The Expert:
Kathy Beasley Ph.D., FACHE CAPT, USN (Ret.) is a retired Navy Captain who had a 30-year career serving in the Navy Nurse Corps. Upon retirement from military service, she worked for a decade at the Military Officers Association of America, where she advocated for military members, their families and veterans on a range of healthcare issues at the national level.
Is pregnancy a dischargeable condition?
Pregnancy is not dischargeable, because a servicewoman becomes pregnant, she is not discharged. What that does, so that particular condition – I just want to focus on pregnancy for a minute – it renders the service member, the servicewoman, temporarily non-deployable, okay. That’s temporarily for the course of her pregnancy, to include the postpartum period, the period after pregnancy. So, in the old days, in the very old days, they would have, discharged a woman for being pregnant, but today that certainly is far from the truth there. So, um, that’s a, it’s just a condition that prevents you from being deployable during your during your pregnancy and shortly for a period after.
How do command teams find out about conditions that make a service member non-deployable?
It, you know, is a responsibility of the servicewoman service and service member to disclose any anything that could, um, impact their deployability, whether it’s during that periodic health assessment or any other time the servicewoman uses, medical, you know seeks health care in the system. she should disclose to her, provider and and her command if there’s a situation that would either partially render her non-deployable or um, you know, need to be looked at. I mean, that’s part of the, you know, service members, you know, we have rights and responsibilities. Certainly, when seeking care we deserve, you know, there’s a DOD patient’s Bill of Rights that’s a big instruction, um, that guarantees you know, quality care, um, privacy and security, um, respectful treatment, among other things. those things, we are guaranteed those those rights as patients, but as service members, we have responsibilities to be transparent and to disclose situations that might affect, um, our deployability.
How can you find out what conditions will make you non-deployable?
Most of the the junior or more senior, command leadership, our unit leadership, would know those things. Those are pretty prescribed, situations and the different services have may have slightly different requirements, but, those things are taught early on. command leadership knows those things, and, certainly, healthcare providers, whether it’s they’re at the clinic level that the military-based hospitals, or or if it’s an independent duty corpsman, for instance, at the at the unit level, they know what those conditions are and would be able to certainly advise a servicewoman on what that would be.
What advice would you give someone with female biology who has questions about a sensitive condition?
Seek out mentors and trusted individuals, whether it’s in their chain of command, outside of their chain of command. Um, someone they can talk to. It could be, certainly, I would tell young women to find a a more senior, um, female, mentor and to use them. Also, chaplains and things are always good resources, but to always have somebody, because you might … Most of us could use, especially when we’re younger, use someone to to help advocate, on our behalf and to bounce questions off of and things like that. And you know, young servicewomen, um, I’m partial to them because they come into the service, they’re awfully young, they leave their families behind. They’re mothers, they’re sisters, you know, the parents, and they frequently, you know, find themselves somewhat alone, so I’ve always recommended to seek out a mentor and I was always taught, you know, more senior female service members, to, you know, to look out for for those, junior junior sailors, and and soldiers and airmen, too. So it’s, that’s what it takes. It takes everybody helping each other.
Can you stay in the military if you have a non-deployable condition?
It depends on what the condition is, and I mean, something you know, I mean you break a leg, you have a severe orthopedic injury that is going to require extensive rehabilitation. You are definitely non-deployable and are you going to be put in a disability evaluation system? I think that remains to be seen, because usually, you will have a course of treatment for a chronic or severe injury to see if you will be able to progress. I mean, you’re monitored, and pretty closely by, your your probably physician providers on those things so it doesn’t necessarily render you dischargeable.
Are you allowed to seek civilian medical care outside of the military health system?
During the course of a service member’s military life, they would probably, well they for sure will be experiencing and maintaining most of their care to a military treatment facility. We call them MTFs. That’s the base hospital or base clinic. Um, frequently though, if there’s a condition that they need some other specialty care for or some care that the base doesn’t provide, the base hospital doesn’t have, they will send them on a consult – we call it a referral – out to the civilian TRICARE network. So TRICARE is the managed care civilian network, care that supplements and supports the military health system. So they would need a referral. Now, that doesn’t stop people from, seeking care on their own, um, at their own expense if they want to on the outside. And they, you know, you can do that, but, um, I wouldn’t recommend it, um, just because, I don’t know what condition you would you would really want to seek that. I mean, you’re liable for for full payment if something happened or something, and if the military didn’t refer you, so I wouldn’t, um, advocate for that. Then, when the individual, if they are on a referral, gets seen on the outside, and I know a couple individuals right now who are pregnant and they have been referred out for their pregnancies to the civilian network so they’ll be followed on the outside. Then they come back into the military health system with those records of care, so that’s that’s kind of what happens in in that scenario.
Does outside treatment need to be disclosed to command?
If someone seeks care on the outside, not with a referral from the military provider, they, and if it’s for something that will affect their military readiness, their individual medical readiness, they’re obligated to disclose that to their military provider or to their chain of command because it affects their military readiness.
If command discovers that civilian treatment is being received, can it be used against the service member?
It depends on what what the situation would would be when what, you know, they were not disclosing, um, but if it was fairly cut and dry, I mean, I think it would just go into the record. And you know, the the individuals, you know, and I know they’re counselled and and things. I know that they understand, um, or at least they should, anytime you seek care in the outside, um, you know it is somewhat risky to a certain extent, for them, depending on what it is again.
If a service member feels they’re being dismissed or not believed by their medical provider, what options do they have?
This is part of the, you know, DOD’s patient’s Bill of Rights. Um, she has the the right to seek a provider asking for a change, in providers that will, you know, meet her needs and feel listened to in a culturally competent and sensitive manner. I would advise a servicewoman to, you know, go into the clinic or the base hospital. They usually have the providers on, you know, pictures up. We have a variety wide variety of hospitals and stuff that typically will have them pictures up on on a board or a wall somewhere. They’ll certainly have them listed, and they will have their specialties their medical degrees, their areas of, specialty, which, you know, women’s health would be certainly in there. You can see whether they’re male or female and and make your selections on that, so so, um, they do have the the the opportunity for the most part to select a provider.
If you don’t like your medical provider or are uncomfortable with them, can you see someone else?
I would advise going to the, um, the the clinic, the clinic desk or whoever’s administering, um, you know, that that particular clinic or, um, base hospital. Um, to go to the administration of the specific area and request. I mean, at most base hospitals, whether they’re Army Air Force or Navy, have patient representatives, patient advocates, those kinds of people there. And those people’s pictures and contact information are posted in in the clinics or somewhere in the hospital, and hospitals will have several, whereas clinics may have maybe one or two. Depends on the size, but there’s people there that you can talk to.
If a service member is discriminated against within the military health system, what are their options? What if the doctor outranks them?
Most probably the physician or nurse practitioner will most likely outrank because a young service member, certainly not somebody more mid-grade or something, you know, probably not, but by and large, the the providers, the physicians and the nurse practitioners, I’m thinking of mostly, have advanced degrees, so they are higher in rank. So typically they would be at the 0405 level, so yes, it could be somewhat intimidating for a young service member to be to be seen, with someone as a higher rank, but they need to understand that these are healthcare providers. They are doctors and nurses there to deliver healthcare to them, so they will, you know, need to to develop a trusting relationship with them, and for the most part, you know, they’re going to be right there, um to, to to to take care of the servicewoman. Um, if if she feels discriminated against, that’s a whole different thing and that discrimination is not tolerated in the military at all, so that is a, UCMJ offense and should be reported to her. She should take that to her chain of command.
If a service member doesn’t want a treatment that is recommended to them, do they have the right to refuse it? If so, how will that affect their service?
She does have the right to refuse treatment, um, but the providers on the other hand, the medical providers, you know, are obligated to provide full disclosure to that servicewoman on what that would involve by denying treatment or not going with the with the treatment option. you know, that’s part of the the medical diagnosis. You always give your patients, you know, what the recommended is, what okay, if you don’t want that course, this is what this would lead to. or maybe you there’s a hybrid, you can do this or that, but always it would get down to the servicewomen. When what that condition, what that diagnosis, and what her refusal would be – how would that affect her her deployability and her medical readiness. And the providers are obligated, you know, and they will, tell you what, what that would result in. And if the servicewoman is not comfortable with that diagnosis or the that course of treatment that’s being suggested, they do have the, um, ability to appeal that or to, you know, get a second opinion, is what we would call it. So, you can certainly do that within the military health system or request it, with from a civilian provider too, so there’s a process for that at the military, treatment facilities and that’s probably where that would occur, um, to to go through that process.
Why is it important for people to know their patient rights and advocate for themselves?
It’s so important, to know your your rights. you know, again, um, you you want to, I would stress to servicewomen, you want to maintain your health, your healthy status, to make sure that you you know are exercising and doing the healthy lifestyle. All those things that are important to to maintaining a, you know, a positive attitude of resiliency because let’s face it, service, in the military, it’s very rewarding but it’s very difficult at times too. And you know frequently, our servicewomen they, you know, go on to get married. I’ve known many dual-service couples and that’s that’s a whole balancing act in in and of itself, and when they start having families, you know, you you you’re advocating for your children within the military health system too, not not just your yourself, but your your children getting seen by them. The pediatricians in the base hospital and things, and you know, know you become the knowledgeable and the the resource for your husband and and everything else. So you know, we all know women make many of the healthcare decisions in the family and that’s not, any different in a in a military family. So, um, just get educated on things so, you know, you help you and your your own family, and those, coming behind you. the the young women that you will end up mentoring also.
