By Brian Todd

(CNN) — Hundreds of current and former VA doctors, nurses and other caregivers have issued a warning to the Department of Veterans Affairs about the negative impacts of the agency’s recent staffing cuts and other policy changes.

In a mass letter sent Wednesday to VA Secretary Doug Collins, the agency’s inspector general and congressional leaders, obtained by CNN, the group warns that workforce reductions and moves to outsource care to private sector doctors and healthcare facilities will harm veterans.

“We write to raise urgent concerns about proposed policies which, in addition to ones already enacted, will undermine VA’s healthcare system, overwhelm VA’s budget, and negatively affect the lives of all veterans. We have witnessed these ongoing harms and can provide evidence and testimony of their impacts,” the group wrote.

More than 160 doctors, psychologists, nurses, researchers and others signed the letter initially. Since the group sent the letter, the number of signees has grown to 350, according to one of the letter’s organizers. More than 25 doctors signed the letter by name, and many others signed it anonymously.

In recent months, CNN has spoken with more than a dozen doctors and nurses in the VA healthcare system about similar concerns. Many of them asked to remain anonymous out of fear of retaliation from the VA.

The letter does not mention President Donald Trump by name, but it references recent staff cuts and other policies undertaken at the VA since Trump took office in his second term. Collins and other VA officials have repeatedly stressed the changes will not hinder veterans’ care and are in fact designed to reduce bureaucracy and improve efficiency at the agency.

In response to the letter, VA press secretary Peter Kasperowicz said, in an email to CNN, “VA is serving Veterans much better under the Trump Administration than it was under the Biden Administration, and the numbers prove it.”

Kasperowicz said the backlog of veterans waiting for VA benefits is down considerably under the second Trump administration and cited a recent announcement that the VA is realigning $800 million to improve infrastructure at VA health care facilities. Of the shift toward more private sector care for veterans, Kasperowicz said, “VA has made it easier and faster for VA-enrolled Veterans to access care from non-VA providers at the department’s expense.”

Democratic Sen. Richard Blumenthal, the ranking member of the Veterans Affairs Committee, said of the doctors’ letter, “Courageously and powerfully, VA physicians are sounding an alarm– in fact, a five alarm fire– on devastating damage to VA health care as a result of this Administration’s funding cuts, contract cancellations, and personnel firings. Their warnings, made at great personal risk, need to be heeded.”

Doctors react to recent VA moves

The doctors who signed the letter – entitled “The Lincoln Declaration” after President Abraham Lincoln’s call for veterans’ care that served as the basis for the VA’s creation – are particularly worried about the rapid pace of the VA’s moves toward outsourcing veterans’ care. That policy is collectively known as “community care,” and the VA has been devoting an increasing percentage of its budget to that system over the past several administrations, both Democratic and Republican.

The doctors write, “Rapid growth of purchased (community) care … threatens to divert resources from VHA’s high-value direct care.” VHA refers to the Veterans Health Administration, the medical arm of the VA. The VHA oversees all of the agency’s hospitals and clinics and almost every aspect of veterans’ health care.

The doctors wrote that if the trend toward outsourcing to the private sector continues, “VHA facilities may be forced to close, and veterans may be forced into costlier, often overburdened community health systems ill-equipped to meet their specialized needs.”

Dr. Dean Winslow is willing to take any risk of retaliation from the VA for the letter. Winslow, who signed the letter by name, is a retired Air Force colonel who served in four deployments to Iraq and two to Afghanistan as a flight surgeon. He now works as a professor of medicine at Stanford University and has medical staff privileges at the VA facility in Palo Alto, California, specializing in infectious diseases.

The VA “has a special expertise in caring for veterans”, Winslow told CNN. “It’s a multi-disciplinary, integrated system. It’s worth fighting for.”

“The non-VA system doesn’t have the expertise. And the for-profit, insurance-based private system is incredibly expensive and inefficient,” Winslow said.

Joye Henrie, a psychologist and veteran who owns Desert Wise, an outpatient mental health clinic in Albuquerque, New Mexico, also signed the letter by name. The clinic is in the private sector, but it specializes in treating military members and veterans referred there by the VA.

Although her clinic benefits from the VA’s outsourcing of care, Henrie says she’s concerned as a veteran who gets her own physical medical care at the VA. “Farming us veterans out to the lowest bidder is hardly in keeping with Lincoln’s promise,” Henrie told CNN. “Veterans are not a commodity, nor should our healthcare be.”

One of the most prominent veterans’ advocacy groups is also supporting the doctors’ protest letter. Kyleanne Hunter, chief executive officer of Iraq and Afghanistan Veterans of America (IAVA), said in an email to CNN, “The VA is a public health system that centers on veteran care. It is part of the promise made to everyone who serves. We must do everything we can to ensure that promise is kept.”

According to the IAVA, less than a third, 31%, of its members who had experience with the VA’s community care system felt that private community care providers understood their medical needs, and only 14% said they had confidence that private and VA teams coordinated properly.

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