Routine GI health needs not met

WASHINGTON — The number of Army medical centers and clinics that provide timely access to routine medical care has hit a five-year low, Army records show, often forcing soldiers and their families to seek treatment off base.

About 16% of Army patients, particularly family members, can't get appointments with their primary physicians and are sent to doctors off the installation, according to the results of a nine-month Army review finished late last year. Some of those patients end up in emergency rooms or urgent care centers, says the study, which the Army provided to USA TODAY.

Army records show that 26 of its medical centers, hospitals and clinics are unable to meet the Pentagon standard requiring that 90% of patients get routine care appointments within seven days. Those are the worst results since the start of the wars in Iraq and Afghanistan. That's a 13% increase from 2005 in the number of medical facilities unable to meet the standard.

This year, the Army surgeon general, Lt. Gen. Eric Schoomaker, authorized 12 medical facilities with the worst access problems to hire more primary care doctors, says Col. Ken Canestrini, who's in charge of improving access to health care for soldiers and their families.

Although 85% of patients get in to see their doctors, Canestrini says, Army officials understand the others are unhappy about not receiving the access they want.

Some of the worst problems for access to care are at installations that house units doing some of the heaviest fighting in Iraq and Afghanistan, Army records show.

Six in 10 patients received on-time routine care in 2008 at the Fort Bragg, N.C., hospital, which has not met the routine care standard since 2005. Bragg is home to the 82nd Airborne Division and special operations forces that have been fighting in the two wars consistently.

Routine care makes up about 25% of all visits and includes issues such as chronic knee injuries or lower back pain.

The Army deserves a C— grade for access, says Sheila Casey, the wife of Gen. George Casey, the Army chief of staff. She regularly tours Army bases to meet with military spouses.

The Army doesn't have enough doctors to provide care both to families and soldiers at home and to those in combat, say Casey, Canestrini and Col. Jonathan Jaffin, the surgeon general's director of health policy and services.

Hospital commanders have overloaded their base physicians with too many patients, Canestrini says, so appointments to see doctors are quickly used up.

Schoomaker ordered the off-base medical visits to make it easier for families to receive care, even if it costs more, Jaffin says.

By Gregg Zoroya, USA TODAY