Musings on Military Recruitment and Electronic Health Records

Eh, What was that you said?

In 2023 the military, with the exception of the Marine Corps- Hoo AH!,  failed to make its recruitment numbers by a total of 41,000 warm bodies for the Army, Navy, and Air Force combined. The Army is at its lowest manpower level since 1940. Why is that? Many reasons are given: military preoccupation with DEI and antiracism, fallout from Covid especially vaccine mandates (now rescinded), the Biden administration’s denigration of all things American, lowered levels of patriotism, social media influences. One issue, perhaps the most important, is the health of military recruits.

It is a well known fact that Gen Z (those born after 1995), the most likely to be recruited today, is the least active of all the generational groupings, e.g. 50% of Gen Z adults are overweight or obese.

Perhaps one of the most significant factors is the Military Health System Genesis, the electronic health records program adopted by recruitment centers in March 2022. Genesis was created by the company Leidos and cost $4.3 billion. Like all electronic health information systems, it is capable of providing incredibly comprehensive medical data on any recruit. Ever have surgery? Received a prescription for a pain medication? Been prescribed medication for ADHD? Been treated for anxiety or depression? Had an anaphylactic reaction? Genesis will ferret this out.

Gone are the days of military recruits self-reporting their medical history and/or lying to recruiters. Military history is rife with stories of underage recruits lying about their age to be inducted, then going on to serve successfully, some even heroically. Along with increasingly voluminous objective medical data on recruits, the number of disqualifying conditions has skyrocketed. You can be disqualified for insomnia.  As things presently stand, 77% of young Americans would not be considered physically or mentally qualified to serve in the military.

Reflecting on this, I look back on my own military enrollment with amusement.

In 1974 I was accepted into medical school at the University of Miami. With no means to pay for the tuition- I believe it was then about $5000/year, I had to find a way to fund this. I did not want to borrow money. I learned that the military offered scholarships in exchange for post-graduate military service. This seemed like a good deal, and I went to the local Navy recruiter with my medical school acceptance letter in hand. I was immediately signed on. As part of my processing, I had to go to the local induction center for my required physical exam.

I have had a high frequency hearing loss most of my life, likely from barotrauma resulting from two incidents involving powerful firecrackers that exploded next to me leaving me partially deaf for a day, and with tinnitus (ringing in my ears) that persists to this day.

Part of my physical involved a hearing exam in a soundproof room. When I exited, the examiner looked at the result and said, “That’s a helluva hearing loss, son. I’m afraid we can’t accept you.”

“But I am already in,” I said, and showed him my papers indicating I was enrolled in the scholarship program. He didn’t bat an eye or hesitate.

“Oh, that’s fine then.” He signed off on my hearing test and sent me on to the next station.

I wonder how things would have turned out today.

Richard T. Bosshardt, MD, FACS

P.S. My hearing loss has never held me back. I served 13 years in the Navy and have practiced as a surgeon for 35 years. Today, at 71, I have trouble understanding conversations in a loud environment and I often confuse consonants, but so far have not needed a hearing aid (My lovely wife might disagree).