Military medicine
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Traumatic injuries were the most common reason for admission of pediatric patients to military hospitals during the recent wars in Iraq and Afghanistan. We compare survival and interventions between female and male pediatric casualties. ⋯ Among pediatric patients treated by U.S. medical personnel in Iraq and Afghanistan, females had a lower survival to hospital discharge despite similar severity of injury. Further studies are necessary to elucidate causes for this finding.
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The treatment of severe and life-threatening COVID-19 is a rapidly evolving practice. The purpose of our study was to describe the characteristics and outcomes of patients with severe or life-threatening COVID-19 who present to a Military Treatment Facility (MTF) with an emphasis on addressing institutional adaptations to rapidly changing medical evidence. ⋯ Patients who present to an MTF with severe or life-threatening COVID-19 are largely retirees, with only a small fraction comprising active duty personnel. The institution of order sets and early consultation can help facilitate prompt patient care for COVID-19.
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The purpose of this article is to challenge the premise of a recent commentary suggesting that chiropractors should become commissioned officers. An overview of the early practice guidelines and current scientific evidence for the use of spine and peripheral manipulation is provided. The Military Health System is designed to support military operations and currently includes a large contingent of active duty musculoskeletal healthcare experts to include sports medicine-trained family physicians, orthopedic surgeons, physician assistants/associates, doctors of physical therapy/physical therapists, occupational therapists, and podiatrists. The evidence is clear that it is not in the best interest of our military services to commission alternative practitioners whose practices are out of step with the rest of medicine.
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Residency programs in the combined specialty of Internal Medicine-Pediatrics (Med-Peds) are not offered in the military graduate medical education system despite existing in the civilian sector for over 50 years. This residency consists of 4 years of training and results in the development of board-certified internists and pediatricians who can care for patients from infancy to death. This versatility, combined with an emphasis on the transition from childhood to adulthood, would be valuable to the Military Health System. ⋯ As there are already military residency programs in pediatrics and internal medicine, the required infrastructure for such a training program exists. The addition of this residency may also lead to more interest in military medicine from prospective applicants to medical school. This essay uses personal experience to explain how the addition of this specialty to the military would benefit the medical mission domestically and abroad.
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All healthcare leaders will inevitably face patient death and dealing with loss. While leaders have different preparation for this, many lack comfort and confidence navigating death, whether it be of a patient, family member, or colleague. Learning how to support others in dealing with death is a fundamental leadership skill.