Civilian health care perplexing

Posted March 08, 2009, at 11:58 p.m.

In last week’s column, I touched on the idea that military families feel disoriented when they are transferred from a community heavily populated by other military families to one that is not. At least one of you said I make it sound like I’m from another planet. Well, in fact, now that Dustin and I are out of our element (large Navy towns such as San Diego, Calif.; Norfolk, Va.; and Pensacola, Fla.), sometimes it feels exactly that way.

We are navigating new territory, one without a squadron Spouse Club or military hospital, and no aircraft carrier in sight. Sometimes I miss the view of military ships on the horizon; other times I am glad that my house doesn’t shake from fighter jets passing by.

For me and Dustin, two kids who grew up in the military, this is the first time we’ve not lived in a Navy town. We knew there would be adjustments. We just didn’t know exactly what those adjustments would be.

By far, one of the biggest adjustments has been the lack of a military hospital. For as long as I can remember, I have been treated by military doctors at military hospitals. Because of this, I have a child’s understanding of health insurance. The first time I had to fill a prescription while on vacation and not near a military base, I felt like the pharmacist was speaking a foreign language. He wanted my insurance policy number, a guarantor and (gulp) a co-pay.

“Don’t I just show you this [holding up military identification card] and you give me the medicine?” I asked.

Turns out, it doesn’t work that way off-base. There is paperwork, insurance cards and money (lots of money) involved. I was relieved when I returned to the familiarity of the military hospital, where all I need to know is my husband’s “last four” (the last four digits of his Social Security number), and Uncle Sam takes care of the rest, including assigning me a physician.

When we moved to Maine and outside of any military treatment facility area, I had to find my own doctor. I felt like a college student picking a major. I was sure I would screw it up. I wanted my mom — or, at least, Uncle Sam — to help. How does one go about finding a doctor? It was harder than I thought.

Some doctors, in fact, fill up and quit accepting new patients. When one doctor’s office turned me away, I wanted to cry like Richard Gere in “An Officer and a Gentleman”: “I’ve got nowhere else to go!” This doesn’t happen within the bubble of the military hospital. The onus is on the military, not the individual, to make sure that everyone in the family has a competent doctor, their records are where they should be, and the doctor gets paid. To be honest, if my 33 years as a military dependent is any indication, this type of system breeds complacency. Until now, I’ve never had real ownership of my own health care. It’s scary — like jumping into the deep end without a raft — to be in control, but also liberating.

Yet, if I’ve been sheltered by military medicine as a dependent, Dustin has been even more sheltered as a service member. When we were in big Navy towns, Dustin didn’t go to the hospital. The doctor — aka “flight surgeon” — came to him. Flight surgeons are feared by military pilots because they have the power to find you a new career path based on physical ailments. Pilots are notorious for not seeking treatment for fear that the flight surgeon will take away their ability to fly.

I forgot what an adjustment it would be for Dustin to see civilian doctors here in Maine, until he came home from a dentist appointment one day and could not stop talking about it. “Did you know that you are supposed to brush in circles, not back and forth?” he said. “And look at this neat toothbrush the doctor gave me.” He treasured the tiny spool of complimentary floss that came with it. That’s when it occurred to me: Either Dustin’s dentist is a very attractive female, or he’s as giddy as a kid in a candy shop to see dentistry outside the beige cement walls of the military clinic. There it is not uncommon for them to yank out your wisdom teeth, pat you on the back, and send you off to work again.

Dustin has been simply indulgent, however, when it comes to his general doctor’s appointments with the civilian physician here. Where once he would hide his headaches and stuffy ears from the flight surgeon, just this week he has seen his civilian doctor three times.

Yep, he’s pretty much addicted to this quasi-civilian lifestyle. I suspect we both are.

Maine author and columnist Sarah Smiley’s writing is syndicated weekly to publications across the country. She and her husband, Dustin, live with their three sons in Bangor. Her new book, “I’m Just Saying … ,” is available wherever books are sold. You may reach her at sarah@sarahsmiley.com.

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