Good plan, right materials essential to effective Military Health System

Dr. Karen Guice, principal deputy assistant secretary of Defense for Health Affairs, performing the duties of the assistant secretary of Defense for Health Affairs, listens during a discussion at the AMSUS (the Society of Federal Health Professionals) 2016 meeting at National Harbor near Washington, D.C., Dec. 1. Guice led the panel and was joined by (from left to right) Army Lt. Gen. Nadja West, Army surgeon general; Air Force Lt. Gen. Mark Ediger, Air Force surgeon general; Navy Vice Adm. Raquel Bono, director, Defense Health Agency; Navy Vice Adm. Forrest Faison, Navy surgeon general (not pictured); and Army Maj. Gen. Joseph Caravalho, Joint Staff surgeon (not pictured).

BUIlding requires a variety of skills and talents to ensure the building will withstand anything,” said Dr. Karen Guice, principal deputy assistant secretary of Defense for Health Affairs, performing the duties of the assistant secretary of Defense for Health Affairs. “Build carefully with clarity of purpose using the right materials but ready to meet necessary change of new requirements.”

Guice led the Dec. 1 panel discussion at the AMSUS (the Society of Federal Health Professionals) 2016 meeting at National Harbor near Washington, D.C. Guice was joined on stage by Navy Vice Adm. Raquel Bono, director of the Defense Health Agency (DHA); Army Lt. Gen. Nadja West, Army surgeon general; Navy Vice Adm. Forrest Faison, Navy surgeon general; Air Force Lt. Gen. Mark Ediger, Air Force surgeon general; and Army Maj. Gen. Joseph Caravalho the Joint Staff surgeon.

Guice invoked the AMSUS meeting theme of “raising the bar” using the analogy of a reinforcement bar in construction to describe how the Military Health System (MHS) is like a building with several rooms and floors. Each part is built for its own roles, such as the humanitarian room of MHS working to solve the Ebola crisis in West Africa in 2014, and the room with changes being made to better TRICARE, the health benefit for military members, retirees and their families. But there must be connectivity between the floors and hallways to bring together the different rooms, and those construction bars must not become barriers

“We in the MHS have organizational silos, serving as our physical barriers to conversations, collaboration, cooperation and coordination,” said Guice. “Commitment to performance goals and common purpose are more important to team success than team building. Real teams are the most successful spearhead of change at all levels.”

Caravalho talked about the interservice and international flavor of military medicine, pointing out how it needs to be a flexible, globally integrated operation.

“We’re going to have to be agile, innovative and think outside the box,” said Caravalho, adding U.S. military forces must be ready to face the challenges of a battlefield that exists on several levels, aka, multidomain.

Guice pointed out that in an operating room, the service affiliation and even the national origin of doctors and nurses makes no difference to those receiving care. “Once you’re in scrubs, cap and mask, we all look pretty much the same to the patient,” she said.

Bono continued the theme, pointing out how raising the bar means being able to meet the changing needs of military members who have to go to the battlefront and those medical providers who must be ready to follow them there.

“Our needs of readiness are evolving as we speak,” said Bono. “Our ability [to be flexible] in a multidomain, multifunctional conflict depends on our ability to think things differently.”

Ediger said the Air Force is redefining medical readiness to reflect a full spectrum of needs and abilities. “So we’re capable of doing the things we need to do in support of combat or disaster relief operations,” he said.

Faison pointed out how the vast majority of military members are millennials, born after 1986. This is a group known as early adopters of technology to make their lives more convenient.

“They and their colleagues in that generation are fundamentally changing health care and health care delivery,” said Faison. “And we must adapt to that or we will become irrelevant.”

West reminded the providers at AMSUS they exist to serve those vital medical needs of those who wear the uniform. And there’s really not much room for error when it comes that.

“If we don’t get taking care of the service members right, it really does not matter what else we get right,” said West. “That’s why we exist.”

Guice said all construction needs a good plan that is inclusive of the ideas of many people who feel they all have value and are working together as a team for a single purpose. She said DHA is far from a perfect organization when it comes to instituting everything needed for constructing the ideal environment of inclusion and cooperation.

“But isn’t that part of raising the bar?” Guice asked those attending the session. “There’s always more work to do, and higher levels of performance are always possible.”