Saturday, March 24, 2012

One Size Does Not Fit All

Our concept of care is always patient and family focused and we will never lose our perspective in caring for our beneficiaries.
from Navy Medicine's Mission Statement

Awaiting an elevator by the library I noted a call for kids to submit posters for the upcoming "Month of the Military Child" in April. The military has some fun programs for kiddos and their families, particularly for families overseas, such as recreation and sports programs, local trips and tours, and after school clubs and activities.
Drawing by the Mule- sad that her "Dada" is not at home- she emailed to him

With a consistent uptick in patient numbers for behavioral health in the month of March, March Madness takes on new meaning- my husband's excuse de jour for his late homecomings. Perhaps attributed to the uncertain time period families endure as they await orders for upcoming moves that mark time in Navy life. In Japan as spring continues to hibernate, spring fever may be contributing to this sense of madness too.

Full disclosure: I don't expect the Navy to "care about me" as much as I expect the Navy to "cover its ass." I don't say this lightly, but it has evolved from the ways the bureaucracy demonstrates priorities in actual experiences versus the slogans thrown my way.

When I seek health care for my children or myself, I have been reminded on numerous occasions by the active duty personnel that it is a "privilege" for us to obtain our health care from the military facility, particularly if I even blink with frustration at say waiting six months for a dental appointment. "This clinic is for active duty personnel first, then we serve families. You can go out in town." I respond, "Really, do they speak English? How do I know what the standards of care are in town?" Town, in our case, being Japan. It appeared I was really annoying this "customer service" person with these pesky questions. She did not tell me where I could obtain this out in town appointment or answer my question on standards, but then the state of Japanese smiles, read dentistry, is not reassuring.

In the end, I waited over three months for one child to get an appointment and six months for the other. I have enough to negotiate in my life so I prefer to skip the hassle of going to the dentist in another language, in another location. Truth is I prefer the centralized location and one stop health offerings military medicine offers. However, when a uniformed sailor's first instinct is to dish out the privilege comment to a beneficiary for barely mouthing, "six months," it smacks of family members being second class citizens. I don't need the reminder, I understand the Navy's priority is the active duty personnel, but the hospital motto fed my irritation.

Here to Serve with Care
Motto of U. S. Naval Hospital Yokosuka, Japan

As a Navy brat myself, I benefited tremendously from the experience of living abroad in high school, however, moving to yet another new school for my senior year of high school was not a high point in my life- new academic standards, new cultural rules, no friends, and a rough transition from a small military school to a large public one. It was tough and pretty much anyone who has known me, has heard me reflect on this experience in some fashion.

Friends with a set of orders to yet another duty station and soon to be seniors in high school have my empathy. Their desire to return their children to their home of record to finish high school instead of taking them to a new city, a new state, with a new set of rules, new academic standards, and no community ties or support, seems like a family that is really thinking of their children's needs and futures.

The Navy bureaucracy's response to this kind of situation is, "No can do." There is nothing in place or any options to deal with military families that are sacrificing being together for returning their children to a known school system to facilitate their chances for college placement. The reality of doing what is best for your children during the month of the military child strikes a chord of reality versus the ad campaign slogans. There is no flexibility in the system to support families at different stages and with different needs.

Perhaps a case needs to be made for why I perceive Navy policy being rooted in a "cover its ass mentality." Ever heard of a safety stand-down? No work will take place until every person has signed off on some urgent policy by the close of business no matter how obscure so that the paperwork is in order, nothing left flapping in the wind except the appointment that was cancelled to make way for the time.

I want policies that support families and not advertising campaigns with no teeth. Let's all adapt a more realistic approach to the situation. If the Navy doesn't want irritated family members, then consider the policies guiding the lives of families, consider the messages active duty personnel tell the families they interact with, and consider that as much as military families have to be flexible so does the military itself. One size does not fit all.
One size does not fit all.

1 comment :

  1. I could not agree with you more.

    The "patient and family centered care" slogan particularly rankles me. A few years ago I chatted with a Naval officer who mentioned he was chairing the committee responsible for redesigning the hospital for the merger with Walter Reed. I asked how many family representatives were serving on his committee. He seemed shocked and befuddled by my question. "None."

    As for the USNH Yokosuka dental clinic, I could write a book about my family's surreal experiences there. I think everyone who works there should be required to do a six-month internship at a civilian dental office.


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