The Commissioned Corps of the
USPHS has been in existence since 1798. Currently, it provides medical support to the Coast Guard, the National Institutes of Health, the Food and Drug Adminis- tration, and other agencies. USPHS has a reserve component that may be funded to develop a reserve component simi- lar to the Reserve Components of the Armed Forces. It may then be integrated into the National Guard for community service.
As such, professionals could provide
services on a part-time basis, and earn a salary, retirement credits, and military privileges. Those who participate would be able to receive their own complimen- tary health care insurance for themselves and their dependents. Their professional activities would also be covered by the Federal Tort Claims Act. Patients should be charged on a slid-
ing-scale basis. No one should be refused for lack of resources. Novel methods of funding from nonappropriated sources should be encouraged, such as lotteries, court fines, seized assets, and lease of government assets. There may be many other ways of funding. I’d like to hear your suggestions. You may email me at rvosbournmd@aol .com.
Raymond V. Osbourn, MD San Antonio
like. The malady is very real as boxers have long known, but its insidious on- set delays recognition and diagnosis by patients, physicians, families, and mar- riage counselors who don’t realize that remote head trauma from contact sports might be the cause of erratic behavior, headaches, confusion, depression, and distorted executive functions in men of all ages.
Dementia often follows and is usually
masked and denied by the bewildered patient who, in his hopelessness, will often resort to sexual promiscuity, alco- hol or drug abuse, or both. Lou Gehrig’s disease, Parkinson’s disease, and several other dreadful neurological diseases can and do follow, as former high school, college, and professional football players are now realizing to their horror. Subclinical, nonconcussive, repetitive head trauma, as well as more dramatic concussions in childhood, youth, and later can cause cumulative brain dam- age. Add military and nonsports-related head trauma to the historical picture, and some of the cases of erratic behav- ior in men, from high school age and older, are explainable. Affordable, diag- nostic scans for CTE will soon be avail- able rather than having to wait for an autopsy.
Add head trauma to past medical history assessment
Were I still actively practicing internal medicine, I would add sports-related and head trauma to the categories about which I specifically inquired in my as- sessment of a patient’s past medical his- tory. Were I in the insurance business, I would make sure my examiners did the same.
Almost daily, reputable medical stud-
ies reveal new information about chronic traumatic encephalopathy (CTE) due to head trauma in sports such as tackle football, ice hockey, soccer, and the
8 TEXAS MEDICINE June 2014
Some treatment for the symptoms of CTE will also be available, but no cure is likely because the problem is due to structural damage to the brain. However, CTE is one of the few causes of dementia that is preventable by avoidance of head trauma. To my knowledge, it is not known yet if head trauma incurred in children’s league contact sports could be involved in the evolution of the malady.
Jim Harris, MD Marshall
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