Impact of VA Research on Health Care for All: Contributions Over Nine Decades and Counting.

Abstract

In 2015, the Veterans Administration (VA) celebrated 90 years of VA research. As Associate Chief of Staff for Research at the Birmingham VA Medical Center, I pondered how to celebrate this momentous occasion for the yearly VA Research Week. My first questions were how has a structured VA Research Program been in existence for 90 years and how did it all start in 1925, 20 years before the National Institutes of Health?1 My thoughts since then have become especially poignant in view of the recent turmoil within the VA system that has led to questions about its position in the Healthcare System. I respond to this invitation not as the section would imply in its title: Viewpoints, but more so to share the 90-year journey of the VA in melding its tripartite mission of patient care, education, and research. Before World War I, hospitals were considered charitable institutions for the impoverished, and the sick and injured were cared for in their homes. Passage of the Langley Bill in 1921 marked the transition from a Soldier’s home with compensation/pension for injury to a true medical center orientation. The Veterans Bureau took over all Public Health Service Hospitals, and by 1925, the Veterans Bureau oversaw 50 VA hospitals and 30 000 hospitalized veterans. In 1924, a 22-member council on Medical and Hospital Affairs comprised leaders in academic, public, and private medicine endorsed a system of diagnostic hospital beds. They also initiated the US Veterans’ Bureau Medical Bulletin, and the establishment of a research program with emphasis on research related to veterans’ medical conditions. The VA Medical Bulletin (Figure A) underscored the Medical Council’s idea of a hospital-based research program seeking methods to cure disease by systematic bedside observation with an emphasis on outcomes. Before World War II, there was not a strong …