FEBRUARY 4, 2023 – Rear Adm. Cynthia Kuehner, commander of Naval Medical Forces Support Command, was part of a panel that spoke before the South Texas Chapter of the American College of Healthcare Executives (ACHE) during the Healthcare Landscape Conference held on Jan. 27. This year’s theme was “Strategic Imperatives for the Future of Healthcare Delivery.”
The admiral was joined by Army Brig. Gen. Deydre Teyhen, Brooke Army Medical Center commanding general, and Air Force Brig. Gen. Al Flowers, Director of Manpower, Personnel and Resources, and Chief of the Medical Service Corps. These officers were joined by Mr. Robert Goodman, Chief of Staff, Office of the Army Surgeon General and member of the Senior
The military panel provided an overview of the Military Health System (MHS) and took questions from a moderator and the audience compromised of healthcare management professionals and students.
During her opening statement, Kuehner expressed gratitude for the opportunity to address the audience regarding the future of healthcare within the MHS, as well as the direction Navy Medicine is taking over the next five years based on the recently published Navy Surgeon
General’s 2023 campaign plan.
“We are making foundational changes in how our entire enterprise operates to meet combatant commander requirements for the warfighter,” said Kuehner. “Navy Medicine is taking this urgent action to aid our Naval Forces and Marine Corps, operating in a contested battlespace that is quickly growing in lethality, complexity and scope.”
The admiral took a moment to discuss two of the warfighting concepts that form the operational approach to winning a high-end fight with geographically dispersed Naval Forces.
“The Navy is taking a new approach at sea and ashore with Sailors and Marines supporting Distributed Maritime Operations (DMO), and Expeditionary Advanced Base Operations (EABO)” explained Kuehner. “These new warfighting concepts will allow the Navy to fully integrate and synchronize military operations across all domains.”
Questions centered on how collaboration between military and civilian healthcare systems can better prepare both for future conflicts. Each panelist discussed how civilian-military collaboration during COVID provided lessons on how to leverage these partnerships to prepare medical personnel to enhance warfighter survivability in the future.
“The future of healthcare delivery for Navy Medicine will likely involve shipboard battle injuries including burns, smoke inhalation, immersion, blast and penetrating wounds,” said Kuehner. “In the same way we provided Navy medical personnel throughout the nation to assist civilian hospitals, clinics, and FEMA sites during COVID, current civilian-military partnerships are in development that will ensure our healthcare teams are experienced and equipped with the knowledge, skills and abilities required to respond to a range of complex injuries and sustain life in austere environments. Additionally, we must have capabilities that maximize force preservation through the prevention and treatment of diseases and non-battle injuries.”
One of the challenges acknowledged by the panel is the recruitment and retention of medical personnel. This prompted questions about monetary bonuses, and the possibility of either incentivizing military providers to remain in the service or bringing civilian medical staff into the
Flowers emphasized the importance of strengthening collaboration through the Defense Department’s Skill Bridge program, which allows military personnel to support the civilian healthcare system while also advancing skills in critical care.
“There is no training like a battle zone,” said Flowers. “We need to be ready to fight now because the enemy will not wait. Just in time may become just too late.”
Teyhen approached the topic differently by discussing becoming more efficient. “We need to make systems more efficient to optimize healthcare,” said Teyhen. “We need to get systems leaner to ensure patients see the right provider the first time and not have their healthcare elongated by seeing several providers before getting the right care.”
Goodman was more pragmatic in acknowledging money is just not there to provide bonuses to incentivize additional recruiting. He emphasized that the total cost of military healthcare includes those who are serving today as well as those who have served, along with their family members.
“The rapid change in healthcare from 100-plus hospitals 25 years ago, to 45 today is a reality,” said Goodman. “There is a need to redirect expenses to move to volume-based care. Although the military is smaller, the retiree population has outpaced the number of providers necessary to deliver care.”
Kuehner also acknowledged the military is suffering from many of the same issues that civilian providers experience. It was a good transition to the final question regarding resilience.
“Resilience is critical to our ability to succeed in our mission,” said Kuehner. “It is not an individual issue, but rather requires leadership engagement and environmental interventions. There is a need to focus on getting the systems resilient, because the people are already there. It needs to be universally applied.”
The consensus of the panel was military healthcare providers can be cobbled together to meet the demands of an ever-changing medical environment, but there is a need to focus on increasing stability in order to create lasting resilience, according to Goodman.
The admiral closed out her comments with the panel by focusing on three areas that she wanted to clarify regarding Navy medical professionals.
“First, Navy Medicine is an ecosystem in which beneficiary care and expeditionary medicine are inextricably linked, where we work together with our Service and Defense Health Agency counterparts and together, we succeed,” said Kuehner. “Second, family readiness is warfighter readiness, and as we have learned from the pandemic, we must be capable of not just performing damage control surgery, but also responding to a variety of medical threats, wherever they may arise.
“Finally, in addition to preparing for the high-end fight, Navy Medicine has a significant role in projecting Soft Power,” explained Kuehner. “Our partnerships with industry, academia, and our allies help advance interoperability across medical communities – and the humanitarian and disaster relief aid we provide strengthens strategic partnerships and is a powerful tool for diplomacy and peace. We don’t do it alone!”
Story by Randy Mitchell
Naval Medical Forces Support Command