Journal of General Practice

Treating Veterans of Iraq and Afghanistan: A State Needs Assessment of Civilian Physicians in Internal and Family Medicine

Abstract

Sally A. Koblinsky, Katie M. Hrapczynski and Leigh A. Leslie

Background: With the return of troops from Afghanistan and Iraq, growing numbers of primary care physicians in the United States are treating veterans and their families for war-related conditions. However, little is known about civilian providers’ capacity to address the needs of this population. Objectives: This study sought to assess civilian internists and family physicians’ knowledge, confidence, practices, and training needs in treating war-related conditions of recent veterans and their family members. Method: An anonymous needs assessment survey was administered online by the Maryland Board of Physicians. A convenience sample of physicians in internal and family medicine (N=145) reported on their treatment and referral practices, knowledge and confidence in treating 14 veteran conditions, and preferred training modalities. Results: Only 12% of respondents were military veterans, but 42% of internists and 22% of family physicians reported some training in a Veterans Administration or Department of Defense facility. Although more than 70% of respondents treated veterans in their practices, approximately 60% never screened for military status and more than 40% never referred patients for VA care. Internists and family physicians did not differ significantly in their knowledge or confidence in treating any of the targeted conditions. Overall, both groups reported low knowledge of best practices and limited confidence in treating war-related conditions of veterans and family members. Respondents reported substantial interest in training to treat veteran patients through face-to-face trainings and webinars. Conclusion: Civilian primary care physicians are often the first practitioners consulted by veterans and their spouses/partners about war-related conditions. Findings reveal a clear need to enhance their capacity to treat this population. Trainings should: improve providers’ screening for military/veteran status, increase knowledge of best practices for treating war-related conditions, enhance physician confidence in providing care, and improve coordination of treatment between VA and civilian health providers.