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Did Madigan’s PTSD team break faith with soldiers?

Post by TNT Editorial Board / The News Tribune on Feb. 27, 2012 at 7:52 pm |
February 27, 2012 5:08 pm

This editorial will appear in tomorrow’s print edition.

The United States has a history of losing interest in its combat veterans after they’ve lost their military usefulness. Shame on all of us if that has happened at Madigan Army Medical Center.

The Army has been investigating the practices of a psychiatric team charged with confirming diagnoses of service-related post-traumatic stress disorder among soldiers. The question is whether doctors were dispassionately looking at symptoms or trying to save the Pentagon money by minimizing disability claims.

Someone deserves credit for taking this seriously. Both the commander of Madigan and the leader of the PTSD review team have been temporarily relieved of command. Twelve soldiers who had their PTSD diagnoses reversed at Madigan have since been re-examined by Walter Reed, where doctors concluded that six of them indeed suffered from the disorder.

That 50 percent error rate looks bad, to say the least. The Army is now seeking to review the cases of all soldiers who had their PTSD diagnoses thrown out at Madigan in the last four years.

For combat veterans, the stakes are big. A severe case of PTSD is a crippling condition; the diagnosis can lead to medical retirement, an immediate pension and a lifetime of medical care.

That can cost the taxpayers upwards of $1 million per retiree – good reason to screen for soldiers who may not actually have the disorder. But the job of the team was to verify symptoms, not approach individual cases with an intention to save the government money.

Last November, an Army ombudsman reported that one doctor on the Madigan team had admonished colleagues to be “good stewards of taxpayers’ dollars” – a statement that smacks of bean-counting, not professional psychiatric judgment.

Veterans with PTSD – once called “battle fatigue” or “war neurosis” – have always been under-treated.

The condition has sometimes been dismissed by those who’ve never suffered the kind of trauma that produces it, which include explosions, attacks, sustained terror, sights of death and suffering, and other brutalities of war. But the effects – relentless nightmares, flashbacks, hair-trigger reflexes and unprovoked rages among them – can thoroughly ruin a veteran’s life if they go untreated.

PTSD is a routine byproduct of combat, yet it carries a stigma that keeps many away from treatment. Some fear the diagnosis will not be kept confidential, some doubt the therapy, some are ashamed and some don’t want to acknowledge the condition to themselves.

A Rand study released three years ago estimated that only about half of the military personnel suffering from emotional wounds sought professional help. Of that half, only half got competent therapy.

The U.S. government is already saving untold fortunes on veterans who need help but don’t get it. It has an obligation to watch for false claims, but it can afford to err on the side of the veteran who’s seen a buddy cut to pieces with shrapnel.

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