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July 7, 1989, Vol 262, No. 1 >

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ARTICLE | July 7, 1989

VA—Medical School Affiliations: An Unfair Partnership

Iris Fletcher Norstrand, MD, PhD
JAMA. 1989;262(1):31. doi:10.1001/jama.1989.03430010043019.
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To the Editor.—  The words "university" and "medical school" are magic ones that conjure up visions of Nobel prize— winning research, superb teaching, and quality patient care. How gratifying to conceive of a 50/50 marriage between the Veterans Administration (VA) and the medical school, with a meeting of the minds between physicians of both institutions, culminating in top-notch medical care for the veteran! Unfortunately, such an idyllic arrangement can never exist until certain reforms are instituted. Not only have money and power been the motivating forces rather than quality care for veterans, but, in most instances, the medical school has assumed complete control of the relationship to the detriment of the veteran1-3 and the VA physician.Historically, when the VA was founded in the early 1930s, guidance by medical schools was necessary because VA hospitals were little more than "old soldiers' homes" and because there was a critical shortage

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