With more soldiers leaving combat because of medical problems associated with advancing age, doctors and Army planners are adjusting to offer better treatment and to prevent unfit soldiers from seeing combat.

Doctors at Landstuhl Regional Medical Center in Germany, for example, are adapting to handle more heart and hernia patients, two of the top three non-combat injuries they treat.

Later this year, a doctor specializing in angioplasty will join Landstuhl’s staff so the hospital can perform the procedure regularly rather than sending patients to Walter Reed Army Medical Center or local German hospitals.

And, Dr. (Col.) Randolph Modlin, chief of cardiology at Landstuhl, said he has pushed the Army to bring more treadmills to Iraq so field doctors can better evaluate chest pain using stress tests. He said half of all patients who arrive at Landstuhl with chest pain are returned to combat because they have no medical problem.

Landstuhl doctors last year also helped change Army policy to allow hernia patients to return downrange on light duty. Now 90 percent of soldiers treated at Landstuhl head back to war after surgery, up from just 30 percent before the change, said general surgeon Dr. (Col.) Tyler Putnam.

The Army also is looking at changes to prevent unfit soldiers from going to war in the first place.

The service is considering tougher physical fitness standards for all ages, said Michael Kilpatrick, deputy director of deployment health support in the Office of the Assistant Secretary of Defense for Reserve Affairs. And, it is planning to change the way it monitors reservists’ health.

During monthly call-ups, soldiers may be required to report any recent health problems, Kilpatrick said. If a troop pulled his back during a racquetball game, for example, he may be dropped from the reserves until he is fit enough to go to war, he said.

“There is nothing more frustrating for a commander than to have someone in theater for a couple of months and then leave because of a problem that they knew about before but suppressed,” he said.

An electrocardiogram test may be added to yearly physicals of older soldiers to catch heart problem before deployment, Kilpatrick said.

Some of the measures are aimed at ending a mentality that has been common among part-time soldiers, he said.

“This attitude of, ‘We’re never going to be called up, or we’re five years away and will be retired by then ...,’” Kilpatrick said, “kind of got us to where we are today.”

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