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OEF/OIF Active Component and Reserve/National Guard Female Health Care Provider’s Barriers to Care

Mengeling M, Cretzmeyer MT, Torner J, Sadler AG, Booth BM. OEF/OIF Active Component and Reserve/National Guard Female Health Care Provider’s Barriers to Care. Poster session presented at: Women's Health Annual Congress; 2011 Apr 2; Arlington, VA.


Objectives: Qualitative methods explored barriers to care for servicewomen who are also military health care providers. Methods: Fourteen focus groups stratified by Officer/Enlisted personnel and deployment status were conducted in five Midwestern states; three OEF/OIF era Reserve/National Guard (R/NG) Officers (N = 15) and two OEF/OIF era Regular Military (RM) Officers (N = 9) focus groups. The research team developed a coding dictionary of relevant themes. Twenty-nine percent of the transcripts were independently coded by two researchers. Agreement between the coders was 80% or better for the majority of themes/codes. Remaining transcripts were coded by one of the two trained researchers and entered into NVivo 8.0 for data management and analysis. Results: Health care providers articulated unique barriers to accessing care as a function of their military role. Similar barriers were expressed by both Activate Component and Reserve or National Guard Officers. Barriers included putting others before self ("doctors aren't supposed to need doctors" and "we are the last people we take care of"); knowing the person that they have to seek care from ("I stalled and stalled and stalled and finally went over to women's health then one of the nurse practitioners I almost never see, so ok she can do my Pap"); and lack of privacy or role overload while being a patient when seeking health care ("I've had my patients in the waiting room start talking to me about their medical problems while I'm sitting there waiting for my [mental health] appointment"). Implications: Military health care providers have unique barriers to care due to their military role. There appears to be a cultural mindset that doctors don't need care or have time for care, have discomfort with boundaries as they must receive mandatory annual care from peers they may work with routinely, and moreover have greater barriers to mental health care given lack of confidentiality when they share waiting rooms with their own patients. Impacts: The barriers encountered by military health care providers may contribute to amplified symptoms and adverse health consequences due to delayed care. VA clinicians must recognize that there may be disparities in care for this high risk population.

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