Derms Give Back: Caring for Veterans

Dermatologists care for the nation’s veterans 365 days a year.

Caring for veterans inspires dermatologists like Joshua E. Lane, MD every single day.

Dr. Lane practices in Columbus, GA, near Fort Benning, a large military base, and many of his patients are veterans. He was so moved by their service and selflessness that he joined the United States Air Force at the age of 44 and now serves as a Lieutenant Colonel with the Georgia Air National Guard in addition to his "day job" as a dermatologist and Mohs micrographic surgeon.

Never Forget

“It’s hard not to be amazed by these people,” he tells DermWire. “We have the freedoms that we have today because of our veterans.”

Dr. Lane routinely treats vets from World War II, the Vietnam War, and Operation Iraqi Freedom, and their skincare needs differ based on where and when they served.

“World War II vets have a lot of skin cancer because of their age and the fact that their generation didn’t take steps to prevent skin cancer,” he says. Veterans who served under Iraq and Afghanistan’s desert sun also have an increased risk of skin cancer. 

“We see a lot of rashes, too,” he says. Other vets have burns and wounds that require specialty care with lasers to promote healing.

Lane’s current focus is on getting more military personnel to use sunscreen. “I’m talking to military dermatologists across the world on how to better promote sunscreen use.”

Caring for Vets

Veterans can receive care through the Veterans Health Administration, an agency under the Department of Veterans Affairs (VA) that is the United States’ largest integrated health care delivery system. The VHA serves more than 9 million veterans at nearly 1,300 health care facilities. 

Congress passed the Veterans Access, Choice, and Accountability Act in 2014 to address wait times and quality of care at some VA facilities by expanding non-VA treatment options for eligible veterans. In 2018, the VA MISSION Act of 2018 established a new Veterans Community Care Program, which makes it even easier for veterans to receive such community care if:

• A veteran needs a service not available at any VA medical facility.
• A veteran lives in a US state or territory without a full-service VA medical facility. 
• A veteran qualifies under the “grandfather” provision related to distance eligibility under the older Veterans Choice Program.
• Drive time and/or appointment wait time to a specific VA medical facility is too long.
• The Veteran and the referring clinician agree it is in the best medical interest of the veteran to receive community care based on defined factors.
• The VA has determined that a VA medical service line is not providing care in a manner that complies with VA’s standards for quality based on specific conditions.

What’s more, the VA MISSION act strengthens VA’s ability to recruit and retain clinicians, authorizes “Anywhere to Anywhere” telehealth across state lines, and establishes a new urgent care benefit that eligible Veterans can access through VA’s network of urgent care providers in the community.

 “There are still a lot more patients than dermatologists available for veterans,” Lane says. “Active-duty military members are pretty well cared for, the gaps are among the retired veterans, and there is not enough staff to see these people.”

To better care for our nation’s heroes, communication between private practices and VA hospitals needs to be optimized so this care is more seamless and easier to access, he says.

“Patients across the country struggle to access to dermatologic services,” agrees Brian B. Adams, MD, MPH, a professor and the Drs. Mutasim, Gloster, Jr. &  Claassen Endowed Chair of Dermatology at the University of Cincinnati College of Medicine and the chief of dermatology, VAMC-Cincinnati in OH.

“Many providers are closed to new patients and wait times are often measured in many months, but if you are a veteran, you will get in for your skin ailment sooner than almost any other office or health care system in the area,” he says.