October 2014 Direct

by U.S. Medicine

November 10, 2014


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VA Proposes Physician Pay Increases, Begins Major Recruiting Campaign
WASHINGTON – The maximum rates of annual pay for incoming VHA physicians and dentists would be increased as much as $35,000, under a VA proposal announced last month. The updated pay tables would allow physicians and dentists newly hired by VA a potential annual pay increase of $20,000 to $35,000, according to specialty. The new salary ranges will be made effective Nov. 30, following the 60-day Federal Register notification period. More

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Craig Bryan, PsyD

Better Recruit Screening Probably Won‘t Solve Military Suicide Crisis
SALT LAKE CITY – The roots of the rising suicide rates in servicemembers and veterans reach back into childhood home environments and pre-military experiences, according to a quartet of recent reports. Childhood trauma such as physical or sexual abuse, living with a mentally ill adult or a substance abuser and witnessing domestic violence increase the risk of suicide during and after service, as do suicide attempts prior to enlistment and sexual assault prior to and during service. As more evidence of pre-enlistment factors in suicide emerge, controversy over the need for mental health screening has also intensified. More

Charles W. Hoge, MD

Who Has PTSD Now? New Definition Creates Challenges for Clinicians
SILVER SPRING, MD – A new study raises critical questions about the change in the definition of post-traumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and how that will affect diagnosis and clinical care of servicemembers and veterans now and in the future. For example, the research from Walter Reed Army Institute of Research found that 30% of servicemembers screening positive for PTSD under the old DSM-IV criteria were excluded when DSM-5 criteria were used, and about 20% of those who met criteria under DSM-5 would not have been identified using the older DSM-IV criteria. More

After Lackland Bat Infestation, 200 AF Trainees Received Rabies Prophylaxis
SAN ANTONIO – The largest ever military investigation of rabies exposure involved more than 900 Air Force personnel interviewed and 200 receiving post-exposure prophylaxis (PEP) at a cost of about $400,000. In a recent issue of the Morbidity and Mortality Weekly Report, the national Centers for Disease Control and Prevention reported the January 2014 incident, which involved rabid Mexican free-tailed bats sighted in an older building used to house an Air Force basic training squadron. PEP, consisting of human rabies immune globulin and the four-dose vaccination series given over 14 days, was indicated for 22% of the recruits. More

From the Editor-in-Chief:

“To be prepared for war is one of the most effective means of preserving peace.”
– George Washington (1732-1799)

Editor-in-Chief, Chester “Trip” Buckenmaier III,

We cannot relax as the current conflicts wind down; rather, we need to leverage the military medical experience gained into the medical advances happening daily to prepare our medical response for the next war. While I cannot predict where or what the next war will be like, I am confident it will look nothing like the past 13 years of conflict. Today‘s providers are teaching tomorrow‘s medical warriors. We must ensure that we motivate ourselves and our students to apply the lessons of the present but be aggressive in inculcating the new medical knowledge being developed at an ever-increasing pace. Perhaps this military medical preparation, as George Washington suggested, will help deter future conflict but if recent history is any guide, likely not. In that instance, federal medicine‘s commitment to always advancing warrior care becomes even more vital. More

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Brenda L. Mooney
Editorial Director,U.S. Medicine
[email protected]
39 York Street
Lambertville, NJВ  08530

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