Fast-Growing Population of Women Veterans Look
More Toward Health Care Outside of VA System
By Andrea Johnson and Taylor Klusman
Springdale resident Heather French, who served 13 years in the Air Force, worked in a position of authority. She knew she needed medical attention for her back pain and mental health problems, but she sought care in secret to avoid being perceived as weak.
“You get labeled, either as someone who is whining or can’t handle it,” Heather French said. “And as a woman, you can’t do that – period. You can’t be weak in any way shape or form.”
Air Force veteran Heather French stands with her husband Bob, who also served in the Air Force, outside their home in Springdale Dec. 10. Both use VA medical services within the Fayetteville-based system. Photo by Andrea Johnson
Bob French, her husband who also served in the Air Force, acknowledged the stigma.
“She had to be twice as tough as me,” he said.
On the medical side of the military Heather French said that she thinks military doctors tend to be dismissive of health problems among active duty service members. After leaving the military, she sought care at VA medical centers and eventually received specific diagnoses, she said.
The number of women veterans seeking health care through the Department of Veterans Affairs nearly doubled between 2005 and 2015; approximately 83 percent of them nationwide still access health care outside of the system, according to VA reports.
Reasons for seeking outside care include difficulty in the VA system with processing previous military medical records, verifying service eligibility and few open appointment slots without a lengthy wait time.
“That’s really unfortunate because they have benefits that they have earned through their military service,” said Mark Worley, chief of staff for the Veterans Health Care System of the Ozarks in Fayetteville.
In 2015, 22.4 percent of women veterans used VA health services nationwide, compared to 13.1 percent in 2005, according to the 2015 Women Veterans Final Report released earlier this year.
In the Fayetteville-based system, 3,265 women veterans used VA health services between Oct. 1, 2016 and Sept. 30, 2017 – a 16.6 percent increase since Oct. 1, 2013, according to Fayetteville VA data.
Women comprise the fastest-growing population in the military. In 2015, women made up 9.4 percent of the total veteran population in the U.S.
They are projected to make up 16.3 percent of all living veterans by 2043, according to the VA report. In 2016, Arkansas was home to 21,361 women veterans, according to a VA fact sheet. Nationwide, the number of women using VA health care has doubled since 2000. Barbara Bilton, women’s health coordinator at the Fayetteville VA hospital, has seen this growth in Fayetteville. “The women veterans program manager before me only had about 1,500, so it’s doubled very, very quickly,” Bilton said.
The women’s health coordinator is responsible for advocating on behalf of veteran patients and ensuring that they are aware of all the care available – within and outside of the VA system. “We partner with any doctor’s office in the area who would like to provide service to our veterans, and they will then go out into the community, after they get it approved by us, and get that care,” Bilton said.
Barbara Bilton, women’s health coordinator for the Veterans Health Care System of the Ozarks in Fayetteville, explains her role in helping women veterans determine how to get the care they need Nov. 16. Photo By Andrea Johnson
Heather French said before visiting the VA medical center in Fayetteville, she did not know her problems were the result of post-traumatic stress disorder and her back pain the result of scoliosis, an abnormal spine curvature. When she left the military, the care provider she saw at a VA medical center in El Paso, Texas, made her think her concerns were merely complaints, she said. But her PTSD was debilitating.
French would go grocery shopping at 3 a.m. to avoid crowds. Anxiety plagued her anytime she found herself in a crowd, and sometimes panic attacks followed. “Panic attacks are not a joke. I would freak out in Walmart, and that’s silly,” she said.
She experienced paranoia, where she always thought someone was waiting to attack her. A friend encouraged her to visit the VA hospital in Fayetteville where she received the official diagnosis of PTSD, she said. For the first time, someone explained her PTSD symptom of hypervigilance, a state of high alert and increased sensitivity to one’s surroundings. “It was a legitimate thing that I needed to deal with, and with their help, it was great,” she said.
Almost 12 percent of women veterans struggled with PTSD in 2015, according to the VA report from that year. PTSD, major depressive disorder, migraines and lower back pain also show up most often as service-related disabilities.
Army veteran Katie Rose Martin has not received a mental health diagnosis but has experienced back pain and migraines. She eventually sought care for her back from a military doctor, but she waited too long, fearing the stigma attached to admitting injury, she said.
Her pain was compounded, Martin said, adding “had I gone to see the doctor, I would probably still be in the Army.”
Army Veteran Katie Rose Martin sits in the University of Arkansas School of Law Nov. 10 where she attends classes. Martin receives free health services, except dental care, through the Department of Veterans Affairs because of her 70 percent disability rating. Photo by Andrea Johnson
She was medically discharged from service. Martin receives free medical services through the VA, except for dental care, because of her 70 percent disability rating, so she does not get health care elsewhere, she said.
“I’m not going to pay for something if I can get it for free,” Martin said.
But it makes sense that veterans seek health care outside of the VA system, she said. As a busy second-year University of Arkansas law student, her schedule often makes it difficult to schedule appointments with the VA. If not for the cost, she would make appointments at civilian medical centers that have more available time.
Compared to the VA medical centers she visited in Princeton, West Virginia, and Roanoke, Virginia, Fayetteville’s proves the best, Martin said. The Beckley VA Medical Center in Princeton did not have an OB-GYN, so patients must accept referrals to see an OB-GYN at a civilian clinic.
The Fayetteville VA employs one OB-GYN, who is male, in its women’s clinic. Martin appreciates the women’s clinic because she can take care of all her primary care needs in one place geared toward women’s needs, she said.
For all other women’s health needs, VA employees refer patients to the all-female Pink Team, which, among other tasks, can investigate sexual trauma. One in four women who use VA health care experienced military sexual trauma, according to reports to the VA. For this reason a section of the Fayetteville VA hospital has a women’s clinic with its own waiting room. Women who are uncomfortable seeing the male OB-GYN there may be referred outside of the VA system, Bilton said.
“It’s very uncomfortable when you think about a gender-specific exam after you’ve had some sort of military sexual trauma,” Bilton said. “You want that serenity. You want that quietness and being served by just women, so we provide that for them.”
VA Pushes Outreach to Help Vets
By Andrea Johnson and Taylor Klusman
The Razorback Reporter
At the Fayetteville VA hospital and elsewhere, getting the word out to veterans about the range of health care services is a major priority.
“When they get out of the military they’re just ready to go,” said Barbara Leseberg, Transition and Care Management program manager for the Fayetteville VA. The last thing a service member will want to do is listen about health care services. “They don’t want to hear what their commanders are saying – ‘Hey you’re eligible for this.’ They just want to get out, so they tune them out,” Leseberg said.
An increase in outreach specifically targeting women veterans could attract more patients, said Barbara Bilton, women’s health coordinator at the Fayetteville VA hospital.
VA employees focused on outreach often attempt to get the word out by driving to several towns and asking around for recently discharged military personnel, Leseberg said.
“We’ll go to national guard units, we’ll go to American Legions – any place where we think we can get our name out there. And we’ll leave our cards everywhere,” Leseberg said. “We brought in 476 new veterans at the end of this fiscal year, so that’s pretty huge.”
This method has succeeded in many cases, though it alone cannot be relied on to locate all of the women veterans not utilizing the VA, especially because many do not immediately identify themselves as veterans, according to the VA.
“It was tougher being a woman. The old saying is, ‘you have to work twice as hard as a man to be a woman marine,’” said Kathy Jeffrey, public relations chairwoman of the Arkansas State American Legion.
Many women wait to be asked if they served and in what branch, instead of saying it outright, Bilton said.
VA outreach extends to all veterans rather than focusing on women or men, but some efforts are aimed at increasing the number of female veterans. For example, VA employees organized a baby shower for veterans or veterans’ spouses at the Fayetteville VA hospital Nov. 16. At that time, 50 pregnant women resided in the Fayetteville service area, Bilton said.
Part of the attraction for VA patients is the knowledge that every caretaker is aware of their veteran status and can assist accordingly.
“We’re getting a lot of female veterans now. That’s a big focus is women’s health and more women are starting to come to the VA,” Leseberg said.
This outreach program is news to some female veterans. Army veteran Katie Rose Martin said she was not aware of outreach efforts geared toward women nor of the women’s health coordinator. Air Force veteran Heather French goes to Mercy or other civilian clinics but she also doesn’t notice outreach efforts, such as a care provider informing her of VA service eligibility, she said. She had a mammogram screening at Mercy because it was a familiar location, she said, and she didn’t think to look into VA mammogram screenings.
Bilton said veterans should double check with the VA to see if their medical procedures would be covered. “Everyone in the community takes our patients,” Bilton said.