PHYSICIANS ON THE FRONT LINE
TREATING THE ACTIVE DUTY AND
RETIRED MILITARY PATIENT
AUTHOR Todd Hockenbury, MD
I
am a 1981 graduate of the US Military
Academy at West Point. During my four
years at the Academy, I was immersed in
the traditions and history of the US Army.
I initially planned an Army career in the
combat arms, but my interests in anato-
my and physiology steered me towards a
medical career. I was able to return home and
attend the University of Louisville School of Medicine on a Health
Professions Scholarship. I completed my orthopedics residency at
Fitzsimons Army Medical Center in Denver. My introduction to
military patients began early in my training, treating active duty
soldiers ready to deploy to Desert Storm, as well as WWII and
Vietnam veterans. I served for 20 years in the US Army. I have been
stationed in New York, Colorado, Georgia, Oklahoma, Germany,
Croatia and Ft. Knox, Ky. I served 12 years as an active duty phy-
sician and orthopedic surgeon taking care of active duty soldiers
and their families, as well as retirees. I experienced wartime med-
icine firsthand while stationed in a MASH unit, caring for United
Nations soldiers from 25 different countries in the early days of the
Yugoslavian conflict.
It continues to be a privilege to treat military patients. Military
personnel are driven and goal-oriented. An injury or illness disrupts
their ability to complete their mission and may hamper possibility
of promotion. The importance of physical readiness cannot be
overemphasized. Soldiers have specific height and weight require-
ments. Soldiers, Marines, Airmen and Sailors are required to pass
a physical fitness test on a yearly basis. If the test is failed, they will
not be promoted to a higher rank. This may seem trite or even cruel,
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LOUISVILLE MEDICINE
but the military exists to fight and win wars. Without able-bodied
people, the mission cannot be completed. If a soldier is not deploy-
able to fight due to medical reasons, they are medically discharged.
The US Army Medical Corps motto is “Conserve fighting strength.”
Active duty military patients have different requirements and
duties from civilians. They are asked to move to different parts of
the world, often with little warning. They typically change duty
stations every three years, making continuity of care a challenge.
They are often asked to be separated from their families for months,
or even years, at a time. They have to put up with uncomfortable
living conditions and physical hardships that most civilians are
incapable of imagining. They take part in physically rigorous and
dangerous training exercises. Finally, they are asked to go to war
and put their lives at risk to defend the military interests and all
citizens of the United States of America.
Army medical community hospitals and medical centers still
exist, but their numbers are diminishing. It is now common for
military personnel to be referred to nonmilitary physicians for
care. Additionally, retirees often get medical care in the Veterans
Administration System. If a specific type of care is unavailable there,
referrals are made to non-VA physicians in the local area.
As an orthopedic surgeon with subspecialty training in foot and
ankle surgery, I am often asked to evaluate and treat both active
duty and retired patients. Coming from a military background, I
understand the active duty soldier’s concerns about the possibility of
their military career being cut short due to an injury or illness. I also
understand the retirees’ pride in their service and the mechanism by
which a service-related injury may cause long-standing disability.