Serving one’s country not only means putting yourself in harm’s way before a foreign enemy, it also means putting your health in the hands of a military health system that has no real accountability for making fatal mistakes.

In the civilian world, a patient who is misdiagnosed and harmed by such a mistake can sue their doctor for malpractice. But this recourse does not exist with the military’s health providers, who can miss a serious medical problem with an individual and not worry about being taken to court, or even have their mistake shared with other patients.

About 1.3 million active-duty service members have to use the military’s healthcare system for care. For those who experience poor treatment, they are “virtually powerless to hold accountable the health care system that treats them,” according to Sharon LaFraniere at The New York Times.

“They are captives of the military medical system, unable, without specific approval, to get care elsewhere if they fear theirs is substandard or dangerous,” LaFraniere wrote. “Yet if they are harmed or die, they or their survivors have no legal right to challenge their care, and seek answers, by filing malpractice suits.”

Up until 18 months ago, most military personnel couldn’t even file complaints about poor medical treatment. But even though that avenue is now open, the complaints are mostly just filed away and don’t see the light of day, nor are they shared with the public because “investigations at military hospitals and clinics are confidential.”

Part of the reason for that, according to LaFraniere, is to prevent the 2 million or so civilian relatives of those service members from seeing the results, since they are not barred from filing malpractice suits. Even the military personnel themselves are not informed of the results of any inquiry that may have been undertaken in response to their complaints.

Cheryl Garner, a retired military intelligence officer told the Times: “There is just no transparency. You can’t sue. You have no insight into the process. As active duty, we just don’t have much recourse.”

Compounding the problem is the fact that the hospitals themselves don’t follow regulations. “Military hospitals often fail to conduct safety investigations that the Defense Department mandates when patients suffer serious harm or die,” wrote LaFraniere.

Potential whistleblowers are also dissuaded for calling attention to matters they see as being detrimental to patients. Medical workers who do speak out about problems with patient care often suffer reprisals.

In a project that has helped to reduce patient injuries, some military medical officials are adopting a program called I-PASS, which is a system of training and communication tools to improve transfer of patients between medical providers. About 80% of serious medical mistakes that are detrimental to patient health and wellbeing occur as a result of miscommunication between caregivers during the handoff of patients from one health care facility to another, according to The Joint Commission, a non-profit group of more than 20,500 U.S. health care organizations. Nine civilian hospitals have already partnered with military medical officials to implement the program. To date there has been a reported 30% reduction in patient injuries caused by medical errors as a result of the employment of I-PASS, according to a study performed by Walter Reed National Military Medical Center and the Uniformed Services University of Health Sciences, both of which helped develop the program.

-Danny Biederman, Noel Brinkerhoff

To Learn More:

Service Members Are Left in Dark on Health Errors (by Sharon LaFraniere, New York Times)

Military Partnering with Civilian Hospitals to Reduce Medical Errors (Health.mil)