Column Editor – Katherine Locke
Jamie Eller is a third year medical student at Nova Southeastern University College of Medicine.
Please introduce yourself and your background for the PULSE readership.
My name is Jamie Eller. I am a third year medical student at Nova Southeastern University College of Medicine in Ft. Lauderdale, Florida. It’s a little complicated trying to explain where I grew up because I moved a lot during my childhood. I mostly “grew up” in Missouri, and that is where I went to nursing school, but I identify my “home” as Galveston, Texas, where I practiced as a nurse for five years. Most of my family and friends reside in Texas.
You moved frequently as a kid because your parents were in the military. Can you elaborate on the challenges that posed?
From an adjustment standpoint, at the time it didn’t seem like a big deal. It was just something I had to do. But looking back, I realize it had quite an effect on me. I would move in the middle of the school year and find that my new school was learning something I had already learned and it made me feel that I had some educational gaps. I felt insecure and reluctant to be social with others in fear that I would come off as the stupid kid. After awhile I began to avoid trying to make friends because I was going to move soon anyway. On the plus side, I became a very independent person.
From a healthcare standpoint, I was a very angry kid on the inside. I wasn’t mad at my parents or anything in particular. Luckily, I turned to sports to take out my feelings, but unfortunately many kids in the military turn to drugs and alcohol. I realize now that no one took the time to ask me how I was feeling. How I was coping with changing schools or my father being deployed for the past year. I was a good student, excelled in sports and seemed happy enough on the outside, so no one took the time to ask how I felt on the inside.
What was pediatric healthcare through the military like for you?
It can be a scary place for a kid. Most of the hospitals are very plain and dark light. Many of the hospital staff are soldiers themselves and are required to wear their military uniforms, so sometimes there are not very many people walking around in the more friendly scrubs. Everywhere you go, whether it is pharmacy, labs, diagnostic imaging, you take a number, sit down and wait. It’s easy to begin to think that you are nothing but a number in the military system.
Fortunately, there are new military hospitals being built today with the pediatric patient in mind.
What are some challenges faced by healthcare provided through the military?
Continuity of care, both from a patient and physician standpoint, is the biggest challenge. Civilian pediatricians have the advantage of seeing their patients for several years and can actually build good rapport. Military pediatricians are lucky if they get to see the same patient for more than two or three years.
What are some challenges pediatric patients and/or their parents may face when they leave the military healthcare system?
Getting a copy of your medical records seems to be quite the ordeal for some people. The military system has its own electronic records that can be accessed from any of their hospitals, but there is nothing linking them to any civilian EMR system. Parents have to be pretty diligent when it comes to obtaining records.
The biggest thing though is finding physicians who accept Tricare, which is military health insurance. Some active duty patients are allowed to use civilian resources when there is a shortage of military healthcare resources in that region. Many physicians are unaware of what Tricare is.
However, once out of the military system, becoming accustomed to civilian healthcare is quite easy.
How can osteopathic pediatricians make that transition easier on patients?
Just take the extra five minutes to have some small talk with your patients. Ask them how they are doing in school. Do they have friends? Are they happy at home? What do they do when they are sad? Is anyone they know actively deployed? Just taking the time to ask can mean a lot. You might uncover something that the parents are overlooking. Not to mention that many parents in the military are very young and inexperienced, and at times acting as a single parent while the other is deployed. You, the physician, can bring issues to light for them.
What are specific issues a pediatrician may want to look for with a new patient with military parents?
Find out if there is a parent or family friend that is currently deployed, or if they’ve already experienced a loved one being deployed. Find out if they are new to the military, and how many times have they had to move. Ask parents where they are from, and what kind of support system they have. Become familiar with local support groups for spouses and the many extracurricular activities provided by the military. Realize that deployments can last 6 - 18 months and at times back-to-back deployments can happen. Recognize behavioral issues and help parents recognize the signs of childhood depression.
How did your experience growing up as a child of military parents influence your desire to become a physician and particularly an osteopathic physician?
My dad would be gone for a year at a time, and my brothers and I became very close and learned the value of life and duty at a very early age. My father and many family friends are US Army EOD (Explosive Ordinance Disposal). My mother, both of my brothers, my grandfather and many other members of my family have served. I learned very early on that my dad disposed of bombs and how dangerous of a job it is.