Prosthetics Are Different

Buerkle said she is concerned, because prosthetics are different from other items ordered and need to be treated that way.

“Amoxicillin is amoxicillin. A thermometer is a thermometer. But a prosthetic is unique to that person and to his needs or her needs. That’s my concern with this,” she said.

Petzel said he agreed this is “the most personal of work that VA does.”

“The reforms that we are talking about will not interfere with that process. The physician orders the prosthetic, and that order can be very specific,” he said.

In a pilot that took place in three VISNs, Petzel said physician satisfaction was measured about whether they felt the prosthetic they ordered had been purchased.

The pilot found that, “100% of the time, the contracting officer adhered to the prescription,” Matt Matovsky, VHA assistant deputy undersecretary for Health, Administrative Operations, told the subcommittee.

Petzel said that VA will continue to monitor whether physicians’ orders are followed, as well as the timeliness of purchases and whether the patient and provider are satisfied.

“When we have been into this for a year or six months, we will look at the overall process and see what it has accomplished and see if, indeed, we are doing, overall, a better job of purchasing than we were before,” he said.

Veteran service organizations were not represented at the hearing to testify, but Petzel said VA officials have met with some VSOs recently, and they are on board with the reforms. Buerkle, however, suggested that VA officials make sure that they include more VSOs in conversations about the process.

“There is nothing more important than the veterans and making sure that, when they come home without a limb because they have served this nation, that they have what they need and that they are not dealing with some contracting officer who has some discretion to give him less of a device than he deserves,” Buerkle said.

VA officials also told the subcommittee that a plan for a comprehensive office of rehabilitation and prosthetics has been developed and is in “approval stages,” according to Lucille Beck, PhD, acting chief consultant for VA’s Prosthetics and Sensory Aids Service.

“In that office, we will have a national program director and large staff devoted to prosthetics and sensory-aid service. It will be managing the clinical practices, the procurement and contracting, the regulatory issue and development of all of the programs,” Beck said.  

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