Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems from Patient Empowerment Network on Vimeo.

What can veterans expect for the patient experience in VA versus civilian healthcare systems? Expert Dr. Drew Moghanaki from UCLA Health explains common experiences for veterans in VA  and civilian healthcare systems and information about the PACT Act.

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“…be aware of who’s providing care, and obviously give them a break if they don’t understand anything about what it means to be a veteran. The quality of healthcare really builds upon a culture of trust. You may be better served finding other physicians or providers who are veterans themselves.”

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Transcript:

Lisa Hatfield:

Dr. Moghanaki, are there systemic issues within the healthcare system that disproportionately affect veterans?

Dr. Drew Moghanaki:

Well, this makes me realize that healthcare systems aren’t just automatic systems. They’re environments where there are people like myself who work in a healthcare system. And depending on where a veterans getting care, that staff may or may not know much about what it means to be a veteran. So let’s take three different examples. Obviously, if you come to VA Medical Center, our veterans, many of them told me they feel like they’re back on base. We understand the mission. We understand the cause. We understand the victory. We also understand the suffering. And we can connect better than anyone else in this country with veterans. 

And we’ve got the access to the best treatments available to truly take the best care that we can with a comprehensive approach through the VA healthcare network, which now consists of over a 1,000 clinics and over 100 high-quality, multi-functioning health care medical centers. But let’s take option number two, where a veteran may be receiving care in a community hospital. And in that situation, you may run across some of the healthcare providers who know something about what it means to be a veteran.

Either, if you’re lucky, they themselves were a veteran and provided some service, or they were raised in a family where they know other people who have served in the military and they understand the basic principles.  And so those healthcare providers, even though they may be civilians themselves or veterans working in a community hospital, at least kind of get it.

But then there’s a third scenario where veterans will go to a community hospital, and the people taking care of them don’t really know what it means to be a veteran. They only know the television version or the Hollywood version of it. And they think they know, but they really don’t know. And I’ll tell you, that’s who I was when I first started working in the VA about 12, 13 years ago. And I’ve been so fortunate to get a lot of lessons on what it means to be a veteran. And over time, I’ve gotten to know a lot of soldiers and veterans myself just in my personal life to truly understand. And so I think my activation tip for here is to really be aware of who’s providing care, and obviously give them a break if they don’t understand anything about what it means to be a veteran.

The quality of healthcare really builds upon a culture of trust. You may be better served finding other physicians or providers who are veterans themselves. And, of course, if you’ve got access to VA healthcare, check-in with the VA Medical Center and see, hey, what’s the quality of my care here? And I’ll probably be saying this later on in this recording, which is that if you are a veteran and not yet eligible for VA healthcare, please do check in because the PACT Act recently approved by Congress has truly expanded eligibility, and you may be eligible and not know about it.


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Do Black and Latinx Veterans Face Unique Lung Cancer Challenges?

Do Black and Latinx Veterans Face Unique Lung Cancer Challenges? from Patient Empowerment Network on Vimeo.

What unique challenges do Black and Latinx veterans face in lung cancer? Expert Dr. Drew Moghanaki from UCLA Health explains the importance of trust, second opinions, and proactive advice for the best care.

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“…for anyone who might have some trust concerns. No one owns you as a provider that you have to get care from them. If you’re comfortable, you can ask for a second opinion. If not, it is absolutely okay. Patients all the time are getting second and sometimes even third opinions. And I strongly recommend getting another opinion if you’ve got any questions or doubts, because that trust alliance is so important to get the best lung cancer care…”

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Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Transcript:

Lisa Hatfield:

Dr. Moghanaki, what specific challenges do veterans from the Black and Latinx communities face when trying to access healthcare services, and what are we learning from these challenges, and how is that information shaping care for veterans facing lung cancer?

Dr. Drew Moghanaki:

Well, this question just reminds me that healthcare is complicated, especially lung cancer care. And the most important thing for anybody getting care, regardless of what social, economic background or ethnic background they may be from, is to find a team that you trust and who you know will care about you. And that’s the best way to make sure you get the best treatment. I myself as a physician. I’ve also been a patient at times.  And if I don’t trust my care provider, I basically ask for a change. And I know that can be difficult.

And so here’s my activation tip for anyone who might have some trust concerns. No one owns you as a provider that you have to get care from them. If you’re comfortable, you can ask for a second opinion. If not, it is absolutely okay. Patients all the time are getting second and sometimes even third opinions. And I strongly recommend getting another opinion if you’ve got any questions or doubt, because that trust alliance is so important to get the best lung cancer care, because it’s not going to be a one-time visit. You were talking about relationships that can last months or even years to get the best treatment for your lung cancer.


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Lung Cancer Strategies for Veterans: Research and Care Insights

Lung Cancer Strategies for Veterans: Research and Care Insights from Patient Empowerment Network on Vimeo.

What’s important for veterans with lung cancer and care partners to know about research and care? Expert Dr. Drew Moghanaki from UCLA Health discusses research initiatives, screening recommendations, and patient advice for proactive care.

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“…if you’ve got a cough that won’t go away, push hard to say, ‘Look, I really just want to take a look inside my chest.’ It won’t be a low-dose screening chest CT. It’ll be a regular chest CT. And that CT, even if normal, can be a nice baseline for future scans in the future if more scans are needed.”

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Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Transcript:

Lisa Hatfield:

Dr. Moghanaki, can you speak to your research around strategic initiatives for veterans facing lung cancer? And what should your patients, their care partners be asking as they seek care?

Dr. Drew Moghanaki:  

I really care about driving down the symptoms and the burden of lung cancer, and there’s a lot of great treatments out there that are safer and more effective than ever before. Our patients are living better lives and longer lives, and I really focus a lot on that type of research. But one of the things that really probably has the biggest benefit is just earlier detection. And early detection takes place by having an annual chest CT scan with a certain type of CT scan that’s a lower dose of radiation that the scan requires. And we don’t scan people who have symptoms.

So I’m talking about people who are at risk. And right now, our best measure of who’s at risk for getting lung cancer are people who smoked a lot of cigarettes in their lifetime. And they basically once a year get a scan, and we’re looking for lung cancers at the earliest time that they’re sprouting, and that’s because if we catch it early, we’ve got the safest treatments and the most effective treatments and the highest cure rates, and so my activation tip is if you know anybody or if you yourself are at risk for lung cancer because there’s a lot of smoking going on, please get your lungs screened and talk to your primary care provider to get that lung screening scan ordered.

Lisa Hatfield:

Okay. And just a follow-up question for that, if a person does have some type of symptoms, or if I guess if they’re a smoker also, but they have some type of symptoms and they say, “Oh, I’d like to have this low dose chest CT scan.” Can they just ask their primary care provider about that? Or are they, are PCPs automatically going to screen people who have symptoms or have been long-time smokers?

Dr. Drew Moghanaki:

It’s really a standard of care to get some imaging of the chest. If you’ve got somebody with a cough that won’t go away or some sort of pain inside the chest. In that situation, we don’t get a low-dose chest CT. We get a regular CT to take a look. Now, one of the things is if a patient has smoked a lot, people really start to worry, this might be lung cancer. But one of the things that we’re seeing is there’s a lot of people getting lung cancer who never smoked or they just smoked a little bit. And the doctor may say, “Well, I don’t think you’re going to get lung cancer.” And they don’t get a scan. And that’s actually a problem.

So for those patients, my activation tip is, look, if you’ve got a cough that won’t go away, push hard to say, “Look, I really just want to take a look inside my chest.” It won’t be a low-dose screening chest CT. It’ll be a regular chest CT. And that CT, even if normal, can be a nice baseline for future scans in the future if more scans are needed. It’s always good to have a baseline at an earlier age, so we can see if new things show up, if they’ve been there for a while, or if they really are new.


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How Can Advanced Lung Cancer Be Explained to Newly Diagnosed Veterans?

How Can Advanced Lung Cancer Be Explained to Newly Diagnosed Veterans? from Patient Empowerment Network on Vimeo.

How can newly diagnosed advanced non-small cell lung cancer (NSCLC) veterans be informed about their diagnosis? Expert Dr. Drew Moghanaki from UCLA Health discusses the approach and information he shares with veterans and proactive advice for their care.

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“…all veterans to ask their clinicians, ‘Is my cancer the spreading type or not?’ Because that really helps understand what treatments and why what treatments are being recommended.”

Download Resource Guide | Descargar guía de recursos

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Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Insights into Veteran Healthcare | Perspectives from VA and Civilian Systems

Transcript:

Lisa Hatfield:

Dr. Moghanaki, how do you explain advanced non-small cell lung cancer to your veteran patients and their care partners and families?

Dr. Drew Moghanaki:

Yeah, I’m glad you bring this question up. So non-small cell lung cancer often can be localized or it can be advanced. And localized means, as far as we can tell, it’s only in one area but advanced means that it’s started to spread, and they can spread to the lymph nodes and then other parts of the lungs or even other parts of the body. And I try to teach all my veterans, look, we’ve got surgery, we’ve got radiotherapy, and we’ve got drug therapies. And if it’s spreading, we really need the drug therapy to put the drugs into the bloodstream and be able to chase down the cancer wherever it may be.

Because also once it’s starting to spread, there’s going to be not just visible components that we see on the scan, but very likely invisible components. And if tumors are invisible on the scans, well, there’s nothing to cut or to aim at with radiotherapy. So really drug therapy becomes a cornerstone. So I recommend to all my veterans with lung cancer to make sure there’s a clear understanding. “Has the cancer spread yet? Is it the spreading type or not?” Because that really then helps better understand why the different treatments are being recommended.

So my activation tip is for all veterans to ask their clinicians, “Is my cancer the spreading type or not?” Because that really helps understand what treatments and why what treatments are being recommended.


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