Duke’s Collaboration with the VA Hospital to Provide Quality Care for Veterans

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TRANSCRIPT

Dr. Mary Klotman: I recently had the privilege of speaking with Doctor Christopher Hostler, associate chief of staff for the Medicine Specialty Service at the Durham Veterans Administration health care system. Duke's partnership with the VA is crucial as it enhances educational research opportunities while improving patient care for veterans and our broader community.

Chris, it's so good to be here with you. And congratulations on your new VA leadership role. I can say I really knew you when you were an intern, but I know personally how important and how just special this relationship is between Duke and the VA. But not everybody understands that. Can you speak a little bit of what the benefits are?

Dr. Chris Hostler: I think we have a really unique relationship between the Durham VA and Duke. If we look at most VA's around the country, even those with academic affiliates, they have their VA faculty and their academic faculty. And I think our, partnership really stems from having a shared faculty.

If you look at our VA faculty, the overwhelming majority of them are part time VA, part time Duke. And that helps us because our patients know that they're getting the same World-Class care that they do across the street. And it helps Duke, because 8% of North Carolinians are veterans. And so you're seeing a lot of veterans and your clinicians are already aware of all the unique health challenges that they face.

From a research perspective, we have additional funding pathways for, interested researchers through for development awards and merits. And actually, because of this, unique partnership, Durham has been more successful than any other VA in terms of acquiring CDAs and merits.

Dr. Mary Klotman: Well, my whole career started as a VA. Initial early investigator award. So I really appreciated it. And you and I both trained here.

Dr. Chris Hostler: That's absolutely right. And training is a huge portion of our mission, too. And, medical students, allied health professionals, residents, fellows in medicine residents spend 40% of their time over here. And we fund those residents as well. So I think it's an important partnership and one that VA is invested in. And certainly Duke is as well.

Dr. Mary Klotman: So you are unique in that you are a veteran and have had prior military experience. And now your leadership within the VA. How does that experience inform your role?

Dr. Chris Hostler: Yeah, if you can tell from looking around the office, I went to West Point for undergrad and came here for medical school after being medically discharged from the Army.

And one of the reasons I came here was because of the Durham VA and an opportunity to continue to serve, but I think something that the military does really well in terms of, it provides young leaders with, expansive leadership opportunities. You look at a company commander who is typically in their mid 20s, and they're commanding 150 soldiers.

Those are opportunities that aren't necessarily reflected in other sectors. And I think that has really helped me. When, for instance, I was the hospital epidemiologist at the beginning of Covid and, and was asked to run our Covid response. And we were really successful. In fact, we had the most successful Covid vaccine campaign in North Carolina, public or private, as well as throughout VA nationally.

It certainly wasn't all me. We had a great team, but I think that those lessons that I've learned, through the military helped me be able to lead during that time.

Dr. Mary Klotman: And by the way, you're a great chief resident, which is a major leadership role. But in order to stay as we are, we have to change. So what is your vision looking forward in terms of this relationship?

Dr. Chris Hostler: Well, first and foremost, I want to maintain this relationship. And that's not just, stagnant. Something that we need to continue to just keep and stay. So that's something that continues to need ongoing work, because we are fundamentally two separate health institutions that sometimes have different priorities.

But it's a lot of work to maintain that relationship. But I think it's really important. And I think that, for instance, right now we're in the very beginning stages of planning for a new hospital. We have a 75 year old hospital here. And fundamentally, our leadership group, at the VA understands that our proximity to Duke is important because it helps us maintain that relationship as well.

So despite the fact that we care for veterans all the way up to the coast, it's really important for us to maintain this academic affiliation. And it benefits our veterans. It benefits our clinicians.

Dr. Mary Klotman: So the challenge is how do we maintain what is so special but recognize new needs and certainly a growing population of veterans?

Dr. Chris Hostler: Exactly, exactly.

Dr. Mary Klotman: So Veterans Day is coming up. How would you like to see members of the Duke community honor our veterans?

Dr. Chris Hostler: That's a great question. I, I think the general impulse is, Veterans Day or whenever you see a veteran to say thank you for your service. And I think, while well-intentioned and certainly sincere, it's it also tends to cut off the conversation a little bit.

I would encourage people to ask a veteran about their service. So towards that end, this is a way for me to give a little plug for Medicine Grand Rounds on Nov. 22 available, on zoom or in dinner 2002 at 8 a.m. Where we have the sixth annual Veterans Experience Grand rounds. I'll bring three veterans, different branches, diverse experiences, and just ask them to share for 10 or 15 minutes some of their experiences in the military. And for them, it provides a little bit of catharsis. And for me, the, audience, they get a little bit of understanding about what being a veteran is like, so it helps them forge a deeper connection with their veteran patients.

Dr. Mary Klotman: And we learned so much from our veterans. So thank you for all that you do. Dr. Chris Hostler: And thank you for our ongoing partnership.