Serving Those Who Have Served Us
Veterans and active service members of the military represent a very complex patient population with a unique history compared to the general population. Traumatic experiences abroad place service members at much higher risk for specific physical and psychological conditions such as post-traumatic stress disorder (PTSD). Often times, these conditions are not identified during a medical evaluation.1 This may be due to incomplete screening practices, brief patient interactions, or possibly lack of veteran recognition during visits. Taking the time to identify military veterans and thoroughly assess, diagnose, and treat their conditions is crucial to effectively managing their overall care.
Veterans can be exposed to a wide array of traumatic events. These may include:1
● Chemical or pollutant exposure
● Blasts/shrapnel injuries
● Infectious disease
These traumatic events can result in a variety of physical and/or psychological damage requiring specialized care. Physically, veterans may experience dermatologic, reproductive, and infectious disease issues related to their exposure. Other disorders involving psychological elements such as PTSD, depression, suicide, and military sexual trauma (MST) are also more common among military veterans. Many times, only physical injuries are treated, while psychological symptoms may be overlooked.1 The incidence of PTSD alone is estimated to be approximately 10% in Gulf War, Operation Enduring Freedom, and Operation Iraqi Freedom veterans and approximately 30% in Vietnam War veterans.2
Although veterans have unique experiences and associated disorders, their care is often managed similarly to that of a civilian patient. Approximately, two-thirds of military veterans utilize civilian health care providers to manage their care.1 Engaging veterans in the same manner as the civilian population may not be sufficient. Tailoring visits to veterans' unique needs may help improve their overall health care.
It may be difficult to initiate and navigate conversation with veterans who do not feel comfortable discussing their experiences in detail. Consider the following approaches to build rapport with each veteran. Begin by sharing your thoughts on what serving veterans means to you. This may also include your family or friends' service in the military. Next, gain the veteran's trust by reassuring confidentiality, then listening intently as the veteran shares his or her thoughts and behaviors. Lastly, acknowledge the veteran's character. The courage that veterans carried while at service is the same courage that can motivate them to achieve positive treatment outcomes.3 These are just a few ways to engage veterans in conversation. Below are some additional tips on how to alleviate potential apprehension and facilitate a conversation.