Defending Care: Clinical Research at the Veterans Health Administration 2000-2025

Jane Pryma, Boston University

As the U.S. experiences partisan backlash against its federal workforce, sociologists chart how the work of federal research continues amidst mass layoffs, funding cuts, privatization, restructuring, and political purity tests (Vertesi 2026; Wingfield 2025). Sociologists of professions and the state have long explored how frontline workers defend the populations they serve by reshaping federal and state institutions from within. Welfare bureaucrats, asylum case officers, and NIH research officials have been shown to redefine their practices, ethical justifications, and day-to-day routines to protect clients from organizational, structural, and political threats that they perceive as counter to their professional identity and its moral commitments (Best 2012; Epstein 2009; Shiff 2025; Watkins-Hayes 2009). Yet, due to the privatized American healthcare system, scant research has explored how federally employed clinicians have produced new medical knowledge under changing political conditions in the United States. This paper traces how the only federal, publicly managed healthcare system in the U.S., the Veterans Health Administration, built a reputation as a stalwart of cutting-edge, social medicine, experimenting with models of effective care unthinkable in the private civilian system and conducting groundbreaking research on chronic pain, trauma, and gender-responsive healthcare. Through analysis of archival documents, congressional hearings, and clinical research published by the VHA from 2000 to 2025, this paper explores how VA clinical researchers have creatively reimagined models of care within a federal institution bound to the imperatives of the military and fiscal concerns. It concludes with evidence of how VHA clinical researchers are responding to present demands from the executive branch.

No extended abstract or paper available

 Presented in Session 22. Health, Medicine and Body