Tuesday, June 17, 2014

Building Cultural Bridges between Doctors and Troops

Jim Fausone
Veteran Advocate

There has long been a divide between service members and civilian health care providers. According to a Pew study, 77% of veterans say they are not understood by the civilian population, and 71% of civilians say they don’t understand the military.

It is vital to good patient care for civilian health care providers to understand what these patients have experienced during their time in service. Only 36% of veterans are treated at the Veterans Affairs Department, which means millions of family members, as well as troops, are treated by civilian physicians. To start bridging the gap between service members and civilians, the Pentagon is gearing up to promote a new eight-hour course for health care providers to gain a deeper understanding of military culture, titled “Military Culture: Core Competencies for Health Care Providers.”

After a decade of war, the military is breaking new ground during a decade of war, not only helping service members but driving development in the entire psychiatry field.  Before the development of this program the only course available for civilian physicians was a short online course to cover rank, military occupational specialties, histories, and traditions.  Only 20% of the nation’s medical schools teach military culture, and barely half mention the military when teaching about post-traumatic stress disorder and traumatic brain injury. 

According to William Brim, a former Air Force psychologist who is now deputy director of the Defense Department's Center for Deployment Psychology (CDP), this indicates that a much broader outreach is needed. “If a service member were to go in for treatment and their therapist takes an approach of, ‘You poor person, they brainwashed you and took way your individualism,’ that might work for some but a lot of service members would nod their heads, walk out and never be seen again,” Brim said.

Brim strives to change that dynamic. After 4 years of development, the course covers four main subjects; health care provider beliefs and biases, military definitions, language and culture, military functions, and the role of military ethos in health behavior.  The program doesn’t shy away from difficult topics such as sexual assault, physical injuries, traumatic brain injury, and mental health conditions either. The course aims to convey a sense of the warrior ethos, or how service members and veterans view themselves, and how health care providers can use that information to provide the best treatment for the patient.

In its development, the program sought input from veterans, troops, wounded warriors, civilian providers, spouses, and National Guard reserve members, to get their perspective.  The primary goal, if nothing else, is to have health care providers learn to ask a few basic questions that would ultimately improve care for service members, veterans, and their families.

The new course awards those who take it with continuing education credits and will be available through several different websites.  The course was developed in part by the White House’s Joining Forces initiative, so the course will be available on the CDP’s website, the VA’s internal training site, the Pentagon’s website, the Substance Abuse and Mental Health Services Administration, the American Psychiatric Association, and others. 

Brim’s organization is also developing a one-hour course for primary care providers, the National Guard, service members, and families, to help them get the most out of doctors’ appointments.

These programs are a big step in improving the care veterans and service members receive.  New advancements in the field of psychiatry and providing health care providers with a deeper understanding of military culture promises to bridge the gap between service members and civilian health care providers. This means better, more efficient care for some of our nations most valued community members.


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