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Wednesday Jun 06, 2012

Colonel's Request is Simple: Ask Patients if They Served in Military

After 29 years in the Army and multiple deployments to war zones, retired Col. David Sutherland understands that death is a part of battle. What he won't accept is the glaring number of U.S. military veterans who are falling through the cracks here at home.

Sutherland was one of the speakers recently at our Family Medicine Congressional Conference (FMCC). The point of his poignant story was similar to one I told you about earlier this year: Our military veterans are coming home with physical and emotional injuries that aren't being properly diagnosed and treated, and we can help by being aware of their issues and supportive of their problems.

Although some in the FMCC audience that day already may have heard about the Joining Forces Initiative, which is intended to help military families, Sutherland's powerful, heart-wrenching presentation gave us a glimpse of life in the military and a veteran's perspective. He described war as "vile." With words and photos, Sutherland told us about people he served with and the death and destruction they experienced.

Some died in service to our country.

Some survived war and returned home, but they struggled with the jarring differences between living in a combat zone and civilian life and died at their own hands.

Sutherland (pictured here with family physician Sarah Sams, M.D., of Hilliard, Ohio) also talked about veterans who made the difficult adjustment to coming home with the help and support of their families and communities -- including physicians.

Sutherland's request for the roughly 200 family physicians in attendance was simple: be aware, be supportive and be understanding of veterans and the issues they and their families are facing as they adjust to civilian life.

  • About one-third of the veterans  returning from Iraq and Afghanistan will experience signs or symptoms of combat stress, depression, post-traumatic stress disorder (PTSD) or traumatic brain injury (TBI).
  • Alcohol and substance abuse are significant problems, with more than one-fourth of Iraq veterans meeting criteria for alcohol abuse within four months of returning home.
  • The unemployment rate  for Iraq and Afghanistan veterans who have left the military is nearly 13 percent.
  • According to the Department of Defense, former service members account for 20 percent of suicides in this country, dying at a rate of 18 a day.

What does it all mean for family physicians? More than 2.3 million U.S. soldiers served in Afghanistan or Iraq -- or both -- during conflicts that started more than a decade ago. About half of the veterans returning from those two wars are expected to receive medical care in the private sector rather than from the U.S. Department of Veterans Affairs. This is not just a VA problem.

Sutherland said veterans often are stoic individuals who might be reluctant to volunteer information without prompting. But if family physicians make the question, "Have you or a loved one served in the military?" as routine as asking if a patient smokes, it can help. And a follow-up question as simple as, "How are you doing?" could start a life-changing conversation.

To learn more about TBI and PTSD -- including screening tools, CME and information for patients -- visit www.aafp.org/joiningforces.

Glen Stream, M.D., M.B.I.is president of the AAFP.

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