FARAI CHIDEYA, host:
From NPR News, this is NEWS & NOTES. I'm Farai Chideya.
America isn't doing all it can to take care of its wounded veterans. That's according to a presidential commission headed by former Senator Bob Dole and former Secretary of Health and Human Services Donna Shalala.
Dr. C. Martin Harris was also on the commission. He's a practicing physician and chief information officer at the Cleveland Clinic in Cleveland, Ohio. Dr. Harris says troops get exceptional care in the field. The problem is looking after them once they're home, especially if they're going to need a lifetime of help. That's why Dr. Harris and his fellow commissioners recommend what they call care coordinators.
Dr. C. MARTIN HARRIS (Chief Information Officer, Cleveland Clinic): Once a comprehensive medical plan has been put together for their ongoing outpatient care by a team of medical professionals focused on the individual patient, you now have a care coordinator who's responsible for making sure that the patient can have unencumbered access to that care. So, for example, an individual soldier who's actually in Walter Reed may make the decision that they would prefer to have their long-term care delivered in their home market.
While they're not an expert in how to get rehabilitation services in their local DOD hospital, but surgical or ambulatory - other ambulatory medical services in their local V.A. hospital. Those are two completely different administrative processes. It's the role of this recovery coordinator to make that a seamless process.
CHIDEYA: Now, commission co-chair Donna Shalala said your motto, while conducting this review was put patients and families first. What about the family side of this? How much has the government done in the past to really ensure that people, who become caretakers of seriously injured troops; parents, spouses, sometimes even more distant relatives, have a stake in the game and can get what they need done, done?
Dr. HARRIS: Well, as we said in our report, that this is clearly an area that must be strengthened. Again, the nature of these injuries really will require families to fundamentally change their roles. Many family members end up really quitting their jobs, relocating to wherever their loved one is, and becoming a primary caretaker. The only way that that can happen is if the family receives the support they need to make this work.
So the specific recommendations include extending the Family Medical Leave Act for up to six months for spouses and parents of the seriously injured and looking at other programs to support them in term of direct transportation and other kinds of social service supports that go directly to the family members, not to the injured soldier.
CHIDEYA: Now, here in Los Angeles, you can go on many downtown streets and see veterans with PTSD. There are few groups that reach out and try to help them. But what do we need to do to make sure that there's not a repeat of what happened during the Vietnam era, where a lot of people came back addicted, or picked up addictions due to PTSD?
Dr. HARRIS: This is one of the signature injuries of this conflict. And it's a complicated one. Post-traumatic stress disorder may not leave any physical observations. So one of the things that we have to do is to absolutely improve the diagnosis of this disorder. And so every service member returning from the theater should go through a process to help screen and identify people who are at risk or who are actively suffering from the disorder.
The second thing is that once it's diagnosed, we have to be prepared to be vigilant in managing the care because an individual may have mild symptoms of the disease within a few weeks after returning from the conflict. And those may become dramatically more severe in the next six months, a year or two years. The medical programs that had been set up traditionally really were focused on an individual encounter with the patient. What needs to happen, especially related to PTSD, is ongoing surveillance and appropriate management when required.
CHIDEYA: Well, Dr. Harris, thank you so much for your time.
Dr. HARRIS: Thank you.
CHIDEYA: Dr. C. Martin Harris is a member of President Bush's Commission on Care for America's Returning Wounded Warriors, also known as the Dole-Shalala Commission. He's a practicing physician and chief information officer at the Cleveland Clinic.
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