Interview with Angela Weir, RN, Director of Medical Services

What does the Medical Services team do and what impact have they had on the VA?

One of the primary responsibilities of Medical Services is that we assure the quality of care and accessibility of healthcare services to Veterans with spinal cord injury and disease (SCI/D). Primarily the way we do that is we get involved with different committees, but we also conduct site visits to the 25 SCI/D hubs across the country. In normal times, we go into the center and we spend anywhere from 2-3 days meeting with staff. We have a series of questions that we ask, like how they’re getting work done in accordance with the VHA Directive and talk about how SCI/D care should be provided within the VA. Basically, we build relationships and we collaborate with these centers so we can help them find solutions to their problems. For instance, we provide best practices among the SCI/D centers, so if one center is doing something really well, we put them in contact with other centers who could benefit so those centers can also achieve those best practices.

What’s your role on the Medical Services team?

As the Director of Medical Services, I meet with my team, which is made up of two Associate Directors, and we decide who will be taking the lead on which centers and what VA committees they will be representing PVA’s Medical Services team on. For instance, [Associate Director] Juliet Pierce brings an expertise on multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS), so she represents Medical Services on anything having to do with that. [Associate Director] Richard Carson is a C5-C6 quadriplegic himself and a PVA member, so he works on committees involving peer mentoring. The Medical Services team is working on developing the VA’s Peer Mentoring Program and running in all of our centers, although right now unfortunately, this has been inhibited by the COVID-19 pandemic. I also help with the assignments and, along with my team members, write health-related things for PN Magazine and different PVA newsletters. Juliet has been involved with some podcasts trying to get the word out.

What makes the Medical Services a unique offering in the VSO space?

PVA is the only VSO that has physicians and nurses on staff and we bring our knowledge and our expertise on what makes an effective SCI center and what the needs are. The Medical Services team is trained and we all have backgrounds in treating patients with SCI/D.

We are able to bring that expertise and clinical knowledge so that the organization can really advocate for Veterans with SCI/D. The Medical Services team works directly with Government Relations to inform them on how they can best tell a story to Capitol Hill, and we gather the information for them like how many women in the VA have MS. We’re able to work with them, so they can speak in a clinical manner when it’s important to their advocacy work. They work with us when we go to our site surveys and we identify needs in the VA that are there on a national level rather than just at an individual site that can be addressed with policy. Having clinical people be able to go in site, whether it’s in person or virtually, to really learn where sites are excelling and where they’re lacking is very important in helping us determine where the needs are and how we can best help them. It’s a capability unique to PVA.

What’s something that has been rewarding about your job? Would you mind sharing a moment where you saw the impact of your work?

We’re able to see the impact of our work on a regular basis. Once we do a site visit, we write a report and the report goes to the Inspector General and it goes all the way up to the Secretary of the VA and Undersecretary. It’s reviewed by all of the VA leadership. We write what issues are at the various sites and then our recommendations for fixing them. When the secretary reviews our report, they will either concur or nonconcur with the recommendations in our report. Our goal is to have none or very few nonconcurs. We get to come back to our sites on a regular basis and they’ll say, “Because of your recommendations last year, this change was enacted and we were able to implement this”. So our reviews have been really effective at getting changes at the sites and we’re fortunate that we get to see it and hear about it.

For instance, some centers were really struggling with their telehealth implementations and they were really struggling to get it up and running right, so we were able to say, “Oh you know who’s doing this really well? Cleveland”. I sent someone there an email asking if they would be able to talk to those centers and help them through their struggles. Without it even having to be listed as an issue in the report, they were able to solve the problem on their own outside of the report.

We know our work really does benefit the members of PVA ultimately. Every time we shut the lights out at the end of the day, we know we’ve made a difference to Veterans who get their care at various SCI centers and we can see that difference.