Physicians prepare for duty in military

Doctors in the Reserves and National Guard make arrangements for care of their patients, and say the disruption of their practices is a small sacrifice.

By Tanya Albert, amednews staff. Oct. 15, 2001.

Physicians are preparing to trade in their white coats for military fatigues.

About 4,600 doctors in the Army, Navy and Air Force Reserves and National Guard were among the military personnel that President George W. Bush called upon during his first address to the nation after the Sept. 11 attacks in New York and Washington, D.C.

Physicians on alert

"We've been told to be ready," said emergency physician Maj. Richard N. Bradley, MD, a Texas Air National Guard member who teaches at the medical school at the University of Texas Health Science Center at Houston. "They can't give us any details."

At press time, physicians had not been mobilized. Instead, doctors were busy making arrangements so their practices, classrooms and laboratories could continue to function if the military needs their services elsewhere. Doctors could be asked to back-fill positions that active-duty physicians held here in the United States or they could be deployed overseas.

Doctors in the Reserves and National Guard are concerned about the families they'd leave at home, and many are worried about how they might make car payments, mortgages and meet other financial responsibilities on a military salary. They also worry about making sure their patients will be taken care of while they're gone.

For physicians at teaching universities or in large practices in urban or suburban settings, making sure their patients receive care has in many cases been a matter of asking colleagues to take over their patient load or classes.

But for those in rural settings or those who are in solo practice, the task can be a little more daunting as they scramble to find physicians who can fill in while they're gone.

"We're hearing there is going to be a need," said Dustin Koger, vice president of operations for Texas-based Staff Care, which places locum tenens. "We're expecting the biggest need in the rural areas."

Preparing to go

Physician reservists and National Guard members in areas where they may be the only specialist are especially concerned about making sure everything is in order if they're called upon to go elsewhere.

Maj. Francisco Jaume, DO, is the only orthopedic surgeon in rural Coshocton, Ohio. The Air Force reservist is working with the local hospital to find a temporary replacement who could fill in and he is trying to answer questions that many rural physicians in the reserves have.

"Who will take care of patients who recently had surgery?" he said. "When I get back, will I have an office?"

Physicians in solo practice are facing some of those same questions. They, too, are looking for locum tenens who can keep their practice doors open while they're away.

"You always sit and hold your breath when something like this is happening," said Lt. Col. Sidney Van Assche, MD, a family physician in Winnemucca, Nev., who serves in the Nevada Air Guard.

Dr. Van Assche has his own practice and is one of only a few family physicians in the Winnemucca area. But being called up for 30 days of active duty in the past has helped prepare him for what to expect if he has to be gone even longer.

"I've been contacting locum tenens and I have a contingency plan in place," he said.

Physicians faced similar challenges during the Gulf War, said Alan Morgan, vice president of government affairs for the National Rural Health Assn. The association is trying to help physicians work out details before they get the call to leave home.

Morgan said they've been talking to the Bush administration about bringing professionals from the National Health Service Corps into rural areas that are strapped for physicians. He said they also hope to work with the American Hospital Assn. and the AMA on finding solutions.

"We want to proactively address this," he said. "We know this will be an issue."

Small sacrifice

Although figuring out how to take care of patients and practices while they are gone can be worrisome, doctors in the Reserves and National Guard say it's a small price to pay for protecting freedom.

"Anytime you go to war, everybody has to accept some compromises and shortages," said Dr. Van Assche, who said he serves in the National Guard because of the camaraderie it offers.

"This is a big deal, and individual concerns are relatively minimal compared to the threat," added Lt. Col. Michael Opatowsky, MD, a neurological radiologist at Wake Forest University, Winston-Salem, N.C., who is in the Air Force Reserves. "Somebody has to work harder, but the work gets done."

Family physician Maj. Mark Litz, MD, said he is concerned about leaving behind his wife and five children in Muncie, Ind. He just started his new job in September after finishing a stint in the Army.

"But I'm willing to go if that's what is necessary," said Dr. Litz, now a member of the Army Reserves. Dr. Bradley, who would leave behind his pregnant wife and 3-year-old child, has similar feelings.

"The sacrifice of having to leave my family would be tough," he said. "But right now that short-term sacrifice is worth the long-term goal of keeping the country safe."