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AtlantiCare's Macchiavelli, a disabled veteran himself, said his system is ready to help with VA problem

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Dr. Macchiavelli.
Dr. Macchiavelli. - ()

Congress is scrambling to redress the scandal of long waits and falsified records at the Department of Veterans Affairs. High on their list of remedies is making it easier for veterans to get care at civilian hospitals.

On Sunday, Senate Veterans Affairs Committee Chairman Bernard Sanders (I-Vt.) introduced the Restoring Veterans Trust Act, which would make it easier for the VA to hire and fire employees, lease new space for clinics and hospitals, and send veterans to outside providers if care isn’t available within 30 days.

Sen. John McCain (R-Ariz.) said Sunday on “Face the Nation” that he supports giving veterans the option of seeking medical care from non-VA doctors.

“Why should a veteran have to get into a van and ride three hours to get to Phoenix in order to have routine medical care taken care of?” he said. “Why doesn’t that veteran have a card and go to the caregiver that he or she needs and wants?”

Dr. Tony Macchiavelli couldn’t agree more.

Macchiavelli is not only in charge of the Hospitalist Program at AtlantiCare Regional Medical Center, he is a disabled American veteran who learned to navigate the VA  system after a serious injury ended his military career in 1985 — just two years after he graduated from West Point. The VA’s vocational rehabilitation program sent him to medical school.

He wants to see AtlantiCare increase the services it provides to veterans and help relieve the backlogs and delays at the embattled VA system if there were a national system in place that allowed it.

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Macchiavelli, who leads the AtlantiCare employee group “HONORS,” which focuses on helping address the needs of the military and veteran communities, said his Hospitalist Program already provides emergency care to veterans for which they are typically reimbursed by the VA.

But Macchiavelli said he hopes the latest moves and proclamations out of Washington allow him to fulfill his ultimate goal: To provide the full range of medical care to South Jersey veterans who are a two-hour drive from the VA hospital  in Wilmington, Del.

Macchiavelli said AtlantiCare could help ease backlogs at those facilities.

“(VA clinics) are necessary, but they are not sufficient to meet the need,” he said. “What we have to think about is the volume of people that are seeking treatment from the VA. We are willing to help to bridge that gap.”
Macchiavelli feels private help is long overdue. After all, the U.S. has been at war since 2001.

“We have a lot of veterans and returning military who are seeking care,” he said. “And we know that the VA is clearly overburdened and overextended as they deal with the problems of traumatic brain injury and post-traumatic stress disorder.

“When we look at the number of people who are seeking help from the VA, you can’t help but understand that the system is completely overtaxed and needs help.”

While the topic has been in the news this spring, Macchiavelli said he has been speaking to government officials and veterans’ group about providing more options for veterans the past three years.
“We know there is a need from the VA for help and we basically want to build that bridge as a civilian hospital and health care system to see what we can do to help care for our veterans and our military people,” Macchiavelli said.

Allowing veterans to use civilian hospital for non-emergency care, he said, is the policy solution he hopes will emerge from the current debate.

He said doctors in the AtlantiCare Physician Group accept government health insurance plans for veterans when they  provide care that is approved by the VA — and he would like to see the role of civilian doctors and hospitals expanded.

Macchiavelli, 53, was an Army lieutenant serving in Texas in 1985 when he was injured.

“The vehicle I was in went off a cliff and blew up,” he said. “I wound up in the hospital for the better part of a year.”

The medical team at Walter Reed Army Medical Center in Washington, D.C. did extensive bone reconstruction; he had a collapsed lung and ultimately lost the use of his right leg. Today he lives in Brigantine with his wife Helen.

And he has nothing but praise for the care he received.

“I can tell you firsthand that I saw excellent care, based on my own personal experience,” he said. “The quality of the care in the military hospitals as well as the VA was phenomenal.  But I had to learn to navigate the system. It wasn’t something that was easy to do and it could be challenging. And I can say that right now what I’m hearing is a system that is completely overwhelmed and needs help.”

He said the VA will pay for veterans who use AtlantiCare for emergency treatment — and the hospital will treat any patient who comes to the ER, regardless of ability to pay.

“But what about routine care?” he asks. “Let’s say you have a patient who requires chemotherapy or a more specialized procedure? They would have to travel to Wilmington, Delaware, or to Philadelphia for that. And I think that is an opportunity to fill in some of those gaps, which would allow them to use primary care services and have our AtlantiCare Physician Group provide specialty care without the two-hour trip.”

In 2009, Cooper University health care introduced an outpatient office of Veterans Affairs its sciences campus in Camden.  Since the opening, it has welcomed any veteran in need of health care treatment, not provided at the VA Hospital in Philadelphia.

"We would be honored to provide all levels of care to veterans and their families and hope to establish a deeper relationship with the VA Affairs office to provide our service men and women the health care they need and deserve," the hospital said in a prepared statement.


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