WASHINGTON (Army News Service, March 29, 2016) -- The Department of Defense's health care system is in need of an overhaul, and that must be a top national security requirement, said Dr. Jonathan Woodson, assistant secretary of Defense for Health Affairs.
Woodson, who is the principal advisor to the secretary of Defense for all matters relating to military health, spoke at the Col. CJ Reddy Leadership Course in the Pentagon, March 24.
Military health care is still operating in a Cold War posture, he said. The world has changed significantly since that time.
For instance, large formations of troops were once stationed in West Germany, ready to defend against a possible Soviet and Warsaw Pact attack. Large, fixed hospitals were the norm.
Now, interoperable small teams deliver care to troops in far-flung corners of the globe. "We have to adjust our medical posture to provide care wherever men and women are being asked to go in harm's way," he emphasized.
FIDUCIARY RESPONSIBILITY
DOD's health care budget is about $50 billion annually, Woodson said. That's bigger than that of either the entire Department of Health and Human Services, the Food and Drug Administration, or the Department of Labor. In turn, the entire DOD budget is half of the discretionary budget of the United States.
As such, "we have a big responsibility as stewards of the taxpayer's dollar. If we're not, other segments of society will suffer, and eventually, that becomes a national security issue. So this is really important stuff."
ENTERPRISE MANAGEMENT
While cost savings must be realized, "the American public expects us to deliver the standard of care or above the standard of care anywhere in the world," he said. Balancing those two goals is "pretty tough."
Four or five decades ago, "a nurse was a nurse, a doctor was a doctor, many specialties didn't exist, today's medical technologies didn't exist, so it was much simpler to administer care on a local basis and we didn't quite need enterprise management in order to increase economies of scale," he pointed out.
A strategic line of effort Woodson said he's taken for the past several years since assuming his post is pursuing enterprise management for the military health care system -- "and that doesn't necessarily mean joint."
What it does mean, he said, is "creating economies of scale, decreasing variability, knowing where the dollars are going, providing common medical platforms, common business tools that allow us to do our jobs more effectively. We've got to do that."
It also means rethinking how care teams work, redefining the work flow, removing archaic rules and administration processes that impede efficiency and improved engagement with other agencies.
In light of the changing national security and national health care environment, a pivot is now necessary, he said.
GLOBAL HEALTH ENGAGEMENTS
Global health engagement is a new "instrument of national power," Woodson said, providing several examples.
During the recent Ebola outbreak in West Africa, the U.S. military medical mission there had a "strategic impact, with enormous second- and third-orders of effects." The mission there, he said, prevented a complete destabilization of the entire region, both from a security and economic perspective.
Without that mission and help from other U.S. agencies, there could have been a ferment of insurrection and war. "So," he said, "global efforts like this can prevent future kinetic operations."
He added that similar "robust efforts" are now underway in the Pacific region as well.
Woodson said he met with top leaders of Vietnam in Hanoi recently, for instance, to discuss growing their medical capabilities. "That's enormous. Think about the sea change" in that country in only a few decades.
PEOPLE PRIORITY
Another important pivot that needs to be addressed is better management of the medical force, Woodson said.
By that, he said he means across the board: talent management; recruiting and retention; getting the right balance between the active and reserve components; career development; advanced training, including with the private sector; and leader development.
ENGAGING SENIOR LEADERS
Influencing change is also critical, he told the assembled lieutenants and captains. "You must learn to engage senior leaders to help shape future policy."
Woodson then gave the young officers a chance to engage him.
Maj. Lakisha Flagg, the action officer for the CJ Reddy Leadership Course, said medical professionals need to know how to work collaboratively with other medical specialists across the spectrum, advocate for patients, point possible improvements out to supervisors, resolve issues, and influence patient outcomes.
"We all have the potential to make positive changes by exercising good leadership," she added.
Capt. Stephen Krutko, an instructor at the Army Medical Department Captains Career Course, said medical personnel contribute to readiness by ensuring patient care is delivered in the most efficient and high-quality manner available, particularly to the warfighter in the combatant commands.
But medical personnel in theater quite often do so much more than that, he offered. They help the Army and America build strategic partnerships with other countries through global health engagements, he said.
Having that strategic, as well as tactical focus, builds heavily on crafting good leadership skills, he said. A doctor or even a medic has the power to impact world relationships.
Capt. Jose Mendoza said that his job, as chief of Nursing Services at Dilorenzo Tricare Health Clinic here, requires a high level of leadership skills.
"Every day I'm leading people on my staff, emphasizing quality of care patients should be receiving, safety, customer service support and medical readiness," he said.
"What basically sets us apart from civilians is readiness," he added. "We must be ready to deploy in a matter of hours."
ABOUT THE CJ REDDY COURSE
The five-day course was started in 1992 as a leadership development program for the most promising lieutenants and captains in the Nurse's Corps. This was the first year that the course was opened to junior officers across the entire Army Medical Corps as well as medical personnel across the DOD.
The course features a number of high-level speakers from across the DOD and other agencies. While some of these leaders are from the medical field, others are not. For example, a lieutenant general gave a talk about the importance of mission command and how the medical corps plays a small but significant role in that.
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