Doctors advised to look for links between illness, military service

Oversight of veteran status can hamper medical care and even cost patients money in the form of missed medical benefits

Martin C. Evans
Newsday

Doctors and other clinicians who treat veterans often miss links between certain maladies and a patient’s prior military service — oversights that can hamper medical care and even cost patients money in the form of missed medical benefits.

That was the conclusion of veterans advocates who pointed to a host of medical maladies found to have possible links to military service, including cancers, Type 2 diabetes, Parkinson’s disease and heart conditions.

The advocates, who spoke at a Friday symposium at Nassau University Medical Center, urged clinicians to take steps to identify veterans among their patients, and to learn about medical and psychological conditions linked to military service.

Because doctors often fail to determine a patient’s status, veterans often go without cash benefits and medical supplies offered by the Department of Veterans Affairs, they said at the symposium organized by the Nassau Queens Performing Provider System, an alliance of Long Island’s largest hospital groups.

“How many of you ask if your patient is a veteran?” asked Rick Gales, a veterans service counselor for the Town of Hempstead who addressed the symposium’s audience of about two dozen medical professionals. None raised a hand.

One of the attendees was Dr. Samia Qazi, who is chief of primary care at Nassau University Medical Center.

“It makes me realize we need to ask more questions, and to link their service to problems they may be having,” Qazi said.

Organizers produced the symposium in response to a Rand Corporation study, which concluded that few of New York State’s health care providers — less than 3 percent — are fully equipped to address veterans’ needs.

The study’s authors said health providers often fell short because of unfamiliarity with military culture, a lack of knowledge concerning military-related injuries, a lack of screening for health problems common to veterans, or other deficiencies.

“These findings reveal significant gaps and variations in the readiness of community-based health care providers to provide high-quality care to veterans,” Terri Tanielian, a Rand senior behavioral scientist and the study’s lead author, said shortly after the report was released.

“It appears that more work needs to be done to prepare the civilian health care workforce to care for the unique needs of veterans,” Tanielian said.

Veterans advocates say these shortcomings are especially alarming now because federal officials are considering whether to encourage more veterans to use private health facilities rather than medical services offered by the Department of Veterans Affairs.

About one in three veterans now see outside doctors through the so-called Choice program, which Congress enacted after learning in 2014 that sick veterans often waited for more than a month to be seen at a VA health facility.

And the Congressional Budget Office has estimated that legislation approved two weeks ago could persuade an additional 640,000 veterans nationwide to seek private care — a 75 percent expansion over the Choice program’s current levels.

On June 6, President Donald Trump signed the $55 billion Veterans Affairs’ Mission Act, which further expands the ability of veterans to bypass VA facilities by using taxpayer dollars to see private doctors.

Long Island has one of the nation’s largest concentrations of former military personnel, with an estimated 122,000 veterans living in Nassau and Suffolk counties, according to census data. About one in four Long Island veterans were treated through the region’s VA medical facilities in 2017.

Military service exposes individuals to multiple hazards that often lead to chronic health problems, said Dr. Elizabeth Werns, a physician at the Department of Veterans Affairs Medical Center in Northport.

During the Vietnam War, more than 2 million U.S. GIs were exposed to the toxic herbicide known as Agent Orange, which has been associated with elevated rates of diabetes and heart problems. Soldiers who participated in the 1990-1991 Gulf War were exposed to ammunition containing depleted uranium, and acrid smoke spewing from out-of-control oil fires. And all war veterans display high rates of hearing loss, as well as chronic knee, back, neck and shoulder pain associated with carrying heavy packs of ammunition and other gear.

David Cockerel, who is the 1st vice commander of American Legion Post 342 in Freeport, was among veterans advocates who said private sector doctors must ask patients if they once served in the military because veterans often do not volunteer this information.

“A lot of these guys end up in the regular medical system,” Cockerel said. “They end up feeling alienated and misunderstood.”

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