ShareThisThe Army's top medical officer this week rejected assertions that commanders are discouraging doctors at Madigan Army Medical Center in Tacoma, Wash., from diagnosing soldiers with post-traumatic stress disorder.
"Absolutely, the Army is not putting pressure on any of our clinicians," said Army Surgeon General Lt. Gen. Patricia Horoho in remarks to lawmakers in the House subcommittee on defense appropriations.
They were Horoho's first public remarks on an investigation she launched to review discrepancies between initial PTSD diagnoses at Madigan and later conclusions reached by a forensic psychiatry team at the hospital.
Officials at Walter Reed Army Medical Center are reviewing the cases of 14 soldiers who passed through Madigan with PTSD diagnoses only to have those results changed by the forensic team in such a way that the soldiers would receive less generous disability benefits in retirement. The review was first reported by The Seattle Times.
The Army has suspended the leader of the forensic psychiatry team, Dr. William Keppler, while it conducts its investigation.
Horoho said the Madigan inquiries dovetail with a separate investigation into behavioral health diagnoses for Army forces in Europe centered at Landstuhl Regional Medical Center.
"I am looking at the entire spectrum," said Horoho, who was the commander at Madigan in 2008 and 2009.
Rep. Norm Dicks, D-Wash., the highest ranking Democrat on the appropriations subcommittee where Horoho testified, pressed Horoho to expand an investigation at Madigan to look into an outpatient clinic that was closed three years ago. Dicks said his sources at Madigan believed it was shut down because its clinicians were diagnosing soldiers with PTSD too frequently.
"We've got to find out was this done on the merits, or were they making too many diagnoses of PTSD," Dicks said this week.
Madigan has one of the largest staffs of behavioral health professionals in the Army with some 250 specialists. It's also the only hospital with a forensic psychiatry team that re-evaluates behavioral health diagnoses before medical retirements, sometimes without meeting the patients.
Madigan commanders have sought to diminish the stigma of seeking help for behavioral health issues, and they have sent specialists out in the ranks at Joint Base Lewis-McChord to get a feel for how soldiers are dealing with combat stress.
Yet memos from behavioral health meetings last fall show that some leaders of that staff had begun to encourage clinicians to take a hard look at costly PTSD diagnoses. A medical retirement for post-traumatic stress could cost the government between $400,000 and $1.5 million in lifetime benefits and stipends, according to one of the presentations.
"What we don't want is people making these decisions based on money instead of care of the troops," Dicks said.
(Contact Adam Ashton at adam.ashton(at)thenewstribune.com. For more stories visit scrippsnews.com)
Must credit the News Tribune in Tacoma, Wash.
