On a recent Thursday, Dr. Monty VanBeber left his Hyannis home at 4:30 in the morning, picked up his support staff, and got to Wood’s Hole for the 6 am boat. Usually he sees about 15 patients in a day when he makes his monthly trip to see Island veterans. On that day he would see 22.
“The number gets higher each time we come,” nurse Ashley Rokosz told The Times during a short break in their busy day at Martha’s Vineyard Hospital (MVH). “We add two or three each visit.”
Even though he was on the tail end of a workday that began well before dawn, Dr. VanBeber’s (pronounced Webber) energy was unflagging. Nattily dressed and looking much younger than his 47 years, he spoke passionately about his work. “This is more than a job for me,” he said. “I’m a service-connected veteran. I understand what the issues are.”
Dr. VanBeber, associate chief of community-based outpatient clinics for the Providence Veterans Administration Medical Center in Rhode Island, has been treating Island veterans for three years, and he’s been working in the Veterans Administration (VA) system for 10 years. His primary practice is in Hyannis. He also sees patients in Middletown and New Bedford, and he makes a weekly trip to the Providence VA Medical Center, the closest VA hospital to Martha’s Vineyard.
Dr. VanBeber and officials from the VA and Health Net will attend a community meeting at American Legion Post 257 in Vineyard Haven on Tuesday, Feb. 16, at 4 pm to field questions and address issues Island vets have with health care within the VA system.
Combat vet
Dr. VanBeber enlisted in the Navy, and after graduating with honors from field medical service school in 1988, he was posted in Okinawa, the Philippines, the DMZ in South Korea, and eventually the first Gulf War, where he put his life at risk while giving medical aid to those wounded in battle. Dr. VanBeber received two Navy Achievement Medals, among several others, for his actions during the war. He was also called into war zones in the Middle East during his seven years as a reservist. In 2014, he was named outstanding physician of the year by the Disabled American Veterans (DAV).
“I think it makes a difference if somebody who’s been in combat can talk to a doctor who’s been there,” JoAnn Murphy, Veterans Affairs coordinator for Dukes County, said. “Everybody loves him.”
Although a blushing Dr. VanBeber tried to deflect her praise, he was overruled by Ms. Rokosz and veteran David LaRue, who served “two years, nine months, and 21 days” in Vietnam. Mr. LaRue, who suffers complications from exposure to Agent Orange, said the VA has come a long way since his return from Vietnam.
“When I came back, there were a lot of complaints about VA hospitals and how they functioned for Vietnam vets,” Mr. LaRue said. “But I have never been so pleased with the service I’ve gotten from the VA as I am now. I’m sure there are some places where it doesn’t work as well as it does here, but it’s really working well, and the doc here is a big reason why.”
According to the National Center for Veteran Analysis and Statistics, Dukes County has 1,004 veterans as of September 2015. Ms. Murphy, who served in the Women’s Army Corps from 1972 to 1975 as a Morse code intercept operator, estimates about a dozen of that number are World War II veterans.
There are 400 people in the VA system on the Island, according to Dr. VanBeber. Vietnam veterans comprise the largest percentage of the patients he sees, most often for pulmonary disease, hypertension, and maladies that come with being an aging baby boomer.
Post-traumatic stress disorder (PTSD) is one of the more prevalent diagnoses he makes with veterans who served in Iraq and Afghanistan. “I’m not going to hazard a guess, but I’m sure if that diagnosis had been around during the Vietnam era, it would have been a significant number,” Dr. VanBeber said, to Mr. LaRue’s emphatic agreement.
“Whatever mental health is lacking out there, the VA’s mental health is very robust,” Ms. Rokosz said.
“It’s much better than the private sector, and I know because I work in the private sector too,” Dr. VanBeber said.
Mr. LaRue said Island veterans with mental health issues get exceptional care from Tom Bennett, psychologist and Martha’s Vineyard Community Services’ associate executive director and human rights officer, and a veteran himself.
“I work hand-in-hand with Tom Bennett, in the same way I co-manage cases with other doctors on the Island,” Dr, VanBeber said. “We all work together. I see people with [PTSD] symptoms and I tell them, ‘You deserve the benefits; why not go get this? You should call JoAnn.’ I don’t guarantee the benefits, because I can’t do that. But I want them to get through that process.”
Veterans can qualify for VA benefits if they have a service-connected disability or if they earn below income standards. Income levels on a sliding scale include $31,978 per year for a single person and $40,572 for a veteran with two dependents.
Veterans Choice frustration
Dr. VanBeber, Ms. Murphy, and Ms. Rokosz all help veterans navigate the complex matrix of the country’s largest health care system. Their jobs became more complicated after the passage of Veterans Access Choice Accountability Act of 2014, also known as Veteran’s Choice, which is administered by Health Net Federal Services.
Veterans Choice (VC) was intended to make more local health care options accessible to veterans. They can enroll in VC if the local VA hospital doesn’t have particular specialists available, if they have to wait more than 30 days to get an appointment, or if they live more than 40 miles from a VA facility. In a proviso that makes all Island veterans eligible, they can qualify if travel to the closest VA facility is an “undue burden,” e.g. requiring an airplane or boat.
But the program intended to facilitate health care access has in some ways made it more difficult.
“Veteran’s Choice was terrible,” Ms. Murphy said. “The first time I called, the person on the phone was so nasty it was unbelievable. What if a veteran with PTSD was calling and she spoke to them like that?”
“I field calls from veterans, and I hear their frustration with the program,” Ms. Rokosz said. “I tell them to remember what call center it was, and what person they talked to, because appointments fall through the cracks. It usually takes about four calls to [the VA] over the course of about a month to get someone the care they need.”
Mr. LaRue said that he’s while he’s pleased with his current treatment, his initial experience with Veterans Choice left much to be desired. “When I called, I spent 20 minutes on the phone with them, and all of a sudden she says, ‘I’m sorry, you’re not qualified,’ and hung up before I could ask a question. So I tore up the card and threw it in the trash.”
“A person at a call center in Georgia won’t understand the situation of someone on Martha’s Vineyard,” Dr. VanBeber said. “If they Google Hyannis and see it’s within 40 miles, they ask why you’re not going there. I have to defend them a little. They are trying.”
“It was working wonderfully under the contract we had with the hospital,” Ms. Murphy said. “But when they came out with Veteran’s Choice, it nullified the contract. Thank God Dr. VanBeber is still coming.”
Dr. VanBeber credits the hospital for keeping his Island practice going. “I think the hospital administration has been happy with the way things are working out,” he said. “When Veteran’s Choice came out, they wanted to make sure I was still coming. They didn’t have to have me here; they’re allowed to use anyone they want to.”
Dr. VanBeber has been having weekly meetings with Health Net and VC officials to help resolve specific cases. He’s hopeful that when VA officials make the trip to the island on Feb. 16, it will help them understand the uniqueness of an Island veteran’s situation.
“The system is a work in progress,” Dr. VanBeber said. “When veterans have a problem and I know they can’t get the care they need, they need to notify me so I can work the system to make sure they’re getting the proper health care. It’s frustrating at times, but I’m a veteran, and I’m going to make sure every veteran gets the health care they’re supposed to have. I will see every veteran on Martha’s Vineyard who requests an appointment.”
Veterans with questions can contact Ms. Murphy at 508-693-6887. They can also contact Dr. VanBeber’s office directly: 508-771-3190, ext. 1741. “If we’re closed, there’s a call center in Dayton, Ohio, that answers every single call that comes in,” Dr. VanBeber said. “The next day, I’ll see their chart first thing in the morning.”
Veterans can also contact Bill Stafursky, veterans liaison at MVCS at 508-693-7900, or email him at bstarfusky@communityservices.org.
There is also a Veterans Crisis Line: 800-273-8255 (press 1).
The National Suicide Hotline for Veterans is at 800-273-TALK (8255); suicidepreventionlifeline.org
