The Evolution of Healthcare at the VA

According to Tracy Gaudet, MD: “We know that the soul and the heart are the doorways to healing, and the health of the body and the mind. So now we’re at this amazing place in the history of health care to design for that. And lead the way.”

Dr. Gaudet, a recognized leader in the ongoing evolution of healthcare, is the past executive director of the Veterans Health Administration’s (VHA) National Office of Patient Centered Care and Cultural Transformation. She has spoken and written extensively about Whole Health, a visionary approach to wellness that delivers personalized, proactive, and patient-centered care to US veterans.

At the 2018 End Well Symposium, Dr. Gaudet began a speech with a quote from the well-known author, surgeon, and public health researcher Atul Gawande, MD: “We've been wrong about a basic principle of medicine. We think our job is to ensure health and survival, but really it is larger than that. It is to enable well-being, and well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when disability comes, but all along the way.”

“Whole Health is an approach to health care that both empowers and equips patients to really take charge of their health and well-being.”

VHA evolved to the system of Whole Health under Dr. Gaudet's leadership. A key to the Whole Health approach is to start with what matters most to the patient. For instance, if a person suffers from chronic pain, what would they like to be able to do as a result of pain relief—return to a favorite sport or be able to play with their children or grandchildren? Perhaps they would like to function better at work? “Our healthcare system is designed to start with the problem—the circumstances we don’t like,” explains Dr. Gaudet. "Whole Health is an approach to health care that both empowers and equips patients to really take charge of their health and well-being." 

Whole Health transforms the traditional disease-based model into a new model for the 21st century based on patient-centered healthcare. The VHA’s transition to the system in 2018 was initially deployed at 18 flagship VA facilities around the nation. The VHA currently attends to eight million veterans. “This approach is turning peoples’ lives around, and the clinical outcomes are better,” says Dr. Gaudet.