Good Enough for Government Work: VA Anthropology

Hello all, this post in the Anthro Journey Series focuses on government research as a viable career path for anthropologists by way of an example I know fairly well, anthropologists doing multi-disciplinary team research in the US Department of Veterans Affairs (VA). The VA is one of the largest single employers of anthropologists in the US and the largest Federal employer of anthropologists. I'm structuring this article by outlining the positive and negative aspects of working at the VA, and then concluding with a list of anthropologists and other health scientists doing great work at the VA.

The Up Side

In my mind, the best reason to do health research and program evaluation for the VA is that these studies and projects have a strong potential to directly benefit Veterans of the U.S. armed services. Irrespective of one's views on US foreign policy and military interventions, there is a broad consensus that service members sacrifice a great deal in service of their country and deserve comprehensive support and understanding during their terms of service and afterward when they transition into Veteran status. The VA is at the forefront of many areas in healthcare including care coordination between primary and specialty care, medical informatics, trauma-related mental health care (e.g. post-traumatic stress disorder), traumatic brain injury (TBI) care, and rehabilitation generally. Health research, particularly health services research, contributes to this quality of care and on balance the VA provides a good space and infrastructure for health services research that compares favorably to the private sector. In many VA hospitals around the US, anthropologists play an important role in this research.

For anthropologists who don't want to or can't find a meaningful career in academe, health research in the VA is a blended experience that incorporates some aspects of academe, but is also more streamlined than a traditional academic setting. There is wide latitude for research topics within the framework of health services research (or rehabilitation or clinical research as the case may be) provided it informs Veteran health. There is ample opportunity to publish as a lead or down-the-list author on most research teams. Unlike academe, the burden of teaching and committee service is fairly low. There are research interest groups across VA sites on topics such as obesity and TBI. Sometimes there is opportunity for collaboration between VA research centers and academic or institute research centers. One example of such a collaboration is the TBI Model Systems of Care (TBIMS) which has robust frameworks of collaboration between civilian and VA sites. Of course, this circumstance only pertains to the VA side of the research. In many sites, most senior researchers are primarily affiliated with a University as tenured or tenure-track professors with a secondary affiliation as VA health scientist. In these cases, normal academic obligations pertain.

Another benefit to doing anthropology in the VA is that most research and evaluation is done with a multidisciplinary collaborative approach that can include anthropologists, psychologists, nurses, MDs, DOs, and many other types of clinicians. For instance, I had the privilege of working with and learning from a very talented podiatrist named Latricia Allen during my VA post-doc. I learned things about how foot health ties into general health in areas like diabetes and wound care that I most likely would not have learned in an academic anthropology department. Working with clinicians of a pragmatic bent is very grounding and can help steer clear of the more esoteric and acrimonious debates in social theory. Anthropologists often enrich the design and execution of health services studies as they are often the primary qualitative and community health experts at the table.

The Down Side

While working as a health scientist at a VA Medical Center has many benefits, it is also challenging and stressful in some ways. Unlike TTPs in academe or permanent clinical roles at the VA, most VA research positions are entirely dependent on grant funding or "soft money". If one cannot maintain full FTE grant funding on one's own or someone else's studies, then being cut to part-time or laid off is a real possibility. As with the NIH and elsewhere, VA grants are generally very competitive and seasoned PIs have a distinct advantage in this competition. Workarounds to mitigate this situation do exist, but one must be proactive in finding strategies and mentorship to launch a successful VA career. For those that go the VA route, I highly recommend building a strong network and taking full advantage of webinars and other educational opportunities.

Another drawback I perceived at the VA is that sometimes it seemed that anthropologists had less prestige and were taken less seriously than clinician-researchers. It sometimes appeared as though anthros were brought in as qualitative specialists to check a box to make a study look thorough or mixed methods, sometimes by PIs who didn't demonstrate a firm grasp on or strong appreciation for qualitative methodologies. My caveat here is that this is a sense I got and I did not discuss it widely with other VA anthropologists or other types of health scientists. I would welcome any feedback on this point either in support or rebuttal.

For those do not respond well to large bureaucracies with a long and intricate set of rules and procedures, a career with the VA might not be the best choice. Research studies may take many steps to be approved, including approvals from an affiliated institutional review board (IRB) and approval from the research and development committee of the VA hospital where one conducts the research. The administrative lag time varies by VA site, but usually means that doing anthropology at the VA is not an efficient or nimble process.

Learn More

Here is a link to learn more about Health Services Research and Development at the VA.

I am ending this article by pointing out some of the top-notch health scientists doing important work at the VA.

Among anthropologists: Karen Besterman-Dahan, Margeaux Chavez, Bridget Cotner, Jason Lind, Wendy Hathaway, Bridget Hahm, Kiersten Downs, Nora Arriola, Jacqueline Siven, Nikki Demetriou, Sarah Ono, Karen Dyer, Gemmae Fix, Megan McCullough, and Kara Zamora. There are many more anthropologists doing great work at the VA. Feel free to mention someone in the comments.

Other health scientists doing great work at the VA include: Gail Powell-Cope, Mary Jo Pugh, Risa Nakase Richardson, Christine Melillo, Jolie Haun, Marc Silva, Chris Fowler, Vanessa Panaite, and many more.

Until next time, safe travels.