Monday, February 6, 2012

Army doctor at Madigan suspended over PTSD comments

Two physicians on a Madigan Army Medical Center psychiatric team have been removed from clinical duties, as the Army opens an investigation into whether PTSD screenings for soldiers were mishandled.

A Madigan Army Medical Center psychiatrist who screens soldiers for PTSD has been removed from clinical duties while investigators look into controversial remarks he made about patients and the financial costs of disability benefits, according to U.S. Sen. Patty Murray.

Dr. William Keppler is a retired Army officer who leads a forensic psychiatric team responsible for assessing the PTSD diagnoses of soldiers under consideration for medical retirement at Madigan, an Army hospital located at Joint Base Lewis-McChord south of Tacoma.

Army Medical Command officials confirmed two doctors had been temporarily removed from clinical duties and assigned to administrative work, but they did not name them.

In a prepared statement to The Seattle Times, they said the command has "initiated a top-to-bottom review of the process associated with the forensic psychiatric reviews conducted at Madigan Army Medical Center."

"We are very sensitive to the issues that have been raised to this command and are working hard to address them," the statement said.

More than a dozen soldiers who believed their PTSD diagnoses were wrongly dropped by the Madigan team gained new reviews this year at Walter Reed Army Medical Center in an unusual intervention arranged by Army Surgeon General Lt. Gen. Patricia Horoho.

The forensic team's validation of a PTSD diagnosis can help qualify a soldier for a medical retirement with considerable benefits — such as lifelong health insurance for a retiree, spouse and dependents. The diagnosis also can help qualify a retiree for disability benefits from the federal Department of Veterans Affairs.

Keppler allegedly made inappropriate comments about the forensic team's role as financial gatekeeper in the Army retirement process during a September presentation, according to Murray.

In a meeting last fall attended by an Army ombudsman, Keppler and other team members reportedly made disrespectful comments about patients whose files were under review.

"I am deeply concerned about the things that I am hearing," Murray said. "Their (the doctor's) job is only one thing — to determine whether or not the patient has PTSD. And it's Congress' job to make sure we have the resources to compensate them."

Keppler could not be reached Friday for comment.

PTSD is a condition that results from experiencing a traumatic event, such as a battlefield casualty. Symptoms can include recurrent nightmares, flashbacks, irritability and feeling distant from other people.

As the long wars in Iraq and Afghanistan have taken a toll on troops subject to repeated deployments, the Army has launched extensive campaigns to convince soldiers to overcome the stigma of seeking mental-health care and reach out if they have symptoms of PTSD.

But some medical professionals contend that PTSD is being over-diagnosed.

Meanwhile, some soldiers and veterans advocates have accused the Army of making it overly difficult to get a PTSD diagnosis in order to limit the numbers of those eligible for medical retirement. The Army has denied doing so.

Murray, who chairs the Senate Committee on Veterans Affairs, said she became angered by complaints last fall from Madigan soldiers that their PTSD diagnoses from other Army and VA providers were being unfairly reversed.

In rejecting those diagnoses, the Madigan team cited psychometric tests that indicated some of those soldiers were malingerers.

Some of the soldiers had been deployed repeatedly to combat zones and been diagnosed with PTSD by other medical professionals, according to a review of their medical records.

"Gen. Horoho has taken this seriously," Murray said. "I think it is important to send a message that this will not be tolerated."

Army officials said the removal of the two doctors was temporary and did not constitute a "prejudgement or adverse action."

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