In late May, Secretary of Defense Chuck Hagel ordered a review of the military health care system in light of the ever growing health care scandal at the VA. While the review is still ongoing, early findings, as well as an independent review conducted by the New York Times, show the alarmingly poor state of military medicine.
"As the secretary has made clear, nothing is more important than the health and well-being of our people," said Pentagon Press Secretary Rear Admiral John Kirby in a statement regarding the review.
"Following the review, the secretary will receive recommendations on areas for improvement," the admiral said, "with a specific focus on those areas where we are not meeting a nationally defined standard or a DoD policy-directed standard."
No additional comments have been released by the DoD.
The review is expected to take 90 days to complete, with Secretary Hagel receiving briefings as it progresses. However, only 7 of the more than 350 hospitals and clinics in the military system are being reviewed. They are not the facilities serving the largest populations, nor are they the facilities that have seen the most problems, something that may call the results of the review into question with critics.
While the New York Times report and the entire VA health care scandal have cast an unfavorable light on military health care recently, the problem is nothing new. Studies from a decade ago show that military members and their families had little confidence in a system that is supposed to be one of their most valuable benefits.
According to the report, despite policies requiring periodic reviews of health care facilities and reports when avoidable incidents occur, both rarely happen. Between 2011 and 2013, there were 239 unexpected patient deaths in the military health care system, but only 100 reports were filed.Within the military health care system, errors are a chronic problem, and they seem to mainly fall into two categories: surgical care and maternity care, though that doesn't mean problems don't exist in other areas.
Documents from the DoD highlight some of the shoddy care received at military facilities. One document outlines the problem of "Unintended Retained Foreign Object Events in Obstetrics."
The review found that doctors were leaving surgical instruments, sponges, and other foreign objects inside patients for reasons as simple as ineffective communication and a failure to check or count the items in labor and delivery rooms.
According to the New York Times, the more than 55,000 babies born in the military health care system each year are more than twice as likely to sustain injury during birth as those born in civilian facilities. These injuries often result in severe, life-long problems.
Another document highlighted problems with misdiagnosis and delays in treatment as a result. The document stated that these problems are often due to a "breakdown in communication with and between physicians" and "issues with the continuum of care." It also noted that the typical outcome is some degree of harm to the patient.
Misdiagnosis and treatment delays are so common that almost every service member or dependant has experienced it at some point, sometimes even multiple times. But, thankfully, it isn't life threatening most of the time.
Most errors are fairly straightforward: files go unread or doctors don't communicate with each other. However, there are also stunning cases of ineptitude that sadly resulted in permanent harm or death. These are just a few:
- A young army wife and her unborn baby died of sepsis after being sent away from an Army hospital multiple times when she sought treatment for her symptoms. She was just 21 years old. Her case was not investigated.
- Marine Corps Sgt. Carmelo Rodriquez died of cancer, a diagnosis that was noted in his medical record, but he was never informed of it. He was never referred for treatment and died as a CBS news crew was preparing to interview him. He was 29 years old.
- A pediatric gastroenterologist incorrectly diagnosed a young girl with rumination syndrome without running any tests or reviewing her file and recommended no further treatment. Six months later, the girl was given a full workup at a different facility and it was revealed that she had serious gastrointestinal problems from the incorrect diagnosis and delay in treatment. She required a gastric pacemaker at the age of 11.
- A TSgt. was admitted to a military hospital for a cesarean section to deliver her full-term baby boy. She died 12 hours later after having two surgical sponges left inside of her. She bled to death. She was 37 year old.
- A total of four hospital administrators were relieved of duty citing a "lack of trust and confidence" following the deaths of a 24-year-old soldier and a 29-year-old military spouse. The deaths came mere days after the facility had received a bad report. Womack Army Medical Center, where these deaths occurred, has been plagued with some serious problems.
While DoD talking points say that military medicine is as good or better than civilian care, the New York Times report and DoD documents show that when it comes to patient safety, the military is its own worst enemy.The hierarchical culture and compartmentalization of the military allows errors to fall through the cracks. In addition, the sheer number of people that these facilities are required to see is staggering.
Military dependants are pushed toward enrolling in the Tricare Prime health care plan, as it is more cost effective for the military and virtually free to the service member. However, this creates a situation where a single doctor is responsible for more than 1,000 patients in some cases, making it next to impossible to provide quality health care.
During the DoD's review, visits will be made to the health care facilities being assessed and public meetings will be held with service members to get their thoughts and opinions on the state of military medicine. In addition, service members can email their comments to the MHS Review Group. Comments can be made anonymously. This is perhaps the best way for service members to make their voices heard during this rather limited review.
Photo retrieved from the Military Wallet.