Navy Medicine Feels the Pulse of Music City During Nashville Navy Week

By Valerie A. Kremer, U.S. Navy Bureau of Medicine and Surgery Public Affairs

NASHVILLE, Tenn. (NNS) -- Navy Medicine met with corporate executives, local community leaders, universities, media and the Tennessee Titans to discuss shared medical initiatives and Navy Medicine's role in the maritime strategy as part of Nashville Navy Week, May 7-12.

Rear Adm. Donald Gintzig, deputy chief, medical operations, U.S. Navy Bureau of Medicine and Surgery, was the senior medical officer during the visit.

"It is an honor to be in Nashville and middle Tennessee, which has a rich tradition and heritage of supporting the military," said Gintzig. "We are America's Navy and Nashville Navy Week provides a wonderful opportunity to show the people of middle Tennessee what their Navy does, how we take care of our dedicated men and women in uniform, and the possibilities for those looking to pursue a career in the Navy."

Of the nearly 330,000 active duty Sailors across the Navy, 8,300 come from Tennessee. An additional 2,000 Reserve Sailors also hail from the state, and more than 11,600 retired Navy veterans live in Tennessee, Gintzig noted.

During a meeting with leadership and staff of Centerstone, the nation's largest not-for-profit provider of community-based behavioral health care, the parties stressed the importance of continued medical research and development, the significance of the electronic health record, and heralded the work both continue to do to provide outstanding behavioral health care to the nation's wounded warriors.

"Research and specialized care needs to be a part of the continuum of care," said Gintzig. "One size does not fit all in terms of care models. It is with partnerships with civilian organizations like Centerstone that can make a difference in how we learn from each other's care models."

During Nashville Navy Week, Gintzig also met with students and staff of Meharry Medical College where he discussed Navy Medicine's capabilities in humanitarian assistance/disaster relief, research and development, expeditionary care, and garrison care, while supporting the maritime strategy.

"We are so thankful to have Rear Adm. Gintzig here at Meharry Medical College," said Charles Mouton, dean of the Meharry School of Medicine, senior vice president of health affairs. "It is wonderful to know that what our students are learning at Meharry is transferrable to Navy Medicine and the military."

As a global force for good, Gintzig pointed out the increased capabilities in life saving techniques on the battlefield.

"If we get you to one of our facilities after an hour of being injured on the battlefield, you have a 98 percent survivability rate," said Gintzig. "If we can get you to our medical center in Germany, you have a 99.8 percent chance of survival. These numbers are unprecedented and demonstrate the outstanding life saving capabilities by our corpsmen on the battlefield and the research and development that goes into making these techniques possible."

During his presentation, Gintzig also highlighted how Navy Medicine supports the maritime strategy.

"Navy Medicine plays a vital role in supporting the five 'hard power' capabilities of the maritime strategy: forward presence, deterrence, sea control, power projection, and maritime security...because no ship, submarine, aircraft or other Navy asset deploys without the support of Navy Medicine," said Gintzig. "In addition, Navy Medicine projects and executes 'smart power', the maritime strategy's final priority, through its most visible role in humanitarian assistance/disaster relief missions."

During Nashville Navy Week, Gintzig also met with top leaders, staff, and veterans of the Tennessee Valley Healthcare System, where the parties discussed shared initiatives with Navy Medicine's Medical Home Port model and the Department of Veterans Affairs' Patient Aligned Care Team (PACT) model. Both models provide the patient a team of health care professionals that is responsible for their individual health needs.

"We are honored to have Rear Adm. Gintzig visit the Middle Tennessee Veterans Healthcare System," said Juan Morales, director, Tennessee Valley Healthcare System, Veterans Administration. "It has been wonderful sharing best practices of the Medical Home Port and PACT models, as well as our other life saving and health care capabilities."

Tennessee Valley Healthcare System is an integrated healthcare system comprised of Medical Centers, the Alvin C. York Campus in Murfreesboro, Tenn, and the Nashville Campus in Nashville, Tenn, and many community based outpatient clinics located in Tennessee and Kentucky.

Other events during Nashville Navy Week included: sending 102 World War II veterans on an honor flight to Washington, D.C.; a visit to a fifth grade class at Middle Tennessee Christian School in Murfreesboro, Tenn.; a visit to the future site of the Murfreesboro Fisher House; an address to members of Kiwanis Nashville; a visit to the Tennessee State Veterans Home; an interview on the FOX and CBS morning shows; and the commissioning of 11 new officers at Vanderbilt University's Reserve Officer Training Corps program, among others.

Navy Medicine is a global healthcare network of 63,000 Navy medical personnel around the world who provide high quality health care to more than one million eligible beneficiaries. Navy Medicine personnel deploy with Sailors and Marines worldwide, providing critical mission support aboard ship, in the air, under the sea and on the battlefield.

Nashville Navy Week is one of 15 Navy weeks across the country this year. Navy Weeks are designed to show Americans the investment they make in their Navy and increase awareness in cities that do not have a significant Navy presence.

For more information about Nashville Navy Week, visit http://www.navyweek.org/nashville2012/index.html.

Navy, Academic Medicine Team Up During LA Navy Week

By Valerie A. Kremer, U.S. Navy Bureau of Medicine and Surgery Public Affairs

LOS ANGELES (NNS) -- Navy Medicine and the University of California, Los Angeles (UCLA) examined shared initiatives in humanitarian assistance, family care programs and Wounded Warrior care, as part of Los Angeles Navy Week, July 29.

Rear Adm. Alton Stocks, commander, Navy Medicine East and Naval Medical Center Portsmouth (NMCP), met with leadership and staff and toured the facility during the visit.

"It was a great opportunity to show the admiral our Ronald Reagan UCLA Medical Center and patient care capabilities, especially since UCLA is involved in helping America's wounded military personnel through our Operation Mend Program," said Shannon O'Kelley, chief operating officer, UCLA Health System. "In addition, it was wonderful to learn more about the extraordinary and tireless care both UCLA and Navy Medicine provided during the humanitarian assistance/disaster relief mission to Haiti last year."

During the visit, top medical personnel and Stocks shared similarities and best practices in Navy Medicine's Project FOCUS (Families OverComing Under Stress) and Wounded Warrior care programs such as UCLA's Operation Mend.

Navy Medicine and UCLA collaborated in 2009 to establish Project FOCUS, a family-centered resiliency training program based on evidence-based interventions that enhance understanding, psychological health, and developmental outcomes for highly stressed children and families.

Stocks expressed his appreciation for the successful collaboration with UCLA on Project FOCUS in caring not only for patients, but the family as well.

UCLA medical personnel also shared their experiences with Stocks about UCLA's Operation Haiti. During this time, UCLA medical personnel contributed medical expertise to the Department of Defense's relief effort in Haiti.

"I have a deep connection to Operation Unified Response, Navy Medicine's humanitarian assistance/disaster relief to Haiti, since many of the Navy medical personnel who worked non-stop providing world-class care, were from NMCP," said Stocks. "We are extremely proud of the work Navy Medicine did in working closely with non-governmental organizations (NGOs) and civilian institutions such as UCLA.

During his presentation to staff, Stocks shared how Navy Medicine's emergency medicine and trauma care is a critical piece of the chief of naval operation's maritime strategy. Along with traditional roles like deployments and projecting power abroad, Stocks discussed how international partnerships and providing care through humanitarian assistance missions has further demonstrated how Navy Medicine's emergency medicine and research and development has made an impact on a global scale.

"UCLA plays an outstanding role in supporting the military's mission while providing high quality care to service members and their families," said Stocks. "We look forward to continuing the conversation with shared initiatives with UCLA in the future."

Operation Mend is a unique partnership between Ronald Reagan UCLA Medical Center, Brooke Army Medical Center in San Antonio, Texas, and the V.A.-Greater Los Angeles Healthcare System and has been established to help treat U.S. military personnel severely wounded during service in Iraq and Afghanistan.

For more than half a century, UCLA Health System has provided outstanding healthcare and the latest in medical technology to the people of Los Angeles and throughout the world. Comprised of Ronald Reagan UCLA Medical Center, Santa Monica-UCLA Medical Center and Orthopaedic Hospital, Resnick Neuropsychiatric Hospital at UCLA, Mattel Children's Hospital UCLA, and the UCLA Medical Group with its wide-reaching system of primary-care and specialty-care offices throughout the region, UCLA Health System is among the most comprehensive and advanced healthcare systems in the world.

Navy Medicine is a global healthcare network of 63,000 Navy medical personnel around the world who provide high quality health care to more than one million eligible beneficiaries. Navy Medicine personnel deploy with Sailors and Marines worldwide, providing critical mission support aboard ship, in the air, under the sea and on the battlefield.

Los Angeles Navy Week is one of 21 Navy Weeks across the country this year. Navy Weeks are designed to show Americans the investment they make in their Navy and increase awareness in cities that do not have a significant Navy presence.

Navy Medicine Drops Anchor During Tampa Bay Navy Week

By Mass Communication Specialist 1st Class Farrukh Daniel, Navy Office of Community Outreach Public Affairs

TAMPA, Fla. (NNS) -- Medical professionals from around the Navy met with local healthcare providers, civic groups and community leaders to discuss the current state of Navy Medicine as part of Tampa Bay Navy Week 2011, Jan. 22-29.

Rear Adm. Richard Vinci, deputy chief, Logistics and Installations, Bureau of Navy Medicine and Surgery, was the senior officer representing the Navy during Tampa Bay Navy Week 2011.

"We are here to thank the citizens of Tampa for everything they do for our armed forces, especially the Navy and all of our native Floridian Sailors," said Vinci. "We also want everyone to know that we are good stewards of American tax dollars, by showing them some of the things that Sailors are doing around the fleet. As a key component of good stewardship, the Navy is focused on energy efficiency.

"The Navy is leading the way in developing Biofuels and LEED (Leadership in Energy and Environmental Design)," Vinci said. "Each of the new facilities that the Bureau of Naval Medicine is building is certified LEED Silver or better. We are committed to the environment."

In a meeting with Dianne Morrison-Beedy, Dean of the College of Nursing at the University of South Florida, Vinci shared how Navy medicine is critical to the chief of naval operation's maritime strategy. Along with traditional roles like deployments and projecting power abroad, Vinci discussed how international partnerships and teaming with non-government organizations supports the Navy's mission.

"The Navy truly is the healthcare tip of the spear," said Vinci. "When the tsunami struck in Indonesia, Navy doctors were the first international assistance to arrive at the scene. Health projection pays benefits in the long term. Now, nations like Indonesia and Haiti are more likely to welcome American service members in the future."

Cmdr. Sherri Santos, Navy Nurse Corps; and Lt. Cmdr. Joseph Ayers, Navy Medical Corps from Naval Hospital Jacksonville, met with trauma surgeons from Tampa General Hospital to discuss new experiences, life saving techniques and procedures currently used in the war in Afghanistan.

Ayers spoke about the people they treated during his recent deployment.

"We treated tons of Afghani children who had been injured by IED's (improvise explosive devices)," said Ayers. "Often times, they were the children of Taliban bomb makers who accidentally set off the explosive prematurely. By treating those wounded children, hopefully we sent the message, at least to some of them, that we aren't the bad guys."

According to Vinci, providing care to civilians in need, in places such as Afghanistan, is an example of smart power.

"There are two sides to Navy medicine's mission," said Vinci. "We provide direct medical support to our warfighters anywhere we operate, whether it be on the deckplate or on the battlefield. Marines don't go into the field, and ships don't go to sea without doctors, nurses or corpsmen.

"Smart power is providing humanitarian assistance and disaster relief alongside our international partners to help bring stability and hope to those in need to the benefit of the global community. Navy medicine is often a cornerstone of these important missions."

Morrison-Beedy said she was excited to meet with the staff from Navy Medicine.

"We treat a lot of veterans here, and we are making great strides in areas like rehabilitation and PTSD (Post-Traumatic Stress Disorder)," Morrison-Beedy said. "The information we learn has tremendous value in treating future, returning veterans as well as civilians who suffer similar traumas."

Vinci spoke about the recent advances in research and treatment the Navy is developing today.

"During World War II, we learned the value of plasma and now it's a common practice," Vinci said. "Today, our surgeons are developing revolutionary vascular and transplant techniques through lessons learned on the battlefield."

Along with Navy Medicine, more than 100 Sailors involved with Tampa Bay Navy Week 2011 participated in outreach events around Tampa Bay, and finished with the Gasparilla Pirate Festival, Jan. 29.

Tampa Bay Navy Week is the first of 21 Navy weeks across the country this year. Navy Weeks are designed to show Americans the investment they make in their Navy and increase awareness in cities that do not have a significant Navy presence.

For more information about Tampa Bay Navy Week, visit www.navyweek.org/tampa.

For more news from Navy Office of Community Outreach, visit www.navy.mil/local/navco/.

Jihad and American Medicine

On September 11, 2009, Conversations with American Heroes at the Watering Hole will feature a discussion with Former Lieutenant Commander Adam Frederic Dorin, M.D., MBA, USN, on Jihad and American Medicine.

Program Date: September 11, 2009
Program Time: 2100 hours, Pacific
Topic: Jihad and American Medicine
Listen Live: http://www.blogtalkradio.com/LawEnforcement/2009/09/12/Jihad-and-American-Medicine

About the Guest
Lieutenant Commander Adam Frederic Dorin, M.D., MBA, USN, “served as an officer in the United States Naval Reserve, where he attained the rank of Lieutenant Commander. He joined the Navy in July of 1990. Like his father, he is proud to have served our country as a member of the armed forces. Dr. Adam Frederic Dorin has been in private practice as an anesthesiologist and medical director for nearly fifteen years. He has managed and chaired several anesthesia departments on both the east and west coasts. He has been a volunteer surveyor of freestanding surgery centers across the country and an avid writer for medical journals. He also sits on several editorial boards. Dr. Adam Frederic Dorin is currently the Medical Director of the SHARP Grossmont Plaza Surgery Center, and is an Anesthesiologist at the Grossmont Hospital, Surgery Center and Women’s Center. Lieutenant Commander Adam Frederic Dorin is the author of Jihad and American Medicine: Thinking Like a Terrorist to Anticipate Attacks via our Health System.

According to the book description of Jihad and American Medicine: Thinking Like a Terrorist to Anticipate Attacks via our Health System, “Jihad and American Medicine predicts exactly what happened in the UK, and will likely happen again. Namely, that healthcare workers are uniquely positioned to fly 'under the radar of homeland security' and carry out terrorist missions virtually unimpeded. Dr. Dorin is a physician, author, and expert in healthcare safety and security. He has written what is essentially a counter-terrorism manual geared toward the public, healthcare professionals and government officials on the national security vulnerabilities inherent to the way medicine is practiced in developed nations.


About the Watering Hole
The Watering Hole is Police slang for a location cops go off-duty to blow off steam and talk about work and life. Sometimes funny; sometimes serious; but, always interesting.

About the Host
Lieutenant Raymond E. Foster was a sworn member of the Los Angeles Police Department for 24 years. He retired in 2003 at the rank of Lieutenant. He holds a bachelor’s from the Union Institute and University in Criminal Justice Management and a Master’s Degree in Public Financial Management from California State University, Fullerton; and, has completed his doctoral course work. Raymond E. Foster has been a part-time lecturer at California State University, Fullerton and Fresno; and is currently a Criminal Justice Department chair, faculty advisor and lecturer with the Union Institute and University. He has experience teaching upper division courses in Law Enforcement, public policy, Public Safety Technology and leadership. Raymond is an experienced author who has published numerous articles in a wide range of venues including magazines such as Government Technology, Mobile Government, Airborne Law Enforcement Magazine, and Police One. He has appeared on the History Channel and radio programs in the United States and Europe as subject matter expert in technological applications in Law Enforcement.

Listen, call, join us at the Watering Hole:
http://www.blogtalkradio.com/LawEnforcement/2009/09/12/Jihad-and-American-Medicine

Program Contact Information
Lieutenant Raymond E. Foster, LAPD (ret.), MPA
editor@police-writers.com
909.599.7530

Plan Calls for Sweeping Changes to Mental Health Care Services

By Fred W. Baker III
American Forces Press Service

Sept. 26, 2007 - Servicemembers and their families can expect sweeping changes throughout the Defense Department's mental health care services during the next year. A plan submitted to Congress this month details hundreds of proposed actions that officials hope will make the system more patient-focused. Many of the major changes are slated to be in place by as early as May 2008.

The plan is based on 95 recommendations for change that the department's Task Force on Mental Health reported to Congress in June.

Congressionally directed and funded last year, the task force reported that stigma attached to mental health care, difficult access, bureaucracy and a lack of resources contributed to a lack of adequate care for servicemembers and their families.

Congress provided $900 million for improvements in mental health care services, some funds specifically for advancements in traumatic brain injury and psychological health research, development and services.

The department responded by partnering with the departments of Veterans Affairs and Health and Human Services to develop a plan to work through each of the recommendations, in many cases crossing the bureaucratic borders of each organization, to refocus the delivery of care to the patient's point of view.

This is a paradigm shift for military medicine, said Ellen Embrey, deputy assistant secretary of defense for force health protection and readiness.

"Patient centered-care is a standard of practice in some of the more effective health systems around the country. For large federal systems like the Department of Defense and the Department of Veterans Affairs, patient-center care being imposed on a large number of specialty departments requires a significant commitment to understanding what the patient has to go through and making sure that the providers in that system keep that in mind," Embrey said. "We are absolutely committed to doing what's best for the patient."

The changes also call for a shift in how the department has traditionally focused its mental health care, she said.

"If you look at how the department is currently organized to provide care, ... overall our focus in the past has been on diagnosis and treatment. The shift ... is to help people understand that prevention, and helping people maintain their health, is as important," Embrey said.

This calls for education and training for leaders, providers and patients, she said. The new plan also includes more research.

"That shift requires everyone in the system to understand what psychological health is, how to recognize when it's starting to falter, and what you can do yourself or what resources are available to you," Embrey said.

Probably one of the most visible changes in the system will be streamlined mental and physical evaluation board processes that will offer more consistency between Defense Department and VA assessments, Embrey said. A pilot of the new system will be conducted in the next few weeks, she said. A final system is to be in place by May.

Also key in the plan is ensuring servicemembers and their families receive a full continuum of care during transitions, especially from military to civilian life. Most of the changes have to do with recordkeeping and working to improve provider "hand-offs" of patient information. This is critical, officials said, as patient information often is recorded on the battlefield and passed successfully to military hospitals for care, but sometimes there are gaps as the patient transitions to Veterans Affairs or to a civilian provider.

Officials are also working to bring mental health care access policies more in line with those of primary care access policies. For example, officials want policies across the system to provide initial mental health care services to a patient within seven days of contact, or fewer if the situation requires. This is the standard for primary care access. But in the past, mental health care was always perceived as specialty care, and the standard for receiving an appointment was 30 days.

"Psychological health and fitness must be placed on an equal footing with physical health and fitness," Embrey said. "We have a responsibility to effectively identify and treat all psychological health conditions and ill effects of war, and are committed to accomplishing that through a consistently excellent standard of care across DoD."

Many changes will revise department policies to reflect a more current knowledge of psychological health. And part of the plan is an anti-stigma public education campaign targeting servicemembers and family members who neglect or postpone treatment.

The aggressive timeline for implementing the changes reflects the department's commitment to timely change to the mental health care system, Embrey said.

"This has the attention of our senior leadership, and they are committed to making these necessary changes," she said. "Our families and our servicemembers are the most important part of our ability to do our mission and they deserve the very best treatment."

Since the initial recommendations went to Congress in June, senior Defense Department officials have met weekly. Many changes were already implemented as officials developed the overall plan, officials said.

Winkenwerder Leaving After Six Years at Helm of DoD Health Affairs

By Jim Garamone
American Forces Press Service

Feb. 26, 2007 – After nearly six years in office, the Defense Department's top doctor said he will miss the people of the department who make things happen for servicemembers around the world. In a long-planned decision, Dr. William Winkenwerder Jr. soon will step down as assistant secretary of defense for health affairs and move to a job in the private sector.

President Bush has nominated Dr. S. Ward Casscells to replace Winkenwirder. Casscells is a professor of medicine and public health at the University of Texas Health Science Center, in Houston. The Senate must confirm the doctor before he takes office.

Casscells has served as medical advisor in Baghdad and understands the complexities of the position he is moving into, Winkenwerder said in a Feb. 23 interview with American Forces Press Service.

Winkenwerder said the position is demanding, but rewarding. "It has been a tremendous honor and privilege to work and serve in this position," he said. "It's been a great opportunity and pleasure, and one I never anticipated."

The war on terror has made this a unique time to be assistant secretary for health affairs, Winkenwerder said. "I know that Health Affairs is probably always a hopping place, but I think it has been more of a hopping place in the last five years than it has ever been," he said with a smile.

DoD has been engaged worldwide, and medical support always follows. "I've very proud of the battlefield medicine support," the doctor said. "I'm particularly proud of the advances in mental health and the fact that (seeking mental health care) is less a stigma."

More must be done in this regard, he said, but the military understands the importance of mental health readiness.

Winkenwerder also is pleased that the services have been operating more jointly, he said. The consolidation of Walter Reed Army Medical Center here and the National Naval Medical Center, in Bethesda, Md., is going well, he said, as is the consolidation of Brooke Army Medical Center and the Air Force's Wilford Hall Medical Center in San Antonio.

In addition, the anthrax vaccination program is going well, and the troops are getting better protection. "In November 2001 we didn't have a licensed anything," Winkenwerder said. "(There was) no production, no contract, and it's running well today."

DoD also has invested almost $1 billion in combating bioterrorism facilities and labs, he said.

The doctor said he is also proud of DoD's efforts to assess servicemembers before and after deployments, "so we know much more clearly what has happened to them during their deployments." Part of this is putting in place the information technology to capture all that data. This also helped as the department put in place the individual medical readiness system. This system standardized the way the services viewed servicemembers' readiness for deployments.

DoD health professionals continue to lead in integrating information technology with new hand-held battlefield systems, he said.

Winkenwerder noted he never served in the military, and this both hindered and helped him. "It took me a while to learn the culture of the place," he said. "You have to balance bringing private-sector ideas (into the military), with a recognition of and respect for the existing culture and the existing way of doing things. What I've learned is there is a certain speed and rhythm of change in a large organization. DoD has such a strong culture, and you have to work within the system to get the system to change."

On the Tricare front, he said the health plan was average-rated when he came into office in 2001. "Now it is one of the top-rated in the country; satisfaction in Tricare has gone up," he said. "We've been able to implement all the new contracts -- some $45 billion worth -- and didn't have procurement problems or scandals."

Health professionals are sometimes the best capability the country has to change peoples' minds about America, Winkenwerder said. Military medics rushed to help the people of the Indian Ocean area affected by the December 2004 tsunami and also helped thousands hurt by the 2005 earthquake in Pakistan. The department also has a $100-million-a-year military-to-military assistance program to help combat HIV/AIDS.

However, Winkenwerder said, he does leave the department with some regrets, he said. In 2006, DoD proposed raising fees for some groups for Tricare membership. The doctor said DoD needs to implement changes in the benefit to create a stable financial foundation for the long run.

"It certainly was my fervent hope that we would advance beyond debate and into action with respect to sustaining the benefit discussion," he said.

"I think that will happen," he said. "I'm reasonably confident because there is a growing realization in DoD and Congress that we have to make some of these adjustments. We can debate about how much and how fast, but the adjustments need to take place. My regret is I didn't think of a better take on that issue so we would be further down the road today."

Winkenwerder said he also wishes he could have spent more time on revising and updating DoD's medical personnel system. He wanted to do more with management of the resource and recruiting and development of leaders. "It's a hard thing to do in government, and there is a need to do more," he said.

He said he thinks most of the people in Iraq and Afghanistan who are on the "medical front lines" of the war on terror. "I've seen so many faces, and whether taking care of one of our own of a child or an insurgent, it's an amazing thing to see our people in action," he said.

"The will of the military is remarkably strong," he continued. "What we have to sustain is the will of the American people. That's going to be a challenge. That's a bit of my concern with the focus on the shortcomings at Water Reed. We need to keep the focus on the problems that are really problems of processing and bureaucracy. They are not problems of medical care or the professionalism of the staff."

The doctor said he believes military medical professionals have "done too many great things for people to conclude that they are not top-notch."

He also believes that the next few years will see a growing cooperation between DoD and the Department of Veterans Affairs and that the department will move to the next stage of electronic health records.

His advice for his successor? "Enjoy this experience," he said. "Take advantage of the opportunity to advance positive changes."

Sponsors of the article include criminal justice online leadership; and, military and police personnel who have written books.