Military Medicine

October 15, 2018

Will Supreme Court reconsider government’s immunity from medical malpractice suits by active-duty military?

Although Uncle Sam makes a special vow to provide medical care for those who fight for this nation, he also enjoys special legal shields from lawsuits from them if anything goes wrong with medical services they’re provided. But recent news reports show how past and present service personnel not only suffer shabby medical care but also “grossly unfair” situations when pursuing malpractice claims — and why lawmakers and courts may need to step in to provide fairer remedies.

Kaiser Health News (KHN) and the ABC-TV news affiliate in Los Angeles both deserve credit for spotlighting tough cases involving service personnel and medical malpractice, particularly the Federal Tort Claims Act and the Feres doctrine, a 68-year-old Supreme Court case that bars active-duty military members from suing the federal government for their own injuries.

Walter Daniel, a former Coast Guard officer, has petitioned the Supreme Court to “amend the 1950 [Feres] ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can,” KHN reported, noting this would affect patients in a military health system “with 54 hospitals and 377 medical clinics, serv[ing] about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.”

August 12, 2018

Say what? Mar-a-Lago trio acting as ‘shadow rulers’ of Trump’s VA

by Patrick A. Malone

So, see, Ike, Marc, and Bruce may be pretty swell guys. They’ve done well in business: Ike in comic books and entertainment, Marc in the law and consulting on white collar crime, and Bruce as a medical concierge who gets affluent patients in to see big name doctors.

But this odd trio —Ike Perlmutter, Bruce Moskowitz and Marc Sherman — never served in the U.S. military. They’re certainly not veterans. Perlmutter and Sherman have zero experience in health care. And Moskowitz, while a doctor, is a respected primary care practitioner — not someone known for his direct experience in running big, complex operations.

They also, however, happen to be FOT — Friends of (President) Trump. They pay him to belong to his Mar-a-Lago country club. And, apparently at his request and with the assistance of powerful partisans and the acquiescence of sheepish bureaucrats, Perlmutter, Moskowitz, and Sherman have become “shadow rulers” of the U.S. Department of Veterans Affairs.

June 8, 2018

Is there a doctor aboard? While flying this summer, you may hope so

by Patrick A. Malone

With tens of millions hopping on jets to get to summer vacation destinations, it’s worth noting that medical emergencies aloft aren’t as rare as many travelers might imagine — and it may be beneficial if a doctor happens to be aboard when the need arises.

The nation’s top doctor, U.S. Surgeon General Jerome Adams, of course, may have spotlighted sky-high medical care, when he answered flight attendants’ emergency page to all those aboard a Delta flight from Fort Lauderdale to Atlanta. Details are a bit sketchy. But a passenger on the early May trip apparently passed out, and worried crew needed medical assistance and an evaluation of potential next steps.

Adams said he was pleased to step up and assist the crew as the flight, which was on the tarmac, returned to the airport gate, where a crew member took the ailing passenger off for care, while the Delta plane resumed its planned trip.

March 15, 2018

Veterans deserve better than more scandals at VA hospitals in DC, nationwide

by Patrick A. Malone

More than 100,000 patients in the area surrounding the nation’s capital rely on a flagship hospital for what should be blue-chip care. They deserve better than the continuing scandal that envelops not only the VA Medical Center in Washington, D.C., but also its parent Department of Veterans Affairs.

Investigators have excoriated the VA and its leader for failing to address problems in the agency’s medical facilities nationwide but especially in Washington, because officials, as USA Today reported, “had been informed of the issues repeatedly since 2013.”

The news organization added that investigators concluded “a culture of complacency and a sense of futility pervaded [VA] offices at multiple levels,” such that, “In interviews, leaders frequently abrogated individual responsibility and deflected blame to others. Despite the many warnings and ongoing indicators of serious problems, leaders failed to engage in meaningful interventions of effective remediation.”

February 25, 2018

To treat gun violence as a health crisis, start with existing myth-busting data

by Patrick A. Malone

When partisans refuse to deal with deadly gun violence as a public health crisis and to support and fund rigorous research to guide law-making, it’s unsurprising that extreme and outlandish notions rush to occupy a noxious space in public discussions — a condition one think tank has labeled “truth decay.”

Let’s not stoop, though, to useless bickering about our respective “thoughts” on guns, but rather stick to facts and credible evidence to figure how the nation can better prevent mass shootings.

Exhibit A: A South Florida radiologist’s essay on the lethal results of wounds inflicted by high-powered battlefield weapons like the AR-15 used in the recent mass shooting at a Florida high school.

February 21, 2018

FDA approves a blood test to diagnose severity of traumatic brain injury

by Patrick A. Malone

Federal officials offer a glimmer of hope in caring for head injuries, especially the sharp, repeated, and often damaging blows that afflict athletes and which millions worldwide are witnessing, yes, as part of the Winter Olympic Games.

The federal Food and Drug Administration has announced that it has approved a long-awaited blood test that can help doctors determine the severity of traumatic brain injuries. This test will provide a cheaper, easier, more convenient, and likely faster way to handle the rising health bane of concussions, rather than relying on computed tomography or CT scans using big machines and a form of X-rays.

As the New York Times reported:

December 19, 2017

Seven words that federal scientists are no longer supposed to use (one is “science-based”)

by Patrick A. Malone

What’s going on at the Centers for Disease Control and Prevention?

It’s a federal agency with a $7 billion budget and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Its work and guidance on health matters long has been heeded and well respected.

But the Washington Post — in a story that sounds like it might have leaped from the satirical pages of The Onion or from a monologue by the late comedian George Carlin — has reported that CDC experts have been banned from using seven words in any upcoming communications with Congress about the 2019 budget.

November 13, 2017

First-responders, trauma response wins praise in Texas church shooting

by Patrick A. Malone

In the torrent of the relentless 24/7 news cycle, let’s not allow a new normal to prevail. We can’t forget that just days ago, a madman opened fire on a church in a small town south of San Antonio, Texas, killing at least 26 and wounding 20 or so. It was the worst mass shooting in the Lone Star State’s history, and it added to a horrific and growing toll for recent such gun-related outbreaks.

These incidents not only devastate the communities in which they occur. They also put giant strains of doctors, nurses, emergency medical technicians, and hospitals. All respond in ways that deserve a major salute, as well as empathy, compassion, and shared grief for the victims, their families, and those who seek to save and protect lives in chaotic situations.

The killing in Sutherland, Texas, posed its own unique stresses, with medical experts heaping praise on EMTs and first-responders for their heroic work at the scene, and then speeding those in need to care at hospitals at least 35 miles away.

October 9, 2017

Las Vegas tragedy helps highlight what’s right with nation’s health care system

by Patrick A. Malone

Caregivers and the community in Las Vegas, Nev., deserve a salute for their response to the gun violence last week, which could have overwhelmed a less-prepared community’s medical system.

Las Vegas isn’t a giant metropolis (pop. 2 million in its metro area), and, due to the high costs to operate such a facility, it has just one Level 1 trauma center. That’s a facility staffed and equipped to provide a “gold standard” of emergency care. In the state of Nevada, the only such center is at the 541-bed University Medical Center of Southern Nevada.

It was slammed with more than 100 critical patients, many with life-threatening or fatal gunshot wounds. A torrent of patients also was routed to the hospital, some for treatment of injuries they suffered while fleeing Stephen Paddock’s rampage. First-responders soon were flooding another facility, Sunrise Hospital and Medical Center in Las Vegas—a Level II trauma facility—with hundreds more.

August 25, 2017

Can VA’s struggles, successes help improve health care for us all?

by Patrick A. Malone

Despite the barrage of terrible headlines about reported problems in its care, the VA, aka Veterans Affairs, “continues to perform as well as, and often better than, the rest of the U.S. health-care system on key quality measures [including] patient safety, patient satisfaction, care coordination, and adherence to evidence-based medical practices,” a new study of the embattled agency concludes.

The work, issued by the American Legion and conducted by health care journalists with affiliations including Johns Hopkins University and the University of California, San Francisco, is part of a growing, continuing, and urgently needed re-examination of one of the nation’s major medical providers.

The VA’s struggles, past, present, and into the future, are driven in part by its size and the scope of its mission and commitment, as a recent, detailed article in Foreign Affairs points out: