Reducing medical attrition: the role of the Accession Medical Standards Analysis and Research Activity.

This paper illustrates how adding an epidemiologic perspective to medical accession policy development allows the Department of Defense to address unacceptably high rates of premature attrition, lost duty time, avoidable medical care costs, sick leave, disability, and various wasteful, inefficient practices. The Accession Medical Standards Analysis and Research Activity is a major new epidemiologic entity. Historically, military medical accession policy and waiver deliberations were based heavily on expert opinion. A common limitation of expert opinion is that although experience teaches much about individuals with certain conditions who develop problems, it does not teach about individuals with the same conditions who remain well. The Accession Medical Standards Analysis and Research Activity produces the analyses of epidemiologic data necessary for the joint personnel and medical flag-level Department of Defense Accessions Medical Standards Steering Committee to make evidence-based accession policy decisions.