national institutes of health - FASEB

DEPARTMENT OF VETERANS AFFAIRS
MISSION
A fundamental responsibility of the Department of
Veterans Affairs (VA) is to ensure that the nation’s
veterans receive the highest quality of medical care. The
success of this mission is dependent on the quality and
dedication of the physicians and researchers who work
at VA centers and hospitals. Only by providing a strong
environment for medical research can the VA attract
the outstanding physicians needed to fulfill its tri-fold
obligation to provide optimal care to patients, perform
cutting-edge research and train the next generation of
clinician-scientists.
IMPORTANCE OF FUNDAMENTAL RESEARCH
TO THE CLINICAL MISSION OF THE VA
The VA research program is required to maintain a
talented physician-scientist base and stimulate the
intellectual climate necessary to provide cutting-edge
clinical care for our veteran population. Nearly 70% of
VA investigators are clinicians who treat veterans on a
daily basis; the other 30% are Ph.D. investigators who
support the VA research and patient-care efforts.
Cooperation between medical schools and VA medical
centers (VAMCs), which brings intellectual resources
and training opportunities to VAMCs, flourishes because
of the ongoing, state-of-the-art scientific research.
Outstanding quality patient care in VAMCs can be
directly correlated with the availability of VA research
funding and the close relationships with affiliated medical
schools. This creates a synergistic environment that
provides the best possible care for our veterans. VA
research has underwritten the recruitment and the
retention of talented physicians, including the hard-toattract
sub-specialists necessary to care for the
challenging and aging patient population. VA subspecialists
are frequently researchers who have chosen
to locate at VAMCs, where they have more opportunity
to engage in research that will improve patient care.
Without state-of-the-art resources to promote research,
the VA would never have been able to attract many of
its best clinicians.
ACCOMPLISHMENTS
During the past ten years, unprecedented progress has
been made in the diagnosis and treatment of most major
medical disorders. This progress is directly attributable
to advances in basic understanding of biology and has
substantially improved longevity and quality of life. The
speed with which basic science advances are translated
into improvements in patient care has been accelerating
rapidly. In addition to advances in the diagnosis and
treatment of problems that affect all categories of
patients, such as cardiovascular disease, cancer, arthritis
and degenerative diseases, VA researchers have made
basic research advances critical to progress in diagnosing
and treating medical conditions that are particularly
associated with our veteran population. These include
but are not limited to the following.
Brain and spinal cord injury, amputation and
prosthetics. The current conflicts in Iraq and
Afghanistan provide daily reminders of the need to
provide a rehabilitation program charged with
returning America’s disabled veterans to the highest
possible functioning status. Basic research pioneered
by VA investigators has allowed cells to be grown
in culture that can repair defects in injured and
abnormal nerves and has enhanced the mobility,
bowel and bladder function and independence of
patients with spinal cord injuries. VA researchers
have led studies exploring preventive care for
diabetic patients at risk for amputation, measuring
the efficacy of prosthetic interventions such as the
C-Leg computerized knee and developing survey
instruments to identify barriers to achieving a higher
quality of life. These studies resulted in improved
protocols for diabetic care that reduced the risk of
amputation by 43% from 1999 to 2003.
Post-traumatic stress disorder (PTSD). The
stresses of combat make PTSD a particular problem
for VA patients. VA researchers have been
instrumental in the basic and translational research
that has led to improvements in the treatment of
patients with this disorder. The Food and Drug
Consensus Department Conference of Veterans Affairs Report 21