What Should Civilian Providers Know About Treating Military Patients with TBI?


What should civilian providers know about treating military patients with TBI?


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[Dr. Heechin Chae] For civilian providers out there who are going to see veterans who return to their communities to get care after getting treatment in a DoD setting like Fort Belvoir, Bethesda. They should know this, that veterans are medically—I would say it's a little bit different as far as their attitude, make up, their approach to problems. I will say there are a lot of emotional scars that they've gone through. Some of the scars have not been touched yet because it was impossible to address them because of all these different medical problems that were more urgent that needed to be taken care of. Or they were aware of them, but it was too fresh or not an appropriate time to address them. So I will say that lesson number one is, always assume there are emotional scars that have not been addressed. I think they have to be very sensitive and at least aware of that. Or try to appreciate those before they begin the treatment because oftentimes I see—at least from my experience dealing with veterans when I was on the civilian side— I found out into the treatment and many times I had to reverse or at least the treatment did not become effective because I did not—I was not aware of those emotional scars, which is fairly common in people who—even people who do not have PTSD. If they were deployed, if they actually were in some type of combat setting, it's easy to assume—it's actually important to assume that they have some emotional scars. I will say that's the biggest thing. Number two is they have the mentality of an athlete. They—most of the time they don't—they minimize their problems. So they may not actually tell you exactly how they feel. So when they say headache, there are other things there. If they say back pain, it's usually more than that. They are just going to be very specific to a problem, but they don't elaborate unless you really dig deeper. So the interview has to take a little bit longer or at least give them time to present their problems to you. And they have a hard time trusting medical providers so you have to—again—put them in the driver's seat. Give some time to develop the rapport before you really force your treatment plan to them. You really have to have a buy-in before you actually do something with them.
Posted on BrainLine September 10, 2013.

About the author: Heechin Chae, MD

Heechin Chae, MD was appointed site director of DVBIC at Fort Belvoir and chief of the Traumatic Brain Injury Department at Fort Belvoir Community Hospital in 2011. He will become the director of the National Intrepid Center of Excellence satellite at Fort Belvoir in 2013.

Heechin Chae

Produced by Victoria Tilney McDonough, Lara Collins, and Ashley Gilleland, BrainLine.