STATEMENT OF WILEY R. BLAND, MD, RETIRED

FORMER VA MONTANA CLINIC CHIEF OF RADIOLOGY, BILLINGS

APRIL 21, 2012

Senator Tester, Please accept my thanks for the opportunity to give testimony at today’s hearing to assess and evaluate the health care needs and treatment of Montana’s rural veterans.  

First, a little information about my qualifications: 

I received a Bachelor of Science degree in Chemical Engineering, graduating with honors from North Carolina State University. 

In 1966 I graduated with a medical degree from Duke University and I did my internship in general medicine/Pediatrics there through 1967.  I spent the next two years with the United States Public Health Service at various sites in Alaska.  

From 1969 through 1972 I spent my Radiology Residency at Duke University, serving as Chief Resident my final year.  I worked at the Billings Clinic Hospital from 1972 through 1978 and the next year I worked as a radiologist at Martinsburg General Hospital in West Virginia.

I returned to Billings and served as a radiologist at St. Vincent Hospital for the next 20 years.  In 2002 I joined VA Montana as Chief of Radiology and as a radiologist at the VA clinic in Billings until I retired in 2010.

Senator Tester, I was asked to appear at this hearing to tell you about the difficulties and special circumstances surrounding rural veterans in Montana.  I would like to share important information with you about the Billings Community BasedOutreach Clinic (CBOC).

When Phase 1 of the new VA clinic in Billings was still being discussed, demographics were published that showed the Billings clinic supports approximately 50 percent of Montana’s veteran population in a state that measures approximately 147 thousand square miles.  It also demonstrated that the new clinic needed to be given personnel and a facility to support that many patients.

Billings is approximately 235 miles from Fort Harrison.  To travel that far, and even further from some points east of Billings can sometimes be inappropriate and unnecessary. For instance, Glendive is 222 miles from Billings, which makes a veteran’s journey to Fort Harrison about 450 miles one way.  When the appointment at Fort Harrison only lasts for a few minutes, or if the veteran is quite ill or elderly, it seems ludicrous to have to travel that great distance. If the veteran traveling to Fort Harrison is using his or her privately-owned vehicle and is not at least 30% (or better) service-connected, he or she must pay travel expenses, which include gas, meals, and often an overnight stay in a hotel. 

Today, with the decrease in specialty care at the Billings VA Clinic, there is a perception by veterans and caregivers in Eastern Montana and Billings that the treatments provided by VA Montana Healthcare have become second rate.  The Billings medical community is the most complete and sophisticated in Montana and there should be no reason for patients to seek medical care at Fort Harrison or out-of-state (i.e. Denver or Salt Lake City).  We owe the men and women who have given our country so much, good local health care, not sub-standard care or long, often expensive trips far away from home.

Today, treatment wait-time for critically ill veterans extends out a year or beyond.  Because of this fact, many patients are abandoning the VA Healthcare System.

The Billings CBOC had 2 full-time cardiologists once, but because of the lack of support personnel (i.e. an echo-cardiology technician) and necessary equipment, one of the cardiologists left the clinic.  We currently spend about $500 thousand a year on fee-basis cardiograms and other vital diagnostic procedures, rather than paying the salary for an echo-technologist.

The Billings VA Clinic also had an excellent orthopedic surgeon who passed away and he has yet to be replaced.  This same vacancy has occurred in General Surgery, Urology, and Radiology.

If these trends continue and VA Montana Healthcare does not support the Billings VA Clinic in its efforts to provide 1st rate care, the CBOC will continue on its downward spiral toward sub-standard service to our veterans.  They gave us their best; now it is time to reciprocate.