The transformation of Army medicine has been a topic of great concern for all military physicians, regardless of specialty. It has been proposed that 18,000 uniformed military medical personnel be cut (approximately 22% of 2019 uniformed personnel). Per Vice Adm. Raquel Bono “We will continue to meet all standards for timely access for our beneficiaries, and while care delivery locations may change, our commitment to provide high-quality healthcare will remain steadfast.i” The stated goal is to make a more combat-relevant medical force, but one must question what the actual result of these changes will be. One effect will be an increase in subspecialty deferrals to the network. While use of the civilian system could potentially improve access to care, it is not guaranteed to. Delays in processing the referral and finding an available provider with access can also be challenging depending on the specialty. Sudden shifts in deferrals could overwhelm certain civilian systems. Keeping access aside, these deferrals can also result in numerous problems, including over-diagnosis of conditions and/or prescription of medications that are not compatible with continued military service and difficulty getting the reports and adding them to service members’ records. I recently had three patients in my clinic who presented with the diagnosis of Narcolepsy made by three different civilian sleep specialists ...
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", language="en", issn="0026-4075", doi="10.1093/milmed/usz457", url="http://dx.doi.org/10.1093/milmed/usz457" }