SAN FRANCISCO — Already pilloried for long wait times for medical appointments, the beleaguered Department of Veterans Affairs has fallen short of another commitment: to attend to the needs of the rising ranks of female veterans returning from Iraq and Afghanistan, many of them of child-bearing age.
Even the head of the VA's office of women's health acknowledges that persistent shortcomings remain in caring for the 390,000 female vets seen last year at its hospitals and clinics — despite an investment of more than $1.3 billion since 2008, including the training of hundreds of medical professionals in the fundamentals of treating the female body.
According to an Associated Press review of VA internal documents, inspector general reports and interviews:
■ Nationwide, nearly one in four VA hospitals does not have a fulltime gynecologist on staff. And about 140 of the 920 community-based clinics serving veterans in rural areas do not have a designated women's health provider, despite the goal that every clinic would have one.
■ When community-based clinics refer veterans to a nearby university or other private medical facility to be screened for breast cancer, more than half the time their mammogram results are not provided to patients within two weeks, as required under VA policy.
■ Female veterans have been placed on the VA's Electronic Wait List at a higher rate than male veterans. All new patients who cannot be schedule for an appointment in 90 days or less are placed on that wait list.
■ And according to a VA presentation last year, female veterans of child-bearing age were far more likely to be given medications that can cause birth defects than were women being treated through a private HMO.
"Are there problems? Yes," said Dr. Patricia Hayes, the VA's chief consultant for women's health in an AP interview. "The good news for our health care system is that as the number of women increases dramatically, we are going to continue to be able to adjust to these circumstances quickly."