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Letter to the Editor - Army Times, Navy Times and Air Force Times

Oct. 15, 1997

We were disappointed and surprised that the Times News Service chose to use the Dayton Daily News Series on military medicine without asking the military services for their comments. You did a disservice to the thousands of dedicated and professional men and women who serve day in and day out in medical commands worldwide providing high quality health care for our active duty servicemembers, our retirees and their family members.

Since the mid-1980ís, the military health system has been peer reviewed by an external civilian organization. Consistently, these reviews have found that health care in the military meets or exceeds civilian standards. All military hospitals must be accredited by the Joint Commission on Accreditation of Healthcare Organizations, and meet the same standards as any civilian hospital. For the past several years, average accreditation scores for military hospitals have been in the 90th percentile and have exceeded average civilian scores.

Military hospitals are both inspected and accredited by numerous additional civilian review organizations. These include the American College of Pathology, the American Association of Blood Banks, the Nuclear Regulatory Commission, the Accreditation Council for Graduate Medical Education and Residency Review Committees. Each review organization holds the military to the same standards as civilian medical facilities.

In 1985, the Department of Defense (DOD) established the requirement for military physicians to be licensed by a state licensing authority and gave them until 1988 to comply. In 1992, requirement for unrestricted license was put in place. This DOD policy requires all physicians to have a valid, non-restricted, current state license to be granted privileges to practice independently. While many physicians have multiple licenses, military physicians must meet the requirements of only one state licensing activity. Due to the mobile nature of military service, obtaining licenses in each state to which a physician could be assigned is not feasible. Physicians in the first year of post graduate training are not eligible for licenses and therefore practice under direct clinical supervision. Non-physician providers (eg. physician assistants, nurse practitioners) who seek independent practice privileges are required to have either a license or a certification from an approved non-military authority responsible for professional oversight of the particular specialty.

All providers are subject to ongoing quality assurance review. Providers with a demonstrated lack of competence are subject to loss of independent practice privileges. The name of any provider who has had independent practice privileges revoked or limited is reported to the Federation of State Medical Boards and the National Practitioner Data Bank. Physicians whose professional negligence results in payment of a Federal Tort Claim also are reported. These requirements are the same whether in the private sector or the military.

The vast majority of military beneficiaries do have the ability to file malpractice claims. The Feres Doctrine, created by the Supreme Court, not the military or the Congress, bars active duty members and OCONUS family members from filing claims. For those active duty members sustaining a disability, regardless of cause, the federal government (either DOD or Department of Veterans Affairs) disability retirement, life insurance and medical programs provide both continued health care and income.

In any medical system there will be unfortunate medical incidents. When these occur in the military medical departments and are brought to the attention of the leadership, they are aggressively pursued and appropriately adjudicated. If our customers ever have a question about the appropriateness of care at a military medical facility we want to know about it, right away. We have health benefits advisors at our medical facilities that are there to help people solve their problems. If our customers feel that the response is not as prompt or appropriate as it should be, we urge them to contact the officer in charge of the medical facility so we can institute actions to correct any problems which may exist.

We believe that our military health services system is one of the highest quality systems in the world. We are committed to providing high quality health care for all our customers.