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VA Specialty Care Services

Joe Wallace

While the VA primary care system is the foundation of a veteran’s health journey within the Department of Veterans Affairs, specialty care provides the next level of treatment for specific and complex health conditions.

When a health issue requires more than routine management, a veteran’s primary care team connects them with a wide network of specialists.

The VA approach is to deliver this care in a coordinated way, making sure the specialist and the primary care team work together. This integration is designed to treat the specific condition while still managing the veteran’s overall health.

VA Specialty Care Referral Process

Access to specialty care begins with care in a VA primary care clinic. When a veteran’s Patient Aligned Care Team (PACT) identifies a health concern that needs expert evaluation, the primary care provider initiates a referral, also known as a consult.

This process is a formal request for a specialist to see the veteran. The provider sends the specialist all relevant information from the veteran’s health record, including test results and clinical notes, to ensure the specialist has a complete picture of the situation.

Once the referral is made, the VA’s scheduling system works to find an appointment. The location of the appointment depends on the type of care needed and its availability.

Depending on the facility, VA medical centers often have a full range of specialty clinics on-site, making it convenient for veterans to see their experts in the same facility where they receive primary care.

If a particular service isn’t available at a veteran’s local VA or if the wait time is too long, the VA may arrange for the veteran to receive care from a provider in the community.

While this care is ongoing, the veteran’s PACT stays involved, helping to coordinate the appointment and ensuring that all necessary information is shared. After the specialist sees the veteran, they report back to the primary care provider.

VA Medical and Surgical Specialties

The VA offers a comprehensive range of medical specialties to diagnose complex illnesses. Cardiology services, for example, treat conditions related to the heart and blood vessels.

VA cardiologists perform diagnostic tests, manage chronic heart conditions, and provide advanced treatments. For veterans diagnosed with cancer, oncology departments offer care including chemotherapy, radiation therapy, and surgery.

These services are delivered by a team of experts who create personalized treatment plans. Other available medical specialties include pulmonology for lung conditions, gastroenterology for digestive system disorders, and endocrinology for issues like diabetes.

Surgical services are also a core component of VA specialty care. VA medical centers perform a wide array of procedures, from common operations to complex surgeries. Orthopedics is a high-demand service, addressing joint, bone, and muscle issues that are often related to military service. VA surgeons perform joint replacements, repair injuries, and manage chronic pain.

General surgery covers a broad area of medical procedures. More specialized surgical fields (such as neurosurgery, vascular surgery) are also available depending on circumstances.

Mental and Behavioral Health

VA provides specialty mental health services. These services offer specialized treatment for conditions including Post-Traumatic Stress Disorder, depression, anxiety, and substance use disorders.  Veterans can access individual and group therapy, medication management, and evidence-based psychotherapies tailored to their needs.

There is also help for veterans struggling with substance use. The VA provides a range of programs, from outpatient counseling to intensive inpatient rehabilitation.

Depending on the program, options may include medical detoxification, therapy, and support to help veterans achieve and maintain sobriety. The VA also operates programs for specific populations, such as residential treatment for homeless veterans with mental health and substance use disorders.

Specialized Services for Service-Related Conditions

The VA’s audiology and speech pathology service is one of the most utilized, treating hearing loss and tinnitus, which are among the most common service-connected disabilities. VA audiologists provide comprehensive hearing tests, fit veterans in the VA healthcare system with advanced hearing aids, and offer counseling and rehabilitative services to help them communicate more effectively.

Vision care is another critical area. VA optometry and ophthalmology clinics provide routine eye exams and prescription glasses. Other options include advanced medical and surgical treatment for conditions like glaucoma, cataracts, and diabetic retinopathy.

For veterans who have experienced severe, complex injuries, the VA’s Polytrauma System of Care offers a comprehensive rehabilitation program.

These centers treat veterans with injuries to more than one organ system, which may include traumatic brain injury (TBI), amputation, and burns. An interdisciplinary team of specialists works with the veteran and their family to create an intensive rehabilitation plan aimed at maximizing recovery and restoring independence.

Frequently Asked Questions About VA Specialty Care

What is the role of specialty care within the VA system?

Specialty care is the part of the VA health system that provides focused treatment for health conditions that fall outside the scope of routine primary care. When a veteran’s health requires a deeper level of expertise, their primary care team coordinates with a network of specialists.

The path to seeing a specialist starts with the veteran’s primary care provider. If the Patient Aligned Care Team (PACT) determines a need for specialized evaluation, they create a referral, also called a consult, which includes the veteran’s relevant medical history. The VA then works to schedule this appointment. Many VA medical centers have the necessary specialty clinics available in the same building. However, if a service is not offered at a veteran’s local facility or if wait times are excessive, the VA can authorize care with a private provider in the community.

The PACT remains the central point of coordination, managing the flow of information between the veteran and the specialist.

What types of surgical and medical treatments does the VA provide?

For complex illnesses, medical specialists are available in fields like cardiology for heart and vascular problems, oncology for cancer treatment, and pulmonology for lung disorders.

Orthopedic surgery, for instance, is frequently used to address bone and joint conditions often resulting from military service. Other surgical fields, such as general surgery and neurosurgery, are also available. For any operation, the VA manages the entire process, from the initial evaluation before surgery to the rehabilitative care needed for recovery afterward.

Are there specialized programs for mental health?

VA mental health programs provide more focused and intensive therapies for conditions such as Post-Traumatic Stress Disorder (PTSD), severe depression, and substance use disorders.

Veterans can qualify for evidence-based treatments, medication management, and both individual and group therapy. The VA offers veterans who need help with substance use disorders outpatient counseling and comprehensive inpatient programs that include detoxification and long-term support. Care is confidential and is provided by professionals who understand the context of military experience.

Does the VA offer specific treatments for conditions connected to military service?

There are many programs. The audiology service is a key resource for treating tinnitus and hearing loss, two of the most prevalent service-connected disabilities. In addition to providing hearing tests, audiologists fit veterans with modern hearing aids.

Vision care is another major focus, with optometry and ophthalmology clinics offering services that range from eye exams to advanced surgical procedures for cataracts and glaucoma.

For veterans with catastrophic injuries such as traumatic brain injury (TBI) or amputations, the VA’s Polytrauma System of Care provides intensive, integrated rehabilitation to support their recovery.

How do I Access VA Specialty Care?

Specialty care within the VA health system is typically assigned through a veteran’s primary care provider (PCP). The process generally follows these steps:

• Before accessing any care, veterans must first enroll in the VA health care system.
• Your assigned PCP is your main point of contact for your health care needs. The PCP assesses your condition to determine if a consultation with a specialist is necessary.
• If specialized care is needed, your PCP will make a referral to the appropriate specialist within the VA healthcare system.
• In cases where the VA cannot provide the required specialty care in a timely manner, or if a VA facility is not geographically accessible, a veteran may be referred to a civilian specialist through the VA Community Care program.

What are the VA’s Specialty Care Services?

• Cardiology
• Oncology and Hematology
• Neurology
• Gynecology
• Dermatology
• Endocrinology
• Gastroenterology
• Infectious Diseases
• Nephrology
• Pulmonology
• Rheumatology
• General Surgery
• Orthopedic Surgery
• Neurosurgery
• Cardiothoracic Surgery
• Vascular Surgery
• Urology
• Otolaryngology
• Ophthalmology
• Plastic and Reconstructive Surgery

What are the VA’s Mental and Behavioral Health Specialty Care Services?

The VA offers mental health services for a variety of conditions, including:

• Post-Traumatic Stress Disorder (PTSD)
• Depression and Anxiety
• Substance Use Disorders
• Military Sexual Trauma (MST)
• Schizophrenia and Bipolar Disorder