today accused the department's hospitals of discriminating against Hispanic veterans.

In an email to The Reno Dispatch, Coughlin said that in his review of VA's access audit of medical facilities nationwide conducted May 12, 2014 through June 3, 2014, he discovered that VA healthcare facilities located in cities with sizable Hispanic populations are less likely to have scheduled patient visits within 30 days.

Veterans seeking care at a VA healthcare facility in a city with an Hispanic population of more than 25 percent "are over twice as likely to experience delays in receiving a doctor or clinic appointment," Coughlin told The Reno Dispatch today in an email.

"This violates American concepts of fairness and equality and compounds the injustice of what is clearly already an unacceptable situation," Coughlin wrote. "There may also be ramifications for the possible US Justice Department investigation of VA officials as this can be viewed as a civil rights issue. Thank you for covering this story. What academics normally do is write an article or letter to the editor and submit it to a journal and the publication appears in print in several months to a year or longer. This seems like something that needs to be addressed now."

In a letter sent today to Rep. Jeff Miller (R-FL), who chairs the House Veterans Affairs Committee, and Rep. Mike Coffman (R-CO), Coughlin wrote, "The apparent association with Hispanic ethnicity compounds the injustice of what is clearly already an unjust situation: Veterans experiencing lengthy delays in receiving VA healthcare services, or being placed on secret patient waiting lists. Hispanic patients may be less likely to receive timely referral for healthcare services because of a lack of culturally competent healthcare, because of bias, or because of institutional barriers to their receiving timely, quality healthcare services."

Coughlin, now a director at the Research Center on Health Disparities, Equity, and the Exposome at the University of Tennessee College of Medicine, said VA healthcare facilities located in cities with an Hispanic population of more than 25 percent, according to US Census data, include:

Providence, RI; Bronx, NY; Wilmington, DE; Durham, NC; Miami, FL; San Juan, PR; Orlando, FL; Chicago, IL; Houston, TX; Dallas, TX; San Antonio, TX; Texas Valley Coastal Bend Health Care System (HCS) (Harlington, TX); New Mexico HCS (Albuquerque, NM); Amarillo, TX; Big Spring, TX; Phoenix, AZ; Southern Arizona HCS (Tucson, AZ); El Paso, TX; Denver, CO; Fresno, CA; Las Vegas, NV; Long Beach, CA; San Diego, CA; and Greater Los Angeles HCS (Los Angeles, CA).

Coughlin noted in his letter to members of Congress that in the post-9/11 era, a higher percentage of Hispanics and African-Americans have served in the military as compared to their percentages in the general US population. 

"Minorities are more likely to enlist," he wrote. "Phoenix (which is 40.8% Hispanic according to the 2010 US Census) was ground zero in the scandal involving bogus patient waiting lists and deaths among Veterans seeking care who were placed on those waiting lists. I have not seen anything in VA statements or media reports suggesting that VA healthcare facilities in cities with sizable minority populations are more likely to have long waiting lists or, worse yet, to have had bogus/secret lists, but there have been media reports about problems at VA facilities in New Mexico, Texas, California, Florida, and, of course, Arizona."

Coughlin, who resigned from VA in 2012, told reporters and members of Congress last year that VA withheld research that showed a link between nerve gas and Gulf War Illness and failed to offer care to veterans who identified themselves as suicidal. Several of his charges were substantiated by the department earlier this year.

The VA could not be reached for comment this afternoon.


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