STATEMENT OF
FRED S. WRIGHT, MD
ASSOCIATE CHIEF OF STAFF FOR RESEARCH
VA CONNECTICUTHEALTHCARE SYSTEM
BEFORE THE
SUBCOMMITTEE ON HEALTH
COMMITTEE ON VETERANS' AFFAIRS
HOUSE OF REPRESENTATIVES

June 7, 2004

Mr. Chairman and Members of the Subcommittee:

I am grateful for the opportunity to discuss health care facilities and opportunities for improving health care for veterans in the State of Connecticut.   I will focus on the role of research.  The VA Connecticut Healthcare System (VACHS) Research program has more than 380 active projects led by more than 130 principal investigators. The majority of our investigators are clinicians who also provide patient care in Internal Medicine, Surgery, Mental Health, or Neurology. The research programs of the VACHS medical staff range from basic science  (including molecular biology, cell biology, and genetics) to clinical research (involving clinical trials, health services, epidemiology, and rehabilitation).  Approximately two thirds of the projects are clinical research studies involving human subjects.  The remainder involve animal subjects and other laboratory research.  Last year the competitively awarded funding for these projects exceeded $30 million.  Most of this research activity is concentrated at the West Haven campus

Research is vitally important to our hospital and to our ability to deliver high quality primary and specialty care to veterans.  This is true because of our affiliations with Connecticut's two medical schools: the Newington campus with the University of Connecticut Health Center and the West Haven campus with the Yale University School of Medicine. Nearly all members of the VACHS medical staff have dual appointments as both VA physicians and medical school faculty members.  In addition to their VA patient care activities, VACHS physicians have responsibilities in teaching and research. The medical school affiliations provide benefits to both partners.  Consider, for example the affiliation with Yale University.  The VACHS is important to Yale: the West Haven campus is an important site for clinical rotations by medical students, residents, and fellows in specialty training programs where they contribute to the care of VA patients and are taught by Yale faculty who are based at the VA medical center.  Yale is important to the VACHS: our ability to recruit physicians to the VACHS medical staff is greatly enhanced by the associated appointment to the Yale faculty, the opportunity to serve as a teacher for medical students and residents, and the chance to carry out independent research in an environment enriched by the proximity of the medical school.

Research at the VACHS is relevant to diseases that affect the veteran population, and is aimed at improving the health and health care of veterans. In addition it is important to recognize that the research program brings outstanding individuals to the VA medical staff. These are individuals, who are committed to academic medicine, and who are attracted to work in VA by the combination of providing care for veterans, teaching students, and conducting research in an environment enhanced by the resources of the nearby medical school.  Without a robust research program we would not be able to recruit the nationally recognized clinician investigators who serve as attending physicians, clinical leaders, and specialist consultants to whom our primary care physicians refer patients.

Of course successful research requires energetic and imaginative researchers.  Successful research also requires both funding for project costs and facilities in which to carry out difficult and exacting work.  Research funding comes from several sources.   Approximately one third of the direct cost funding for VACHS research comes from the VA Research appropriation.  Nearly one-half of our funding is provided by grants from the National Institutes of Health. 

The VA research program is different in both size and purpose from research supported by NIH.  VA research provides necessary support for clinician-investigators who are based at the VA in order to serve as VA clinicians providing care to veterans.  The opportunity to carry out research and to teach in medical school-affiliated VA medical centers is critical to recruiting VA medical staff, particularly at hospitals offering advanced specialty services.  We have been able to fund a wide range of additional VA research projects by competing successfully for NIH and other non-VA funds.

Mr. Chairman, this concludes my statement, and I will now be happy to answer any of your questions.  Thank you.