• Natalya C Maisel, Sally Haskell, Patricia M Hayes, Vidhya Balasubramanian, Anupama Torgal, Lakshmi Ananth, Fay Saechao, Samina Iqbal, Ciaran S Phibbs, and Susan M Frayne.
• *Women's Health Evaluation Initiative (WHEI), Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA †Women's Health Services, VA Central Office, Washington, DC ‡Health Economics Resource Center §Women's Health Service, Medical Service, VA Palo Alto Health Care System, Palo Alto, CA ∥Division of General Medical Disciplines ¶Department of Pediatrics #Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA.
• Med Care. 2015 Apr 1; 53 (4 Suppl 1): S39-46.

BackgroundVeterans Health Administration (VHA) primary care providers (PCPs) often see few women, making it challenging to maintain proficiency in women's health (WH). Therefore, VHA in 2010 established Designated WH Providers, who would maintain proficiency in comprehensive WH care and be preferentially assigned women patients.ObjectiveTo evaluate early implementation of this national policy.MethodsAt each VHA health care system (N=140), the Women Veterans Program Manager completed a Fiscal Year 2012 workforce capacity assessment (response rate, 100%), representing the first time the national Designated WH Provider workforce had been identified. Assessment data were linked to administrative data.ResultsOf all VHA PCPs, 23% were Designated WH Providers; 100% of health care systems and 83% of community clinics had at least 1 Designated WH Provider. On average, women veterans comprised 19% (SD=27%) of the patients Designated WH Providers saw in primary care, versus 5% (SD=7%) for Other PCPs (P<0.001). For women veterans using primary care (N=313,033), new patients were less likely to see a Designated WH Provider than established women veteran patients (52% vs. 64%; P<0.001).ConclusionsVHA has achieved its goal of a Designated WH Provider in every health care system, and is approaching its goal of a Designated WH Provider at every hospital/community clinic. Designated WH Providers see more women than do Other PCPs. However, as the volume of women patients remains low for many providers, attention to alternative approaches to maintaining proficiency may prove necessary, and barriers to assigning new women patients to Designated WH Providers merit attention.

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