Politicians and the public often discuss military and veterans’ healthcare as if they are a single entity. They are not. The Department of Defense and the Department of Veterans Affairs operate two entirely separate, siloed bureaucratic networks. While both face severe staffing shortages and crushing backlogs, they are failing our service members in fundamentally distinct ways.
As a physician and a pathologist who has spent a career analyzing diseases of the breast and gynecologic systems, I look at these broken bureaucratic structures the same way I view a complex illness. In medical practice, you cannot just treat the superficial symptoms. To save the patient, you must accurately diagnose the underlying disease pathway. Right now, the most critical systemic failures are occurring in how our federal networks deliver gender-specific care to active-duty servicewomen and female veterans.
Women are the fastest-growing demographic in our military. They are also the most diverse. Nearly 43% of active-duty women identify as racial or ethnic minorities, and black women make up nearly one-third of all female service members. Both healthcare networks remain culturally and structurally trapped in legacy models built by men, for men.
When these medical pipelines break down, it does more than create administrative delays. It actively fuels deep-seated healthcare disparities. For the women of color who disproportionately bear the burden of our defense, a fractured system means delayed diagnoses, fragmented reproductive care, and unequal clinical outcomes. While the healthcare needs of military dependents are a vital issue, the immediate structural crisis affects the women who actually wear the uniform.
The two systems suffer from different pathologies. The VA has accurately diagnosed its needs. It established the centralized Women Veterans Health Care program and built specialized clinics tailored to female physiology and combat trauma. However, this clinical design is constantly choked by a systemic shortage of doctors and nurses. The positions sit empty, causing wait times to skyrocket.
Congress recognizes this operational bottleneck. Lawmakers are currently advancing the bipartisan Women Veterans Specialty Care Access Act, or S. 3999, introduced by Sens. Marsha Blackburn (R-TN) and Maggie Hassan (D-NH). While the VA recently took an administrative step to allow direct-schedule gynecology appointments internally, S. 3999 permanently codifies this right into federal law. It expands this direct access to the Veterans Community Care Program. This ensures women can bypass primary care referrals to see community specialists without delay, preventing a rule change by future administrations.
The active-duty military system suffers from a disease of fragmentation. On-base medical care focuses overwhelmingly on immediate combat readiness. Specialized, long-term healthcare for women is often scattered across disconnected clinics or outsourced entirely to civilian doctors. Compounding this, the persistent cultural stigma surrounding mental health and military sexual trauma deters women from seeking specialized care while in uniform. This creates a wave of unaddressed, compounding trauma that the VA is left to inherit years down the line.
These systemic disconnects highlight the urgent need for statutory intervention. Prior historic frameworks, such as the Deborah Sampson Act, laid a foundation, but they were only initial diagnoses. Current bicameral efforts like the Servicewomen and Women Veterans Menopause Research Act and the Improving Menopause Care for Veterans Act are essential next steps to close systemic research gaps. Lawmakers are also introducing targeted lifelines such as the DOULA for VA Act of 2026 to address maternal health vulnerabilities.
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From my perspective as a physician, far more needs to be done. Passing these bills is a necessary step, but we are still merely managing a chronic condition rather than curing it. Piecemeal legislation and temporary administrative fixes cannot repair a broken institutional foundation. We need an aggressive, top-down overhaul that permanently bridges the divide between military and veteran medicine.
The DOD and the VA can no longer afford to operate in isolated silos. The Pentagon must integrate the VA’s specialized, comprehensive focus on women’s health directly onto active-duty bases before care becomes fragmented. Simultaneously, Congress must fully fund and fix the staffing vacancies that leave VA clinics understaffed. Our servicewomen and veterans stepped up unconditionally to defend this nation. Our federal healthcare pipelines must fix their internal infrastructure to finally protect them.
Eric Wargotz, M.D., is a practicing physician and pathologist specializing in breast and gynecologic diseases. He is the 178th president of MedChi, the Maryland State Medical Society.