Monday, May 28, 2007

Military medicine - A Memorial Day Tribute to U.S. Military Medical Doctors

The training and accomplishments of doctors serving in the U.S. military has always impressed me. These dedicated physicians, with the help of medics and nurses, have steadily reduced death rates on the battlefield and speeded recovery times after injuries. Because of prompt care at injury sites, quick evacuation, and immediate surgery and medical support, our soldiers, sailors, and marines stand better chances of surviving than in any previous war.

In Iraq, improvised explosive devices and suicide bombers have caused an unprecedented number of amputations and traumatic brain injuries. These injuries place new demands on rehabilitation and long-term care.. The media has focused on the good and bad aspects of this care. News outlets tend to praise the doctors and blame the administration when care fell short of expectations.

One neglected aspect of military doctors and the entire military medical system is that its training system produces excellent medical leaders. This leadership stems from organizational skills honed from mobilizing teams of medical technicians, medical corps men, nurses, and other doctors to provide care.

Once the Vietnam conflict ended, the unused skills of medical corps men motivated Dr. Eugene Stead at Duke to conceive the concept of physician assistants, a relatively unheralded innovation now consisting of about 100,000 practicing physician assistants who have improved and supplemented American health care.

In my own circle of doctor friends who have trained and served in the military, I count these.

• George Lundberg, MD, Los Gatos, California, an eminent pathologist who organized and oversaw laboratories for the U.S. Army, became editor of the Journal of the American Medical Association, leader in world health organizations, and now editor-in-chief of Medscape’s General Medical Journal, the world’s largest online peer-reviewed journal. George has been active in international medical circles and is author of Severed Trust: Why American Medicine Hasn’t Been Fixed, Basic Books, 2001.

• Steve Barchet, MD, FACOG, CPE, FACPE, Rear Admiral, MC, , retired, Seattle, Washington. Steve completed over 27 years of military service, first an obstetrician and gynecologist. His final assignment was Deputy Surgeon General and Deputy Director of Naval Medicine. He served in Vietnam as a doctor running a field hospital. Steve is currently coordinator of the Health Plan for Life (Hp4Life), which is dedicated to the proposition that prevention and wellness are the best route to stabilizing health care costs.

• Dr. Michael Parkinson, Alexandria, Virginia, executive vice president and medical director of Lumenos, a consumer-driven plan now owned by Wellpoint. As a former career medical officer for the Department of Defense, and a student of “top-down” military care, he believes a consumer-driven system is the only antidote to the U.S. medical cost problem. He entered the military in 1980 as a flight surgeon, and learned that primary care in the military consisted of learning about environmental risk factors, occupational medicine, disease prevention, and behavior change.

• Dr. Jerry Reeves, Los Vegas Nevada, Jerry served for 20 years in the United States Air Force Medical Corps. Just prior to retirement, he served as Chief of Clinical Medicine at USAF Headquarters in Europe, where he was responsible for the health care delivered by 350 physicians plus medical support personnel at 27 Air Force medical treatment facilities throughout Europe. Jerry is currently the Chairman of the Board of Directors of WorldDoc, Inc, a leading source of health management systems empowering people to lead healthier lives and reduce health costs. In conjunction with his role as Chairman, Dr. also serves as President of Las Vegas Operations of the Hotel Employees and Restaurant Employees International Union Welfare Fund. Prior to his current positions, Dr. Reeves was Corporate Senior Vice President and Chief Medical Officer of Humana Inc. During his three-year tenure at Humana, he led the disease management, population health, and prescription drug programs for their 6.2 million members.

My hats off to Drs. Lundberg, Barchet, Parkinson, and Reeves and to all physicians who served and trained in the U.S. military and who are using their military experiences to make a difference in civilian health care.

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