An American Medical Association panel has recommended that physicians and other health care providers ask about the military history of patients when reviewing their cases.

A group of doctors who advise the AMA on its Current Procedural Terminology codes — a collection of medical terms used to report medical procedures and services to insurance programs — voted to add military history and veterans status to the "social history" part of evaluation and management guidance.

The recommendation, pitched by advocates at the American Psychoanalytic Association, the White House's Joining Forces Initiative and others, was accepted because the groups indicated service members and veterans often don't volunteer this information to their health providers, panel member Dr. Peter Hollman told Military Times on Friday.

"Research shows that [military personnel or veterans] don't bring it up on their own and it could possibly play a role in their condition — exposure to toxins, hearing loss. This recommendation says to those in the field, 'You ought to think about this with your patients,' " Hollman said.

When taking a patient's social history, providers should consider asking about military experience, branch of service, specific jobs performed, and how they feel the military has affected them, said Prudence Gourguechon, a psychoanalyst and former American Psychoanalytic Association president.

"When a patient comes for medical care or behavioral health care, it is important to ask everyone, including children, if they or a loved one has served in the military," Gourguechon said. "A child of a deployed parent, for example, may exhibit behavioral problems that can't be understood without knowledge of his parent's military service."

Hollman cautioned that the CPT recommendations are only guidelines, not requirements. He added, however, that including military history in the CPT codes "adds another measure of importance to this information."

"If you were to look at, say, domestic violence 30 years ago, we weren't taught at med school to think about it. ... We might have asked about child abuse, but we didn't ask whether someone's spouse was beating them," Hollman said. "Like the awareness now paid to that issue, this takes things up a notch. People start thinking about it and pretty soon asking about military service becomes part of the routine."

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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