Exposè Shows Military Hospitals Are Huge Providers of Substandard Care

In a sweeping and horrifically detailed indictment, the New York Times called out the U.S. military hospital system for its shockingly substandard care.

The paper looked at the records of the 40 hospitals across the country run by the armed forces that provide care for 1.35 million active-duty service members and their families, among other patients. The problem of poor care appears to stem from the fact that these hospitals are so small and see so few patients that doctors and nurses don’t get enough experience to diagnose and treat serious illnesses properly. Most of these facilities handle less than one-third as many patients as a typical civilian hospital.

These numbers are so significant that Dr. Lucian L. Leape, a leading patient-safety expert at the Harvard School of Public Health, said, “I think they should be outlawed.”

Another huge problem is one of priorities: Hospitals that must develop practitioner skills to address battlefield casualties don’t have the resources (or will) to hone the skills necessary for a typical hospital caseload of primary and specialty care, such as delivering babies and performing routine surgeries.

Some people who worked at military hospitals question whether, in most cases, the military should even be in the hospital business.

“It’s a dangerous game,” John Schafer told The Times. He served for eight years as deputy commander for clinical operations at Reynolds Army Community Hospital at Fort Sill in Oklahoma. Now he’s senior director of physician services at Comanche County Memorial Hospital nearby. From his office, he can see the military hospital, which treats an average of just 13 patients a day.

“I loved that place,” he said. “But it should not be a hospital. I retired because I could see the unsafe care. Nobody was listening.”

In The Times’ analysis, the biggest problems at military hospitals were found in maternity care and surgery. “Compared with leading civilian hospitals, more than half of domestic military hospitals,” the paper reported, “… performed poorly on one or more measures of harm to mothers or babies in 2011 and 2012. … half of the military hospitals whose surgical data are submitted for outside review had higher than expected rates of surgical complications.”

Among the patients whose suffered from military hospital deficiencies:

  • a woman who had what was supposed to be a routine hernia surgery but ended up having more than a dozen follow-up operations to address complications that have left her in constant pain, and without a stomach, a job or anything resembling her former life;
  • a woman who went in for a checkup during her high-risk pregnancy during which nurses lost track of the fetus’ heart rate for nearly an hour, failed to recognize the emergency and the fetus died. The parents sued for malpractice and received a judgment of $250,000;
  • a 7-week-old baby died of congestive heart failure because of what appeared to be delays and malfunctioning equipment at a hospital where one of its doctors told The Times, “People notice that something is wrong, and they are told to mind their own business.”;
  • an active-duty servicewoman died after medical workers missed the signs of necrotizing fasciitis, a dangerous bacterial infection;
  • a retired officer died of appendicitis two days after being told he had a hernia.

And that’s only a sampling.

Would you send a loved one to a military hospital where even its own medical staffers say, “If you are a physician, it’s very scary. You decide you are going to admit your sick patient, but there is no I.C.U., no gastroenterologist, no pulmonologist, no pathologist. Nobody’s on call.”?

As The Times reported, last year the government paid 21 military patients more than $500,000 each to settle malpractice claims, an indication of “significant harm.”

To learn more about military malpractice, see our backgrounder.

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