Military rank affects medical care, offering societal insights: study

Singh and co-author Stephen Schwab examined 1.5m doctor-patient encounters in US military health service´s records

May 17, 2024
Soldiers bound for Afghanistan stand at parade rest during a departure ceremony on November 4, 2011 in Fort Carson, Colorado. — AFP/File

WASHINGTON: Human relationships are inherently shaped by power dynamics, yet quantifying their impact has remained a scientific challenge.


Now, a large new study published on Thursday in the journal Science reveals that military doctors give more attention to higher-ranked patients, providing concrete evidence about the privileges that come with elevated status, frequently at the expense of the less powerful.

“One of the things we are trying to show is that this is not a military-specific analysis,” said co-author Manasvini Singh of Carnegie Mellon University, arguing the findings are just as relevant to civilian life as they are to the rigid chain-of-command structures of the armed forces.

For their research, Singh and co-author Stephen Schwab of the University of Texas at San Antonio examined 1.5 million doctor-patient encounters in the US military health service´s records.

Rather than exploring how doctors might respond differently to, say, generals versus privates, they chose a more nuanced approach: comparing how soldiers of equal rank, for example two majors, were treated in emergency departments (EDs) by physicians who either outranked them or were outranked by them.

The “high-power” patients who outranked their doctors received 3.6 percent more effort and resources, as measured by tests, diagnosis and treatment codes, time spent with the physician, and opioids prescribed. High-power patients also had better outcomes, with a 15 percent lower likelihood of hospital admission in the following 30 days.