KNOB NOSTER, Mo. — The 509th Medical Group Clinic At Whiteman Air Force Base in Knob Noster looks and feels a bit like a hospital. But instead of scrubs and white coats roaming the halls, uniformed providers wear camouflage. Every so often, the sound of jets flying overhead mingles with the sounds of the clinic.
It’s a unique sight, but one that’s familiar to many service members on military bases across the country. In the military, medical providers serve alongside the patients they treat on a daily basis. It’s a unique way to practice medicine, and it can come with some unique challenges.
Major Vanessa North is a women’s health nurse practitioner at the the 509th Medical Group Clinic, where she provides primary care women's’ health services and coordinates with civilian counterparts for patients who require continued care beyond the clinic. She’s been a nurse practitioner since 1994, and she said what goes on inside the clinic is pretty similar to a standard primary care practice.
“It's a low risk population and low complication. We're doing a lot of screening and a lot of education on how to maintain that screening,” North said.
But according to Major Lucas Bohannan, Chief of Medical staff for the 509th Medical Group, one of the biggest hurdles in providing care on base can be convincing patients to seek care in the first place.
“I'm a doctor - I love my job. I would go through the fire and back to go do my job,” Bohannan said. “Pilots, same thing. And going to a doctor for a pilot could mean they're gonna get taken out of their cockpit and they do not like that.”
Bohannan, who is known as “Dr. Bo” on the base, said that the unique responsibilities of military providers can make it hard for service members to feel fully comfortable disclosing medical concerns.
In the military, providers not only evaluate patients based on their overall physical health, but also on their ability to carry out their duties and perform the necessary functions of their jobs. Commanders have extra authorization to ask medical questions in order to determine if a person is fit for service, which means that receiving a poor bill of health could result in service members being taken off missions or other jobs.
“We have to be reasonable with HIPAA to make sure that we only release absolutely what that commander needs to know. But we're not just treating that patient. We're also helping make sure the mission is accomplished while those health care needs are met as well,” Bohannan said.
This can sometimes cause patients to become reluctant to seek care for fear of career implications, which can lead to concerns going unnoticed. According to Bohannan, many active duty members don’t fully understand the process and are often “terrified” to come to the clinic.
One strategy that’s used to address this is utilizing embedding providers within units. There, they can work alongside the airmen while keeping an eye on them and ensuring that they seek medical care when it’s needed.
“If I said, hey, you look like you're not doing good, I'm gonna send you to mental health - I guarantee their stress just went up,” Bohannan said. “Versus having that mental health provider right there in the unit to just kind of be there as a - almost a member of the team to help kind of catch something early, it’s a lot easier to manage that condition.”
For Major North, it’s nuances like these that can make the job especially unique. North retires next year, and despite the quirks that come along with it, she said her favorite part of her role at Whiteman AFB is working with her patients to figure out care plans that suit their needs and provide education.
“I’m like — what would make my job easier? Not having the military aspect of it. What makes my job rewarding? Having the military aspect of it,” North said.
And even though their jobs might look different from others in the field, Bohannan said it’s the one-of-a-kind atmosphere that keeps providers like him coming back to serve their patients and their country each and every day.
“Most providers in the military, they're not here for the money,” Bohannan said. “They're here for the people. They're here for the culture. They're here for the experience.”
