THE HONORABLE FRANCES M. MURPHY, M.D., M.P.H.
DEPUTY UNDER SECRETARY FOR HEALTH
DEPARTMENT OF VETERANS AFFAIRS
HOUSE COMMITTEE ON VETERANS' AFFAIRS
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
ON VA'S ROLE IN EDUCATING HEALTH CARE PROFESSIONALS
TO DIAGNOSE AND TREAT CASUALTIES OF WEAPONS OF MASS DESTRUCTION
November 14, 2001
Mr. Chairman, I thank you for the opportunity to testify before the subcommittee on VA's role in educating health care professionals to diagnose and treat casualties of terrorist attacks involving chemical, biological, and radiologic agents (CBR). I am accompanied today by Dr. Susan Mather, VA's Chief Public Health and Environmental Hazards Officer and Mr. Kenneth Mizrach, Director of VA's New Jersey Health Care System.
The recent incidents involving anthrax exposure and infection have made clear the possibility of an attack on the United States with unconventional weapons, including chemical, biological, or radiologic agents. Such weapons are capable of inflicting serious harm that could be both widespread and sustained.
The medical consequences of attacks of this kind include both the immediate trauma inflicted and the potential long-term health consequences resulting from that trauma. The types of trauma inflicted could include not only the more obvious physical harm the victims may suffer, but the less visible and often unrecognized psychological trauma, such as post-traumatic stress disorder. Such psychological injuries may manifest themselves only long after the event.
We believe it is of paramount importance that health care professionals throughout the nation receive the education and training that will enable them to better understand and respond to the potential health threats from such unconventional weapons. At a minimum, health care professionals should be able to:
Since physicians (medical students, residents, and practitioners) are not the only health care professionals who would be involved in providing treatment, we strongly believe that education and training programs should be developed that are appropriate for health care professionals at various levels of their careers. All health care professionals, including, but not limited to, physicians, nurses, nurse practitioners, physician assistants, pharmacists, emergency personnel, and health profession students should receive training.
Under Presidential Decision Directive 62, the U.S. Public Health Service (PHS), in collaboration with VA, works to ensure that adequate stockpiles of antidotes and other necessary pharmaceuticals are maintained nationwide and to train medical personnel at hospitals in the National Disaster Medical System to appropriately treat victims of CBR incidents. VA recently received $832,000 from the Department of Health and Human Services to begin development of the training program. The first phase of this program will involve a comprehensive needs assessment of the U.S. hospitals enrolled in the NDMS and the development and piloting of the proposed training model.
VA has long provided ongoing training for health professionals to recognize and treat the victims of chemical and biological agents, but recently we have significantly enhanced our training efforts to better prepare our employees to recognize and respond appropriately to terrorist attacks. We have developed satellite broadcasts covering biological and chemical warfare issues and other educational tools and programs for those who may be charged to render care to victims of CBR incidents. I will describe some of these initiatives.
We have the capability, through our education infrastructure and our education and research cooperatives, to share the programs that we produce with others, thus creating an even better return on investment in terms of preparing the healthcare community to effectively respond to terrorist acts.
We are currently exploring the feasibility of undertaking an effort with DOD and our medical school affiliates to develop and share curriculum for undergraduate and graduate health professionals to prepare them to recognize and respond to the needs of patients who may be the victims of CBR use.
In addition, the Association of American Medical Colleges, in conjunction with other health education organizations and federal agencies including VA, has announced a bioterrorism initiative to help educate and prepare the nation's physician workforce to respond to terrorist attacks. This initiative will focus on the need for information, resources and educational experiences to help medical students and residents deal with the victims of terrorism now and in the future.
VA is well situated to reach a wide audience of practitioners and students through its academic affiliations. VHA is extensively involved in the nationwide training of physicians, medical residents, medical students, nurses, and associated health care professionals. Through partnerships with affiliated academic institutions, VA conducts training and education programs to enhance the quality of care provided to veterans within the VA health care system. Through these long-standing and close relationships, VA also plays a leadership role in defining the education of future health care professionals to help meet the rapidly changing needs of the Nation's health care delivery system. Today, more than 150 VA facilities have affiliations with 107 medical schools, 55 dental schools, and more than 1,200 other schools across the country. More than half the physicians practicing in the United States have received part of their professional education in the VA health care system. Additionally, VA doctors conduct hundreds of research studies in conjunction with their facilities' affiliated medical schools.
Mr. Chairman, in conclusion let me state that VA is a valuable national health care resource. We stand ready to use our considerable expertise in clinical care, education, and research to benefit veterans and other Americans in this time of need. I will now be happy to respond to any questions that you or other members of the subcommittee might have.