.

.

.

.

...

Military Medicine vs. Civilian Medicine

The U.S. Military operates one of the nation’s largest healthcare systems, with nearly 600 hospitals and clinics employing 147,000 medical professionals – about 13,000 of them doctors (Carollo & Nesmith, 1997).

The military’s system offers free, or nearly free medical care to 8.2 million military members, their families and retirees -- that means military doctors treat approximately one out of every 50 patients in the United States. In the past year, military doctors cared for 460,000 hospitalized and 36 million ambulatory patients (Guidance from OSD/PA, 1997), yet they operate in virtual secrecy.

Federal law prohibits the release of military doctors’ records to the public. Their training, certification and complaints filed against them are locked in a military data base. This shelter from scrutiny is not enjoyed by civilian doctors (Appendix A). All physicians with malpractice suits, civilian and military, are required by law to register with the National Practitioner Data Bank (NPDB), designed to allow the public to look up information on a particular physician.

However, more than 75 military medical facilities have never reported a doctor for medical malpractice to the NPDB. Even worse, those same facilities were the targets of claims alleging more than 1,000 incidents of medical malpractice (Appendix B).

In 1986, the military required physicians to obtain state licenses. But in 1996, more than 1,100 military doctors, one of every 11, had not yet obtained licensure (Appendix B).

A Supreme Court ruling in 1950 resulted in the Feres Doctrine, which prohibits members of the Armed Forces from suing the federal government or its employees for medical malpractice. (Feres v. U.S., 1950). Today, the Supreme Court is considering two separate cases challenging the Feres Doctrine on behalf of military members (Appendix C).