Madigan chief gets job back

JBLM: He’d been on leave pending investigation into PTSD diagnoses

Staff writerAugust 1, 2012 

The Army on Tuesday reinstated the commander of Madigan Army Medical Center as it announced major changes in how the hospital will evaluate soldiers diagnosed with post-traumatic stress disorder.

The commander, Col. Dallas Homas, was placed on leave in February as the Army investigated complaints that, to save money, a 3-year-old forensic psychiatry team at Madigan reversed initial PTSD diagnoses of soldiers in line for a medical discharge.

Gen. Lloyd Austin, the Army’s vice chief of staff, announced the service no longer will use forensic psychiatrists, who applied a strict interpretation of the nationally accepted manual for mental disorders, to conduct the reviews and make the most accurate diagnosis possible.

Austin’s statement said that while the forensic psychiatrists’ methods “may be fair and appropriate, it’s simply not optimal for the unique cases that the Army diagnoses and reviews.”

Austin said new policies and procedures are in place to review PTSD cases, without specifying what they are. An Army spokesman said she didn’t have further details.

The top general said Homas would be reinstated immediately after he determined the Madigan commander “did not exert any undue influence over PTSD diagnoses, and that he acted appropriately enforcing standard medical guidelines.”

He expressed confidence in Homas’ leadership as the Army enacts the new policies and procedures.

U.S. Sen. Patty Murray, D-Wash., said the announcements send a clear message that soldiers should be given accurate diagnoses based on the best medical practices.

“The Army’s process of coming to grips with the full scale of the task they face in caring for the mental wounds of war is ongoing, but this is a good step forward,” said Murray, who as chairwoman of the Senate Veterans’ Affairs Committee has been a vocal critic of how the Army cares for its wounded soldiers.

The command that runs the Army’s hospital launched an investigation last fall after complaints of reversed PTSD diagnoses. The regional command that oversee Madigan also launched an inquiry. The Army spokeswoman said she had no information about the status of those investigations.

Scrutiny of the local military hospital led Defense Secretary Leon Panetta in May to order a comprehensive review of how the military diagnoses PTSD. That larger review continues.

The forensic psychiatry team was created at Madigan in October 2008.

Lawmakers began questioning whether the team’s purpose was to root out malingerers after internal memos came to light showing its members urging consideration of the long-term cost of a PTSD diagnosis. One memo said such a diagnosis could cost up to a $1.5 million over a soldier’s lifetime. Madigan doctors said they weren’t trying to short-change soldiers but make the most accurate diagnosis possible.

Earlier this year, Murray said the team overturned more than 40 percent – or 290 of 690 – of the initial PTSD diagnoses it reviewed, involving candidates for medical retirement going back to 2007.

An official familiar with the review process told The Associated Press that 229 service members have been re-evaluated, and of those, 127 have had their PTSD diagnosis reinstated. The official spoke on condition of anonymity because the totals have not been made public.

The Seattle Times reported in April that the Army Surgeon General’s Office had issued new guidelines for diagnosing PTSD that criticized the approach used at Madigan. The newspaper reported the policy discounts tests used to determine whether soldiers are faking PTSD and further stated poor test results do not constitute malingering.

christian.hill@ 253-274-7390 @TNTchil

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