President-elect Obama has announced his new Secretary of Veterans Affairs and it is Gen. Eric Shinseki. He was severely wounded in Vietnam and spent 11 months in the hospital General Shinseki was the US Army Chief of Staff and was forced to retire by Donald Rumsfeld because he was not acting like part of the team. He dissented vigorously regarding the prosecution of the invasion of Iraq. His resolve cost him his job, and he has since been proven right.
His resolve will be tested again as the Bush Administration filled the VA with hacks, incompetents and apologists. James Nicholson followed the Bush party line right off a cliff. Then, General James Peake became Secretary. General Peake when in uniform, as the US Army Surgeon General, failed to acknowledge, prepare and deal with either Traumatic Brain Injury and mental health issues. As a civilian, he continued the policy as it might expose his incompetence. Hopefully, he will quickly retire from the practice of medicine, his tenure has been a disgrace.
General Shinseki should first resolve to clean-up the VAs administrative mess that fails to screen, admit and treat our wounded warriors. The VA would make Soviet apparatchiks blush with its indifference and ineffeciency. Second, he should immediately demote and fire the entire senior management of VA in mental health and traumatic brain injury. The signature injuries of OIF/OEF can be acknowledged and treated. The very capable staffs of many VA sites can be supplemented with civilian resources to get these service members squared away. The policy of denying benefits based on phony science and mindless research by both the DoD and VA can quickly come to an end. Finally, he must seek to chart an independent path; the DoD has an agenda quite seperate from treating and honoring our warriors.
Hopefully this action will signal to Military Health Systems that it is time to clean its house.
Showing posts with label Veterans Administration. Show all posts
Showing posts with label Veterans Administration. Show all posts
Saturday, December 6, 2008
MILITARY PERSONNEL WITH TRAUMATIC BRAIN INJURY AT RISK FOR SERIOUS LONG-TERM
The Institute of Medicine reported this week Military personnel who suffer severe or moderate traumatic brain injury (TBI) face an increased risk for developing several long-term health problems. This evidenced based study reported that conditions include Alzheimer's-like dementia, aggression, memory loss, depression, and symptoms similar to those of Parkinson's disease. Even mild TBI is associated with some of these adverse consequences, noted the committee that wrote the report.
In addition, the report notes that brain injuries sustained as a result of exposure to the force of an explosion without a direct strike to the head -- one of the most common perils for soldiers in Iraq and Afghanistan -- may be underdiagnosed due to the lack of research on blast injury. It calls for the U.S. Department of Defense and the U.S. Department of Veterans Affairs to step up clinical and animal studies of blast-induced neurotrauma (BINT).
The Healing Project would go further and immediately screen and database the 300,000 to 400,000 service members exposed to blasts.
"Explosive devices and other weaponry have become more powerful and devastating throughout the wars in Iraq and Afghanistan, and we are seeing much higher rates of nonpenetrating traumatic brain injury and blast-induced injury among military personnel who have served in these countries than in earlier wars," said George W. Rutherford, professor of epidemiology and preventive medicine and vice chair, department of epidemiology and biostatistics, School of Medicine, University of California, San Francisco, and chair of the committee that wrote the report. "It is important to identify and understand any long-term health effects of these injuries so that wounded service members do not lose valuable time for therapy and rehabilitation."
Studies conducted in Iraq by the Air Force Medical Service with the Headminder system would argue that up to 5% of exposures, that is 15,000 to 20,000 m-TBI injuries, would require additional follow-up. The DoD is only reporting 5,500 injuries total traumatic brain injuries. Furthermore, while animal studies are useful, replicating injuries in animals models are unlikely to provide necessary data to provide human clinical guidance. It is time to implement a web-centric longitudinal screening technology to track the evolution of these injuries in an epidemiologically sound fashion.
While we agree with the Institute in broad strokes, scientists and clinicians have been aware of the injuries and the likely outcome of these injuries since 2004. Neither the DoD or the VA has demonstrated any real interest in identifying or treating M-TBI dealing with its attendant co-morbidities. Both organizations have used research to delay the identification of and/or deny the very existence of the injuries. The report makes it clear blast concussion is not like a sports injury nor is it PTSD (two of the DoDs and VAs favorite excuses why they do nothing). Now that we have a change of government, it is time for Secretary of Defense Gates to clean out DoD HA and US Army Medcom. The delayers, the deniers and the dinosaurs need to be quickly cashiered and replaced by people who will get the job done now.
In addition, the report notes that brain injuries sustained as a result of exposure to the force of an explosion without a direct strike to the head -- one of the most common perils for soldiers in Iraq and Afghanistan -- may be underdiagnosed due to the lack of research on blast injury. It calls for the U.S. Department of Defense and the U.S. Department of Veterans Affairs to step up clinical and animal studies of blast-induced neurotrauma (BINT).
The Healing Project would go further and immediately screen and database the 300,000 to 400,000 service members exposed to blasts.
"Explosive devices and other weaponry have become more powerful and devastating throughout the wars in Iraq and Afghanistan, and we are seeing much higher rates of nonpenetrating traumatic brain injury and blast-induced injury among military personnel who have served in these countries than in earlier wars," said George W. Rutherford, professor of epidemiology and preventive medicine and vice chair, department of epidemiology and biostatistics, School of Medicine, University of California, San Francisco, and chair of the committee that wrote the report. "It is important to identify and understand any long-term health effects of these injuries so that wounded service members do not lose valuable time for therapy and rehabilitation."
Studies conducted in Iraq by the Air Force Medical Service with the Headminder system would argue that up to 5% of exposures, that is 15,000 to 20,000 m-TBI injuries, would require additional follow-up. The DoD is only reporting 5,500 injuries total traumatic brain injuries. Furthermore, while animal studies are useful, replicating injuries in animals models are unlikely to provide necessary data to provide human clinical guidance. It is time to implement a web-centric longitudinal screening technology to track the evolution of these injuries in an epidemiologically sound fashion.
While we agree with the Institute in broad strokes, scientists and clinicians have been aware of the injuries and the likely outcome of these injuries since 2004. Neither the DoD or the VA has demonstrated any real interest in identifying or treating M-TBI dealing with its attendant co-morbidities. Both organizations have used research to delay the identification of and/or deny the very existence of the injuries. The report makes it clear blast concussion is not like a sports injury nor is it PTSD (two of the DoDs and VAs favorite excuses why they do nothing). Now that we have a change of government, it is time for Secretary of Defense Gates to clean out DoD HA and US Army Medcom. The delayers, the deniers and the dinosaurs need to be quickly cashiered and replaced by people who will get the job done now.
Saturday, November 8, 2008
The New President and Healthcare - Part II - Medical Services
Before wholesale changes are made to US healthcare system, Mr. Obama should fix the two health systems that federal government controls. The Military Health System and the Veterans Administration are two of the largest health systems in the United States and have serious problems.
The critical problems with these entities are led by incompetent, indifferent and anti-scientific management. Mr. Obama should immediately request the Bush Administration remove S. Ward Casscells, M.D. and Ellen Embrey. These two individuals are directly responsible for the lack of progress in the treatment of mental illness, mild-traumatic brain injury, traumatic brain injury, suicide and PTSD. They have led a campaign to continue the Bush Administration policy to underreport casualties in the Iraq and Afghanistan conflicts. Further, these individuals have aided and abetted the US Army’s program to deny benefits to wounded and disabled service members. Finally, they will babble endlessly about what we don’t understand about these injuries so it will require years of research. In fact, much more is known about these injuries then they would like Congress to believe. However, these scientific facts fly in the face of their political objectives so they have let contracts to friends of the US Army who will confuse the issue for years.
What to do following the dismissal of Dr. Casscells and Ellen Embrey.
First, quickly review all contracts let by these individuals for contract irregularities and pursue criminal prosecution. Next, remove the US Army from all leadership positions in programs related to mental health and brain injury. The US Army personnel should be replaced by officers from the Air Force and the Navy. The Air Force and Navy are more technologically enabled and lack a political agenda as both branches have honored their disability payments. It is not to say the US Army lacks officers with technical expertise in the areas of mental health or traumatic brain injury but they were excluded from the process because they could not get with the program. Instead, the US Army replaced them with people qualified as occupational therapists and physicians’ assistants. It is time to get organized and led by the right talent. Mental health and traumatic brain injury issues can be solved and could have been largely avoided if it had not become political. Finally, embrace the civilian medical sector. Much of the most advanced research in mental health and traumatic brain injury is at specialized centers such as the Kessler Institute in New Jersey. Civilian entities were willing an able to take a leading role in solving these problems but were denied participation by the hacks running MHS and the VA.
With regard to the VA, Mr. Obama should immediately remove the entire senior management. Dr. Jim Peake is the former US Army Surgeon General. When in uniform, he was part of the program that left the nation unprepared to deal with mental health and traumatic brain injury issues. He not only failed for active service members but also rewarded with even greater responsibility so he could fail them once of service members became veterans. Since the VA is evolved into a system to treat geriatric patients, the surge in younger service members should be guided to civilian medical resources at government expense. The major exception is in PTSD where the VA and CDC did some of the most distinguished work both scientifically and clinically. The VA needs to get some younger more aggressive leadership in this area and capitalize on the VAs expertise. It should also embrace private psychologists to screen and treat the less serious cases locally and triage the most complex cases to VA centers of excellence.
Again, the medical failure at MHS and the VA is not as much a monetary problem as it is a management problem. Last year $2,1B was distributed by Congress to the VA and MHS to treat wounded with TBI and mental health issues. Nonetheless, the leadership is unable to account for much of the spending and the results have been almost nonexistent. With little doubt, the bulk of our service members could have been identified and started treatment. It does and will require funds but funds well spent. Let’s fix the problem and stop the talk.
The critical problems with these entities are led by incompetent, indifferent and anti-scientific management. Mr. Obama should immediately request the Bush Administration remove S. Ward Casscells, M.D. and Ellen Embrey. These two individuals are directly responsible for the lack of progress in the treatment of mental illness, mild-traumatic brain injury, traumatic brain injury, suicide and PTSD. They have led a campaign to continue the Bush Administration policy to underreport casualties in the Iraq and Afghanistan conflicts. Further, these individuals have aided and abetted the US Army’s program to deny benefits to wounded and disabled service members. Finally, they will babble endlessly about what we don’t understand about these injuries so it will require years of research. In fact, much more is known about these injuries then they would like Congress to believe. However, these scientific facts fly in the face of their political objectives so they have let contracts to friends of the US Army who will confuse the issue for years.
What to do following the dismissal of Dr. Casscells and Ellen Embrey.
First, quickly review all contracts let by these individuals for contract irregularities and pursue criminal prosecution. Next, remove the US Army from all leadership positions in programs related to mental health and brain injury. The US Army personnel should be replaced by officers from the Air Force and the Navy. The Air Force and Navy are more technologically enabled and lack a political agenda as both branches have honored their disability payments. It is not to say the US Army lacks officers with technical expertise in the areas of mental health or traumatic brain injury but they were excluded from the process because they could not get with the program. Instead, the US Army replaced them with people qualified as occupational therapists and physicians’ assistants. It is time to get organized and led by the right talent. Mental health and traumatic brain injury issues can be solved and could have been largely avoided if it had not become political. Finally, embrace the civilian medical sector. Much of the most advanced research in mental health and traumatic brain injury is at specialized centers such as the Kessler Institute in New Jersey. Civilian entities were willing an able to take a leading role in solving these problems but were denied participation by the hacks running MHS and the VA.
With regard to the VA, Mr. Obama should immediately remove the entire senior management. Dr. Jim Peake is the former US Army Surgeon General. When in uniform, he was part of the program that left the nation unprepared to deal with mental health and traumatic brain injury issues. He not only failed for active service members but also rewarded with even greater responsibility so he could fail them once of service members became veterans. Since the VA is evolved into a system to treat geriatric patients, the surge in younger service members should be guided to civilian medical resources at government expense. The major exception is in PTSD where the VA and CDC did some of the most distinguished work both scientifically and clinically. The VA needs to get some younger more aggressive leadership in this area and capitalize on the VAs expertise. It should also embrace private psychologists to screen and treat the less serious cases locally and triage the most complex cases to VA centers of excellence.
Again, the medical failure at MHS and the VA is not as much a monetary problem as it is a management problem. Last year $2,1B was distributed by Congress to the VA and MHS to treat wounded with TBI and mental health issues. Nonetheless, the leadership is unable to account for much of the spending and the results have been almost nonexistent. With little doubt, the bulk of our service members could have been identified and started treatment. It does and will require funds but funds well spent. Let’s fix the problem and stop the talk.
Thursday, October 16, 2008
A Proven Technology Detects mild-Traumatic Brain Injury in Combat
On October 12 at the International Conference on Behavioral Health and Traumatic Brain Injury, St. Joseph's Regional Medical Center, Paterson, NJ, HeadMinder, Inc., presented results of the first Military IRB-approved prospective study to be conducted in-Theater.
The study compared the HeadMinder Cognitive Stability Index (CSI) computerized test battery and the Department of Defense (DoD) Automated Neuropsychological Assessment Metric (ANAM) with the Repeatable Battery for Assessment of Neuropsychological Symptoms (RBANS), a paper-and-pencil neurocognitive test currently used by the DoD to screen soldiers.
The study was designed by Lt. Col. (sep.) Gerald Grant, MD (USAF), Maj. William Isler, PhD (USAF), Maj. Monty Baker, PhD (USAF), David Erlanger, PhD (Chief Scientific Officer and co-Founder of HeadMinder), Tanya Kaushik, PsyD, and Col. Robert Seegmiller (USAF). The objective was to determine the validity and reliability of both computerized screening measures as compared to the RBANS. The CSI was accurate in assessing the severity of cognitive compromise following concussive blast injuries. The CSI Total Score correlated very strongly with the RBANS Total Score (.789) and also showed strong concurrent validity with the RBANS in the domains of Attention (.706) and Memory (.680), domains critical in the assessment of blast-related concussion. ANAM was not useful for identifying memory problems, the domain most frequently impaired on the RBANS, and only a subset of ANAM measures seemed useful for screening attention problems.
The CSI is a 30-minute, Internet-based, computerized test that provides automated, objective measures of attention, memory, response speed, and processing speed for initial evaluation of cognitive functioning. The CSI produces standardized reports that enable triage and decision-making appropriate to a user's qualifications – from medic to neuropsychologist to neurologist and other treatment team members.
Dr. David Erlanger, Chief Scientific Officer of HeadMinder, commented, "The CSI has now been shown, under combat conditions, to be the only telemedicine tool capable of serving the needs of the armed services. Especially given the large backlog of unscreened service members exposed to blasts, the HeadMinder System offers a simple, accurate, and objective screening method that can play a key role in identifying and treating servicemen and servicewomen with undiagnosed brain injuries. The CSI is unique in its ability to track improvement over time as soldiers travel between the Military Health System and the Veterans Administration and civilian medical resources. We believe the HeadMinder platform provides the Department of Defense the opportunity to fully comply with the Wounded Warriors Act by screening and tracking exposed service members' long-term well-being. If implemented today, the entire backlog could be cleared in less than two years."
After 5 years of ducking the issue, the DoD can get off their collective bottoms and start screening the 400,000 troops that have been exposed to blasts in Iraq and Afghanistan. While the study in no way implied that every service member exposed suffered m-TBI, it did imply that approximately 20,000 service members have suffered the injury. It is time to identify them and treat them. There is no need for mindless dead-end research projects.
Since S. Ward Casscells, MD , Undersecretary of Defense - Healthcare, has actively and willfully avoided detecting and treating both m-TBI and mental health issues, it is time to contact your representatives to start getting answers (find your representative, find your senator). His desire to deny disability payments and under report causalities is repellent.
A special note if you are represented by any of the following members:
Senator Patty Murray (D-WA)
Senator Hillary Clinton (D-NY)
Congressman Jack Murtha (D-PA)
Congressman Bill Pascrell (D-NJ)
Congressman Todd Platts (R-PA)
make an effort to contact them as they have taken leading positions to help service members with mild-Traumatic Brain Injury, PTSD and mental health issues.
The study was initially funded by the Henry M. Jackson Foundation. After funding was discontinued, the study was completed with funding provided by PanMedix, Inc., and HeadMinder, Inc.
PanMedix was founded in New York City in 1999. Initially focused on the development and deployment of assessment software, the company has evolved to encompass a full range of pharmaceutical and medical assessment services.
Founded in New York City in 1999, HeadMinder is a technology company that is dedicated to the development of Internet-based neurocognitive assessment tools. HeadMinder tests have been shown to be valid and reliable instruments for evaluating cognitive deficits in a range of injuries and illnesses, including concussion, mild-to-moderate TBI, Multiple Sclerosis, ADHD, Alzheimer's Disease, and chemotherapy-induced cognitive dysfunction in cancer patients.
The study compared the HeadMinder Cognitive Stability Index (CSI) computerized test battery and the Department of Defense (DoD) Automated Neuropsychological Assessment Metric (ANAM) with the Repeatable Battery for Assessment of Neuropsychological Symptoms (RBANS), a paper-and-pencil neurocognitive test currently used by the DoD to screen soldiers.
The study was designed by Lt. Col. (sep.) Gerald Grant, MD (USAF), Maj. William Isler, PhD (USAF), Maj. Monty Baker, PhD (USAF), David Erlanger, PhD (Chief Scientific Officer and co-Founder of HeadMinder), Tanya Kaushik, PsyD, and Col. Robert Seegmiller (USAF). The objective was to determine the validity and reliability of both computerized screening measures as compared to the RBANS. The CSI was accurate in assessing the severity of cognitive compromise following concussive blast injuries. The CSI Total Score correlated very strongly with the RBANS Total Score (.789) and also showed strong concurrent validity with the RBANS in the domains of Attention (.706) and Memory (.680), domains critical in the assessment of blast-related concussion. ANAM was not useful for identifying memory problems, the domain most frequently impaired on the RBANS, and only a subset of ANAM measures seemed useful for screening attention problems.
The CSI is a 30-minute, Internet-based, computerized test that provides automated, objective measures of attention, memory, response speed, and processing speed for initial evaluation of cognitive functioning. The CSI produces standardized reports that enable triage and decision-making appropriate to a user's qualifications – from medic to neuropsychologist to neurologist and other treatment team members.
Dr. David Erlanger, Chief Scientific Officer of HeadMinder, commented, "The CSI has now been shown, under combat conditions, to be the only telemedicine tool capable of serving the needs of the armed services. Especially given the large backlog of unscreened service members exposed to blasts, the HeadMinder System offers a simple, accurate, and objective screening method that can play a key role in identifying and treating servicemen and servicewomen with undiagnosed brain injuries. The CSI is unique in its ability to track improvement over time as soldiers travel between the Military Health System and the Veterans Administration and civilian medical resources. We believe the HeadMinder platform provides the Department of Defense the opportunity to fully comply with the Wounded Warriors Act by screening and tracking exposed service members' long-term well-being. If implemented today, the entire backlog could be cleared in less than two years."
After 5 years of ducking the issue, the DoD can get off their collective bottoms and start screening the 400,000 troops that have been exposed to blasts in Iraq and Afghanistan. While the study in no way implied that every service member exposed suffered m-TBI, it did imply that approximately 20,000 service members have suffered the injury. It is time to identify them and treat them. There is no need for mindless dead-end research projects.
Since S. Ward Casscells, MD , Undersecretary of Defense - Healthcare, has actively and willfully avoided detecting and treating both m-TBI and mental health issues, it is time to contact your representatives to start getting answers (find your representative, find your senator). His desire to deny disability payments and under report causalities is repellent.
A special note if you are represented by any of the following members:
Senator Patty Murray (D-WA)
Senator Hillary Clinton (D-NY)
Congressman Jack Murtha (D-PA)
Congressman Bill Pascrell (D-NJ)
Congressman Todd Platts (R-PA)
make an effort to contact them as they have taken leading positions to help service members with mild-Traumatic Brain Injury, PTSD and mental health issues.
The study was initially funded by the Henry M. Jackson Foundation. After funding was discontinued, the study was completed with funding provided by PanMedix, Inc., and HeadMinder, Inc.
PanMedix was founded in New York City in 1999. Initially focused on the development and deployment of assessment software, the company has evolved to encompass a full range of pharmaceutical and medical assessment services.
Founded in New York City in 1999, HeadMinder is a technology company that is dedicated to the development of Internet-based neurocognitive assessment tools. HeadMinder tests have been shown to be valid and reliable instruments for evaluating cognitive deficits in a range of injuries and illnesses, including concussion, mild-to-moderate TBI, Multiple Sclerosis, ADHD, Alzheimer's Disease, and chemotherapy-induced cognitive dysfunction in cancer patients.
Friday, May 16, 2008
Veterans Administration Saving Pennies by Failing to Diagnos PTSD
The Veterans Administration was caught again running roughshod over our service members.
A few weeks ago we posted an item about the VA and DoD avoiding dealing with the suicide problem. Citizens for Responsibility and Ethics in Washington and VoteVets release email telling VA staff to “refrain from giving a diagnosis of PTSD straight out.” Please take a moment and read the e-mail. James Peake, MD, the head of the VA, repudiated the employee, but she remains on the job.
Well done. If you get caught doing what the boss wants done (General Peake has been party to ignoring PTSD and Mental Health since his days as the US Army Surgeon General), we will make a public statement and you keep your job (Dr. Peake make sure she gets a bonus for all those cost savings).
I gather the next revelation will be regarding traumatic brain injury. All the phony screening, bogus research, delay in disabilities payments has been ochestarted by the DoD and US Army since the beginning of OIF/OEF. General Peake and his flunkys at AMEDD rejected a series of proposals to fully screen all troopers for TBI pre-OEF. If you don't identify the injured, don't treat them, you need not pay for them.
Look at how much money we save. DoD and the VA have had the support of the highest reaches of government in this despicable mistreatment of American citizens. The Legislative Branch's inability to deal with these matters for years is almost equally distgusting.
Somewhere between 300,000 and 700,000 troopers have suffered PTSD, Mental Health Problems, and/or TBI. But knows knows who they are or the treatment they have received. The time for special committees, centers of excellence, blue ribbon commissions, fake research conducted by politically connected charlatans is over.
Call your Senator or Representative and demand investigations and prosecutions.
A few weeks ago we posted an item about the VA and DoD avoiding dealing with the suicide problem. Citizens for Responsibility and Ethics in Washington and VoteVets release email telling VA staff to “refrain from giving a diagnosis of PTSD straight out.” Please take a moment and read the e-mail. James Peake, MD, the head of the VA, repudiated the employee, but she remains on the job.
Well done. If you get caught doing what the boss wants done (General Peake has been party to ignoring PTSD and Mental Health since his days as the US Army Surgeon General), we will make a public statement and you keep your job (Dr. Peake make sure she gets a bonus for all those cost savings).
I gather the next revelation will be regarding traumatic brain injury. All the phony screening, bogus research, delay in disabilities payments has been ochestarted by the DoD and US Army since the beginning of OIF/OEF. General Peake and his flunkys at AMEDD rejected a series of proposals to fully screen all troopers for TBI pre-OEF. If you don't identify the injured, don't treat them, you need not pay for them.
Look at how much money we save. DoD and the VA have had the support of the highest reaches of government in this despicable mistreatment of American citizens. The Legislative Branch's inability to deal with these matters for years is almost equally distgusting.
Somewhere between 300,000 and 700,000 troopers have suffered PTSD, Mental Health Problems, and/or TBI. But knows knows who they are or the treatment they have received. The time for special committees, centers of excellence, blue ribbon commissions, fake research conducted by politically connected charlatans is over.
Call your Senator or Representative and demand investigations and prosecutions.
Tuesday, May 6, 2008
The House Veterans Affairs Committee chairman accuses VA of criminal negligence, he should have included the DoD as well.
Dr. Ira Katz got caught lying to the press about suicide rates for veterans so he is now standing before the man. Of course James Peake, Veterans Affairs Secretary, defended Katz because he is largely responsible for the scandalous lack of preparation to handle troops returning from OIF/OEF with neurological and psychiatric problems. James Peake was the US Army Surgeon General from 2000 to 2004. During his tenure, his senior staff officers rejected the implementation of programs that would have dealt not only with mental health issues but also traumatic brain injury. US Army clinicians and researchers attached to Walter Read Army Medical were prepared to implement technology and protocols to deal with these issues before the Afghanistan deployment. AMEDD, the Army Medical Department, represented that they were prepared in 2002 even though it was not; and still isn't.
It is time for the Senate and House to call to account the entire chain of command from DoD and US Army Medcom as they have been responsible for one of the largest medical disasters in US history. Between 400,000 and 750,000 troops have been injured, gone unidentified and are untreated. No one knows who they are. Our jails, homeless shelters, drug rehab clinics and morgues will fill with veterans from these conflicts. This is a crime. It is medical negligence on a grand scale. It is time to go back an investigate the actions and lack of action taken by the DoD and US Army from 2001 forward. Senior officers, the rank of colonel or higher, responsible for epidemiology, traumatic brain injury and mental health should be called before the public, made to explain themselves, and summarily fired. If they are a member of the allied medical professions, their licenses should be revoked.
US Air Force Medcom should be empowered to take over these programs without the oversight of DoD or the involvement of the Joint Services “Red Cell.” The Air Force should further be directed to use the civilian medical sector, particularly the nation’s research hospitals, to treat the massive backlog of wounded active service members and veterans. (The VA should be left to deal with the aging veterans of past wars. It will take years to cure its gross mismanagement.) A hub and spoke system should be implemented similar to the highly successful NCCN cancer program. The objective would be to treat simple cases as close to the veterans homes as possible and complex cases at our finest medical centers that have the resources to handle the most complex injuries.
The $900MM of funding that congress allocated for mental health and traumatic brain injury is being squandered. Research has been delayed and solutions gone unimplemented. The Army’s objective has been to use faulty screening instruments (ANAM), faulty research (the problems related to TBI are transient and stress related), and faulty clinical practice (12 beds for patients in a vegetative state when there is need for 400 – the poly trauma centers are not what they were cracked up to be) in order to demonstrate that they are doing everything. It is pure nonsense.
This is not to say the VA, US Army, and US Navy don’t have some extraordinary practitioners. The field medical personnel of these wars should be lionized as they have demonstrated the resolve to do the undoable. Regrettably, these gallant men and women are not in-charge. Many are separating from the service as quickly as is practical due to incompetent leadership. People like the disgraced general, Kevin Kiley, are in-charge. Follow the party line, don’t report the wounded and don’t treat them. God forbid the Army may have to pay disability for injuries that don’t involve an amputation or blindness. TBI is like a sports injury. Sure! If they understood how serious many sports concussions can be, they would shut up. These blast injuries are far more complex and more serious, but research was repeatedly disrupted or blocked. I will not bother to rant about mental health as the military posture is so outdated it defies comment.
Call your congressmen and demand action. The current buffoons that have abused our troops will exit with this administration, but our active service members and veterans need help now.
It is time for the Senate and House to call to account the entire chain of command from DoD and US Army Medcom as they have been responsible for one of the largest medical disasters in US history. Between 400,000 and 750,000 troops have been injured, gone unidentified and are untreated. No one knows who they are. Our jails, homeless shelters, drug rehab clinics and morgues will fill with veterans from these conflicts. This is a crime. It is medical negligence on a grand scale. It is time to go back an investigate the actions and lack of action taken by the DoD and US Army from 2001 forward. Senior officers, the rank of colonel or higher, responsible for epidemiology, traumatic brain injury and mental health should be called before the public, made to explain themselves, and summarily fired. If they are a member of the allied medical professions, their licenses should be revoked.
US Air Force Medcom should be empowered to take over these programs without the oversight of DoD or the involvement of the Joint Services “Red Cell.” The Air Force should further be directed to use the civilian medical sector, particularly the nation’s research hospitals, to treat the massive backlog of wounded active service members and veterans. (The VA should be left to deal with the aging veterans of past wars. It will take years to cure its gross mismanagement.) A hub and spoke system should be implemented similar to the highly successful NCCN cancer program. The objective would be to treat simple cases as close to the veterans homes as possible and complex cases at our finest medical centers that have the resources to handle the most complex injuries.
The $900MM of funding that congress allocated for mental health and traumatic brain injury is being squandered. Research has been delayed and solutions gone unimplemented. The Army’s objective has been to use faulty screening instruments (ANAM), faulty research (the problems related to TBI are transient and stress related), and faulty clinical practice (12 beds for patients in a vegetative state when there is need for 400 – the poly trauma centers are not what they were cracked up to be) in order to demonstrate that they are doing everything. It is pure nonsense.
This is not to say the VA, US Army, and US Navy don’t have some extraordinary practitioners. The field medical personnel of these wars should be lionized as they have demonstrated the resolve to do the undoable. Regrettably, these gallant men and women are not in-charge. Many are separating from the service as quickly as is practical due to incompetent leadership. People like the disgraced general, Kevin Kiley, are in-charge. Follow the party line, don’t report the wounded and don’t treat them. God forbid the Army may have to pay disability for injuries that don’t involve an amputation or blindness. TBI is like a sports injury. Sure! If they understood how serious many sports concussions can be, they would shut up. These blast injuries are far more complex and more serious, but research was repeatedly disrupted or blocked. I will not bother to rant about mental health as the military posture is so outdated it defies comment.
Call your congressmen and demand action. The current buffoons that have abused our troops will exit with this administration, but our active service members and veterans need help now.
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