Dear Editor,

There has been much talk about a VA Skilled Nursing Facility being located in Buffalo. No one has taken a step back to ask if this is the right thing for veterans and our current health care system. As physicians who currently provide care for our Veterans, we are here to voice our opinion.

Our veterans require several sub-specialists that we simply do not have consistently in our community. Through the current VA system, if we want to refer one of these patients to a specialist it takes weeks to even months to get them the care that they need, and oftentimes they still have to travel out of our county for their care. In our mind, it is an unnecessary burden to already overworked nurses and other support staff, as it is their responsibility to transport these patients.

Others have testified that bringing this skilled nursing facility to Buffalo would only increase continuity of care, and we find this disconcerting. The continuity of care starts with a primary care provider.

They act as the gatekeeper for the patient and help to coordinate specialist visits as well as therapeutic and diagnostic procedures. For example, if a patient requires dialysis, this is not something we offer in our community. This would mean visits to a dialysis center three to four times a week. Again, creating an increased cost for our healthcare system resulting in these veterans having to go outside of our county for medical care.

We also do not believe some members of our community understand the ramifications of placing veterans with psychiatric and behavioral issues in our community. There are no psychiatrists in our community or on our current medical staff. Our hospital is not equipped with a locked unit should they end up in our emergency room or hospital. We only see this causing significant burden to the healthcare system, requesting additional nursing staff as often these patients require one-on-one supervision. There also typically ends up being an additional cost to the county when these patients have to be “titled” in order to get accepted into psychiatric facilities.

We ask that you consider a physician’s perspective on this matter. We choose to be physicians not only because we want to help people, but we want to do what is right for our current healthcare system. Placing a skilled nursing facility in a community with already limited resources does not accomplish that goal.

Alyse Williams, MD; Mark Schueler, MD; Brian Darnell, DO; Jennifer Rice, MD; Blaine Ruby, MD; Ryan Ludwig, MD; Hermilo Gonzalez, MD; Lisa Mullen, MD

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