Have you or someone close to you ever served in the military or armed forces on active duty? Who?
Note that the question does not ask if the person is a veteran. Some veterans will not identify themselves as veterans, even though they are. This may be due to still having an active military status and only seeing veteran status as denoting being separated from the military. It may also come from never having served in a “war zone” and feeling one does not deserve to be called a veteran. Data suggests that many women who have served in the armed forces fail to think of themselves as veterans.
Whatever the case may be, some veterans will answer no when asked if they are a veteran, but they will more likely answer yes when asked if they have served in the military or armed forces on active duty. The term, “armed forces”, is the better of the two terms to use because includes the military services, defined as the Army, Marines, Navy, and the Air Force – and also the Coast Guard. Coast Guardsmen often called up to perform as a military service during periods of armed conflict or war and, in so doing, qualify as veterans. That raises another key point – active duty service is entailed in the definition of a being a veteran.
It is suggested the patient be asked not only if he/she has served, but also if anyone close to him/her has served. Health issues may arise in loved ones of deployed personnel and veterans – generally those revolving around mental health and reproduction. If the family deployed with the spouse, they may be subject to some of the same environmental contaminators (e.g. the Camp Lejeune water contamination situation).
When did you/he/she serve?
It is suggested to give them different options to choose – for example, decades or eras of military service. This will give clinicians a quick idea of what exposures the veteran may have been experienced (See The Military Health Risks by Military Service Era section).
Separating the years into decades or periods is a good tip, for it allows the veteran to give a quick reference if they can’t remember exact dates. Be prepared for veterans, especially those who made a career of being in the armed forces, having served in more than one era.
Where did you/he/she serve?
Different decades and eras of service have different risk associations. Knowing the decade or era, however is not enough, knowing where is equally important to determining unique exposures, especially if it involved being in a combat theater.
An example would be the use of Agent Orange as an herbicide in Vietnam and elsewhere in Asia during the Vietnam Conflict era. And then there are the environmental diseases related to specific geographic areas such as in deserts and the tropics – uncommon to here and not generally considered.
What did you do?
While the military jargon about jobs and titles may be confusing and intimidating, siimply asking what a veteran did while he or she was serving could provide important insights. If he/she does not want to talk about it, the person will tell you that and the question can be left lying. However, the advantage of asking the question can be enormous and most will appreciate that you are showing both professional diligence and concern.
For example, if as implied in the previous question, you find the veteran was never stationed outside of the United States, you might not think they had a high risk of war related mental trauma. Instead, you might find his state side job was to receive returning bodies from a war or worked with the extremely seriously injured. Although this veteran may have never have seen battle, he may be experiencing the effects of secondary trauma.
Do you think your service has affected your health?
This inquiry gives the veteran an opportunity to raise any concerns he/she has regarding his health. The Military Health Risks by Military Service Era section implies why this is important. You It may uncover other related issues. Since military service can affect many aspects of a person’s health – physically , mentally and socially, it is important to let them know you are not only interested in their physical health.
Have you received medical care for this condition from any other provider, including military or VA?
By asking this question, you may find out that the individual is under VA care, for example. It would might lead you to ask if he is receiving medications from the VA he has not yet revealed; that he has already seen a VA doctor who has ordered tests of use to you also, saving both of you both time and money while also helping to ensure patient safety.