A comprehensive and highly useful military model for analyzing and addressing problems that does well in non-military settings as well.
My staff and I were meeting at the end of a long day. As representatives of the regional headquarters they had been working with their counterparts at our subordinate medical facilities on an important project with a tight suspense, and they had met resistance. One exasperated lady at a hospital said, “Tell your boss that we have full time jobs already!” Another one said, “This regional initiative just isn’t my top priority right now”, and one of my staff said “Sir, there just aren’t enough hours in the day.” Everyone who has worked long in leadership and management has heard these complaints time and again.
There is always a temptation to ignore such concerns and keep pushing, but that is rarely the right thing to do. One concern from my staff is that they did not feel as though their counterparts in the clinics and hospitals considered them value added. They wanted cooperation on these vital projects but did not perceive that they had much to give in return. This is a perpetual problem and when I worked in a hospital, I felt the same way about the regional staff.
Continue reading “DOTMLPF-P Analysis and Military Medicine”
Pursuant to the Base Realignment and Closure Law of 2005, the Joint Task Force National Capital Medicine (JTF Cap Med) was established in 2008. Its mission was to integrate military health care in the National Capital Region, including the merging of the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC), and the transition of the DeWitt Army Community Hospital (DACH) into the Fort Belvoir Community Hospital (FBCH). On 15 September 2011 WRAMC and NNMC united to become the Walter Reed National Military Medical Center (WRNNMC) in Bethesda and the billion-dollar FBCH opened its doors. To handle the myriad of issues involved in such a major transformation, the JTF Cap Med endured. Having completed its mission, it was disestablished on 30 September 2013.
In March 2013 the Deputy Secretary of Defense, Ashton B. Carter, directed that the Defense Health Agency (DHA) and a subordinate organization, the National Capital Region Medical Directorate (NCR-MD) , be established on 1 October 2013. The purpose of the DHA was to integrate services that could be shared between Army, Navy and Air Force medicine such as information technology, logistics, education, research, and others. The purpose of the NCR-MD was to continue the work of the JTF Cap Med in integrating military health care in the Joint facilities, WRNMMC and FBCH) and optimize and integrate military medical care in the rest of the military health facilities in the National Capital Region market. This includes the Malcolm Grow Medical Clinic and Surgical Center (MGMCSC – Joint Base Andrews), the Kimbrough Army Community Clinic (KACC – Fort Meade), the Navy clinics at Quantico and Annapolis, the Joint Pathology Center, the National Center of Excellence for Traumatic Brain Injury, and their subordinate facilities.
I came to the National Capital Region (NCR) as Chief Medical Officer at the DACH in July 2007 and have been serving in military medicine in the NCR since. In January 2012 I took over as the Director for Clinical, Business and Warrior Operations at JTF Cap Med headquarters and I maintained that position through the transition to the NCR-MD. These experiences and others have provided many leadership lessons that I hope will be useful to my staff, my students, and others who have interest in these areas. I have assigned one to two readings per month to my teammates at the NCR-MD, and now make them available to all.
What will the Military Health System look like in the future? The operational forces will be more military, and the CONUS facilities will be more civilian.
In the book Retribution: The Battle for Japan, 1944-1945, Max Hastings described how ships’ crews took on the characteristics of their commanders. One captain was not well liked but was respected because “he had a mind like a slide rule.” Most good commanders took care of their sailors.
One characteristic of all effective commanders was that they communicated all that they knew about the strategic situation to their crews. In December 1944 the US Navy had 1100 warships and 5000 support ships. Most sailors never saw the big battles and instead spent the war shipping cargo between ports. For example, it is 5100 nautical miles from Honolulu, Hawaii to Darwin, Australia. Cargo ships took 21 days each way to make the trip. Temperatures in these all-metal ships reached 110 degrees, the odor of fuel and sweat was ubiquitous, and the noise was deafening. Men swabbed, repaired, ate, slept and repeated the process endlessly. They saw nothing but the sea, the sky, their ship, and each other. Few knew how their part, no matter how small, fit into the overall plan for victory.
Continue reading “The Future of the Military Health System”
Few of us are athletes, and even fewer of us are Olympians, but we should all have fitness goals. How to make them, and how do you keep them?
For the past two weeks many Americans have enjoyed the Olympic Games. Watching the fastest runners and swimmers, the finest gymnasts, and the best teams in the world is both an inspiration and a thrill. It stirs the heart to see the athletic prowess that these young stars can reach. So moved, many people commit to improve their own physical fitness and set goals to achieve that end.
Continue reading “How to Pick Your Fitness Goals”