Veterans Care Today: Dr Kalea Colletta Of Edward Hines VA Hospital On How The US Has Improved Its Care For Veterans Over The Past Five Years
An Interview With Eric Pines
Make sure you keep up, not only with medical knowledge, but also with legislation, especially when working in the VA. There are so many new programs to increase service connection for our veterans that keeping up will ensure the best care for our veterans.
The daily headlines remind us of how countries around the world care or do not care for their military service members. How does the United States hold up with regard to how it cares for its veterans? We know in the past questions have been raised about the VA system, but it seems that a corner has been turned and veterans’ care has improved. How exactly has the VA system been improved? How does the US care for veterans compared to other comparable countries? What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes? To address these questions, we are talking to successful physicians, healthcare workers, veterans, or other VA employees and officials who can share stories and insights from their experience about the state of veterans’ care today and how the US has improved its care for veterans over the last five years.
As a part of this series, I had the pleasure to interview Dr. Kalea Colletta.
Dr. Kalea Colletta is a neurologist at Edward Hines VA Hospital where she works closely with patients who have movement disorders, particularly veterans who have essential tremor (ET). ET is a neurological disorder causing involuntary shaking that impacts 10 million Americans nationwide, 10x more than the number of Americans with Parkinson’s. As a doctor in a veterans’ hospital, she understands the devastating toll movement disorders can have on patients and has made it her mission to improve their treatment options.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
Thank you for having me! Absolutely, my passion for medicine, and specifically neurology, began at a very young age as my grandmother had Parkinson’s disease. We were very close and I would attend her appointments. It was then that I became fascinated with movement disorders and that passion continued throughout my career and ultimately led me to becoming a movement disorder specialist at Hines VA Hospital.
During my residency, I truly valued my time at the VA and I ultimately chose to continue my career at the VA because the veterans are such an incredible and inspirational group of people and I truly feel privileged to serve this amazing, and selfless, community.
Can you share the most interesting story that happened to you since you began your career?
The most interesting story would have to be that I had the privilege of treating a veteran with debilitating tremors that he unfortunately was plagued with his entire life. Given this, he was a perfect candidate for deep brain stimulation (DBS), and it changed his life to the point that he was able to work and engage in recreational activities that he was previously unable to do. He also felt more confident going out without tremors. It was a very rewarding experience. I also had a patient that was not a candidate for DBS with severe essential tremor, for whom I prescribed the transcutaneous afferent patterned stimulation (TAPS) therapy, an external wrist-worn stimulation device, and he was able to eat without embarrassment and engage in activities that he had long given up, which was also a very rewarding experience.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My favorite quote is “Be the change you wish to see in the world.” This quote has always guided me to strive to be better, to give my patients the best care, and to engage in research and educational opportunities to grow and improve the field of neurology to the best of my ability.
Are you working on any exciting new projects now? How do you think that will help people?
I am! I have several research projects investigating stimulation devices for use in patients with Parkinson’s disease and essential tremor as a non-pharmacologic alternative treatment. The results thus far are promising and we are looking forward to diving in further. We are also looking at recreational therapy options for these patients as well. Having alternatives to medication that have little to no side effects and confer benefits, not only on the disease itself, but on patients’ overall health, are extremely beneficial for our patients and something that they are looking for.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider is defined not only by passion for the field and knowledge, but also in large part by compassion, intent, listening, and developing a relationship with patients where they feel comfortable sharing details of their life and disease and how it affects them. I find that the best pieces of information that guide treatment are often hidden in what seems to be ordinary stories of their daily life. For example, a simple story about the patient walking their dog can lead a provider to change their therapeutic strategy or recommend something new based on the details. Listening and caring are key components of taking care of patients.
Ok, thank you for that. Let’s now jump to the main focus of our interview. Based on your experience can you please share three recent improvements to veterans care that you are really pleased about?
The VA truly has a deep commitment to our nation’s veterans and it is very evident. One of the most impactful improvements has been the passage of the PACT Act, which is the largest veterans benefit bill, and the Blue Water Navy Vietnam Veterans Act which has greatly enhanced VA healthcare and benefits for veterans exposed to Agent Orange, toxins at Camp Lejeune, radiation, burn pits, and more for our veterans that served from every era. The Mission Act has also been instrumental in increasing access to care for our veterans by increasing access to community healthcare providers in the interest of decreasing wait times for appointments and also expanding the breadth of services covered by the VA. One of the benefits of this that affects my patients and I personally, is access to new and cutting-edge treatments at no cost to our veterans. For example, the VA fully covers costly deep brain stimulation surgeries and external stimulation devices for patients with Parkinson’s disease and essential tremor.
There has also been a push for increasing awareness and care of mental health issues among our nation’s veterans with the advent of Mission Daybreak, which is a $20 million initiative to develop new strategies for suicide prevention.
In contrast, can you highlight three areas of veterans care that still need improvement? What would you suggest needs to be done to address those challenges?
One aspect that can improve is that we still have some issues with access to care. That being said, community and academic facilities have similar wait times for appointments, so it is not necessarily a VA- specific issue, but something that needs to improve across healthcare. Increasing access to care by hiring more providers and encouraging applications within the VA system would be beneficial.
We can also improve and update our older facilities, as well as integrate newer technologies and procedures into more of our hospitals. Some already offer higher level procedures, but expanding this would be beneficial.
The VA already has a robust research program, but increasing collaboration and increasing research endeavors among all of our departments and with other academic facilities can ensure that we are providing higher level and cutting-edge care for our veterans.
From your perspective how does the US care for veterans compared to other comparable countries?
To be fair, I am unaware of the level of medical benefits provided by other countries for their veterans. However, I do believe the US does a commendable job in taking care of our nation’s veterans and are constantly striving for continuous improvement. I would like to think that the US is one of the leaders in the world with regards to care for our veterans.
What exciting new technological or methodological innovations are being used to improve veterans’ health outcomes?
There is a plethora of new innovations being used in the VA. From a neurology perspective alone, the VA is fully covering prescription of cutting-edge transcutaneous afferent patterned stimulation (TAPS) therapy, which is a non-invasive wrist-worn stimulation device to decrease tremor power in patients with essential tremor. We are also performing and referring Parkinson’s disease and essential tremor patients for deep brain stimulation (DBS) surgeries, which is also fully covered by the VA
Transcranial magnetic stimulation, and even at-home simulation, is also being used for veterans with PTSD. In the VA prosthetics departments, we are always utilizing cutting-edge technology for prostheses as well. The VA covers and/ or uses a multitude of cutting-edge treatments for our veterans.
This is our signature question that we ask in many of our interviews. What are your “5 Things I Wish Someone Told Me When I First Started My Career”?
1. Cultivate time management strategies early on. With the amount of clinics and increasing patient load, plus messages and questions from patients, you will need to develop strategies early on to effectively apportion your time.
2. Make sure you keep up, not only with medical knowledge, but also with legislation, especially when working in the VA. There are so many new programs to increase service connection for our veterans that keeping up will ensure the best care for our veterans.
3. Explore the programs at your hospital and in the community to enhance your patients’ care. Many hospitals have innovative therapy programs within the facility for patients and there are many recreational therapy programs in the community that patients can be referred to in order to enhance their overall health and well-being.
4. Make time for your own well-being. I was once told you need to take care of yourself in order to take the best care of your patients. If you are overworked, mistakes are easier to make, so make sure you have a good work-life balance.
5. Engage in other endeavors such as research and/ or committees to vary your interests. This does help prevent burnout and gives you other things to look forward to.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
Thank you! This is a great question! I have to think about this!
Within the realm of healthcare, I would love to increase accessibility to whole health programs to improve overall health of our patients and also decrease the burden on our physical therapy colleagues. I have seen the beneficial effects of daily exercise on my patients in terms of mobility, but also with regards to decreasing hospitalizations, and would love to somehow expand coverage of whole health programs and enhance accessibility to cutting-edge treatments for all patients.
How can our readers further follow your work online?
Feel free to look me up on Pubmed and VA websites. I hope to inspire the next generation of physicians!
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
About the Interviewer: Eric L. Pines is a nationally recognized federal employment lawyer, mediator, and attorney business coach. He represents federal employees and acts as in-house counsel for over fifty thousand federal employees through his work as a federal employee labor union representative. A formal federal employee himself, Mr. Pines began his federal employment law career as in-house counsel for AFGE Local 1923 which is in Social Security Administration’s headquarters and is the largest federal union local in the world. He presently serves as AFGE 1923’s Chief Counsel as well as in-house counsel for all FEMA bargaining unit employees and numerous Department of Defense and Veteran Affairs unions.
While he and his firm specialize in representing federal employees from all federal agencies and in reference to virtually all federal employee matters, his firm has placed special attention on representing Veteran Affairs doctors and nurses hired under the authority of Title. He and his firm have a particular passion in representing disabled federal employees with their requests for medical and religious reasonable accommodations when those accommodations are warranted under the Rehabilitation Act of 1973 (ADA). He also represents them with their requests for Federal Employee Disability Retirement (OPM) when an accommodation would not be possible.
Mr. Pines has also served as a mediator for numerous federal agencies including serving a year as the Library of Congress’ in-house EEO Mediator. He has also served as an expert witness in federal court for federal employee matters. He has also worked as an EEO technical writer drafting hundreds of Final Agency Decisions for the federal sector.
Mr. Pines’ firm is headquartered in Houston, Texas and has offices in Baltimore, Maryland and Atlanta, Georgia. His first passion is his wife and five children. He plays classical and rock guitar and enjoys playing ice hockey, running, and biking. Please visit his websites at www.pinesfederal.com and www.toughinjurylawyers.com. He can also be reached at eric@pinesfederal.com.
