faction with access, clinical services, and staff; any barriers to using services; and recommendations for improvements. “They said they felt respected and that the care was excellent. The doctors and staff took the time to get to know them and learn about their problems. Some individuals even said it was the best care they ever received,” Dr. Boyle says. In fact, one focus group participant stated that the program was like “manna from heaven.” Overall, Dr. Boyle says, veterans in the focus groups gave the program the highest rankings in all areas on a five-point scale. “In every case, it was unanimous. It’s rather unique that there was such positivity and unanimity among all the focus group participants,” he says. “The personal aspects of this one-on-one, the human contact, is amazing,” one focus group participant reports. “These people here are personable. From day one, they make you feel like they know you and they care.” Another veteran agrees: “The staff actually has a connection with the patients, greeting them as they come in, saying things like, ‘I remember when I saw you so long ago, and your hair has grown.’… It’s a personal touch. People need that personal touch with their doctors. It’s very important, especially if you want to keep that vet coming.” the veterans, and access to care is much faster,” says Wilson. In addition, VTCI provides services for anyone who ever served in the military—including those in the National Guard and the Reserves who might not be eligible for VA services, Wilson says. “We want to provide the broadest reach possible,” Dr. McGarry explains, adding that all physicians in the practice participate in the initiative. “Our goal is to provide care when it’s needed, and to do that, everyone in the practice is involved.” hile many of the veterans served through VTCI are already established patients with the VA, the program can be a boon for individuals who have had difficulties navigating the VA system, says Wilson. For years, the VA has been plagued with significant backlogs, lost records, and red tape. Despite a concerted effort to overhaul the system, problems remain. More than a half-million individuals nationally are unable to get an appointment scheduled with a physician within 30 days, while an additional 34,656 veterans are on the “electronic wait list” (EWL) and cannot get an appointment in fewer than 90 days, according to an August 2016 report by the VA. And while the average wait times for appointments are significantly shorter in New Jersey than national averages, it can still be a challenge for veterans in the state to get services. The August report showed that more than two-thirds of New Jersey veterans on the EWL had been waiting for more than 120 days to be scheduled for an appointment. “The VA is overwhelmed. It can be so hard to get an appointment, and they can’t do same-day visits. Veterans call here, and they can get an appointment right away. It’s better for nitially, the practice’s mission was to have 125 VTCI patient encounters, including initial visits for new patients and any follow-up visits—a goal it has surpassed easily. By the end of August, practitioners at the Monument Square site had recorded a total of 275 office visits through the program, with as many as 13 appointments per week, and had 41 future appointments already scheduled. Most of the growth has been because of word of mouth from the veterans who participate, as well as Wilson’s unflagging efforts to help spread the word via avenues such as social media, posting on Facebook pages for veterans groups and more. Though initially slated to end its run in June, VTCI did so well, coming in under budget and benefiting so many individuals, that the state extended funding through Spring 2017. Program advocates—providers as well as patients— say more time is needed to continue what has become an essential service for area veterans. “I’ve become a big believer in this program,” says Dr. Boyle. “It will be a huge disappointment to the veterans if the state does not continue funding it. All focus group participants expressed concern that the program would soon be ending.” In the meantime, the practice is laying the groundwork for future physicians to become more aware of the needs of the veteran population, educating residents and medical students who are exposed to this type of culturally sensitive care, Dr. McGarry says. “Understanding the cultural differences that exist for a veteran population is a blind spot for most doctors,” she says. “The veteran experience is very different from the civilian experience, and that needs to be recognized and reflected in the medical care and services provided. “That all people who serve [in the military] don’t have access to health care doesn’t seem right,” Dr. McGarry continues. “Being involved with a program like this one feels like we’re on the right side somehow.” M Robert Wood Johnson I MEDICINE 25