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Health & Exercise Forum

Make this Veterans Day a Healthy One

Oct 31, 2016
Kristina Borham, MD1, TCMC

Kristina Borham, MD1, TCMC

Guest Columnist: Kristina Borham, MD1, TCMC

 Kristina is from Oxford, Pennsylvania, located in Chester County in the southeastern part of the state. She attended West Chester University of Pennsylvania and graduated with a degree in Cell and Molecular Biology in 2015. Kristina is currently a 2nd Lieutenant in the United States Air Force through the Health Professions Scholarship Program and will be serving as an active duty physician following her graduate medical education. Her interests and hobbies include women’s health, cancer biology, blogging, yoga, and hiking.

Veteran’s Healthcare--Friday, November 11, is Veteran’s Day!

In the United States, there are currently 21.8 million veterans. When compared to civilians, these service men and women have a unique set of healthcare issues that is not easily discernible based on typical patient interactions. As the daughter of a disabled Army veteran and as a first-year medical student and an officer in the U.S. Air Force, this is a fact with which I am well acquainted. Unfortunately, my personal knowledge of veterans’ struggles is not widely shared by the civilian population.

Veterans face a variety of healthcare issues ranging from access to care, mental health, physical disabilities and even transition from military to civilian life. The responsibility to address these issues, however, is not limited to the Department of Veterans Affairs (DVA), as too many in the civilian population believe. According to the 2010 National Survey of Veterans from the DVA, a little more than 41 percent of veterans do not use their veteran benefits for their health care. This means that civilian healthcare professionals are caring for American veterans from military actions ranging from World War II, through Vietnam, all the way to the War on Terror and deployments to Afghanistan and Iraq. As a result, the civilian healthcare sector should be sensitive to veterans’ needs and experiences and become more aware of the role and influence military service plays in regards to these patients’ physical and emotional wellbeing in order to provide the best appropriate care.

But how is treating a veteran different than treating any other patient of the same age and demographics with the same conditions? This question can be answered in a multitude of ways. It is important to recognize that veterans whether designated as “disabled” or not, have experienced things – often emotionally injurious – that the average American has not. These experiences can result in post-traumatic stress disorders, addiction, and chronic illnesses from toxicity, mental health disorders, suicide risk, homelessness and other safety concerns. Additionally, many veterans are unaware of the availability of VA benefits or cannot obtain the level of disability benefits they need to take care of themselves and their families. There is a huge gap between the care given and the care needed, even among the most caring of physicians.

For any type of healthcare provider, one of the largest areas of concern when treating a veteran is mental health. Mental health issues include depression, anxiety, PTSD, and even substance abuse. Military training and deployment can have an impact on the psychological and medical state of individuals. This impact can affect the veteran on an individual level or extend to his or her family in the form of issues such as suicide grief, intimate partner violence, abandonment fear with children, or isolation from the family. With appropriate screening and access to care, veterans’ ability to cope with these hardships can be increased while risks can be decreased.

Despite this urgent need, many clinicians and practices are actually unaware of the military status of many of their patients. A military health history is rarely completed and connections between current health status and deployment are therefore hidden. Additionally, lack of identification of at-risk patients or family members for service-related complications may reduce the access to veteran benefits, as patients often rely on their providers to guide them through the application process or supply resources.

With proper education and increased awareness, civilian healthcare providers can give better care to our veterans. This can translate to better diagnoses, increased access to veteran benefits and the DVA, or simply more appropriate and improved doctor-patient relationships. Our veterans have served us and our country and it is our duty as medical professionals to serve them the best that we can.


The Commonwealth Medical College, located in Scranton at the Medical Sciences Building at 525 Pine Street, will be hosting its fall Keystone Symposium on November 5th entitled “Veterans’ Healthcare: The Physical and Emotional Needs of the Military.” One of the symposium’s speakers, Dr. Jeffrey Brown, served in Vietnam as a decorate front line infantry battalion surgeon and will be discussing the weak link in veterans’ healthcare. Another speaker, Kim Ruocco, representing Tragedy Assistance Program for Survivors, will be discussing suicide and survivorship. Other topics include PTSD and behavioral and mental health. The symposium will take place on Saturday, November 5th from 8 a.m. until 12:30 p.m. and is open to TCMC staff, faculty, students, military members, resident physicians, university students and all other community members. You can register at

If you are a veteran or know a veteran in need and require more information, please visit the sites below:


Read Dr. Mackarey’s Health & Exercise Forum – every Monday in the Scranton Times-Tribune. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.