Doctors Orders
Doctor’s Orders
A veteran of war and vascular surgery offers advice on health reform
A weary American soldier rests on one knee in a dusty foreign desert. The young man’s massive backpack is overflowing with equipment and there are pouches strapped to his belt, tools attached to his boots, and gear affixed to his helmet.
U.S. Air Force Capt. Mario Ramirez, left, and Capt. Suzanne Morris confirm a patient’s identity and prepare to administer a blood transfusion during a medical evacuation flight out of Bagram Airfield, Afghanistan. Image: DoD photo/Senior Airman Chris Willis, U.S. Air Force.
“He’s straining under the load that the country has asked him to carry,” said Jonathan Woodson, Assistant Secretary of Defense for Health Affairs, describing a photograph he shared at the Harvard Medical School Office of Diversity and Community Inclusion’s 2013-2014 Leadership Forum on Oct. 28.
After more than 12 unbroken years of combat operations, the longest sustained period of war in American history, the American soldier has a right to be weary, Woodson said, explaining that his own job in the U.S. Defense Department has been to oversee the health care provided to the nation’s military personnel.
“That’s who we serve,” Woodson said.
Woodson’s presentation focused on the relationship between the U.S. armed forces and civil society, the contributions made by both academic and military practitioners that have benefited both groups, and the shared responsibility that military and civilian physicians and researchers have serving both soldiers and citizens.
Woodson, who trained as a vascular surgeon at Massachusetts General Hospital, was deployed as a medical officer in Saudi Arabia, Kosovo and Iraq. He also served as associate dean for diversity and multicultural affairs and professor of surgery at the Boston University School of Medicine while acting as senior attending vascular surgeon at Boston Medical Center. Woodson drew on his experience and insights from both of those worlds, outlining the opportunities and challenges that both worlds share.
In his current posting, Woodson said, he is responsible for the nation’s military health enterprise, which includes force readiness, biomedical research, and the health insurance system for families of military personnel. The annual budget for this work is $53 billion.
Historically, Woodson said, military medicine has made significant contributions to the advancement of treatments for traumatic injury, shock and sepsis, and to the technology of surgery and medical evacuation.
Today, he said, the integrated defense health agency—with innovative, shared electronic medical records, patient-centered medical records, and comprehensive health education and population medicine approaches that are aimed at increasing individual engagement and participation in the production of their own health—also offers important insights into how the U.S. can improve health care for all its citizens.
For example, Woodson noted that the U.S. employs standards-based educational methods to train front-line military medics who sometimes have only high school educations. These medics go on to perform complex, life-saving battlefield medical procedures and, he said, the same training methods could be used to prepare a new corps of civilian medics to provide similar crucial primary care services in civilian communities.
As the nation develops new systems to meet the military and domestic health care needs of the future, Woodson said, it needs to develop an integrated system that effectively takes information, generates usable knowledge and then creates wisdom within the U.S. health care system.
“Wisdom is when we have everybody operating from an evidence-based strategy to the highest standards,” Woodson said.
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About Harvard Medical School (HMS)
Driving Change. Building Momentum. Making History.
“Since 1872, Harvard Medical School has been the incubator of bold ideas—a place where extraordinary people advance education, science and health care with unrelenting passion.
Whether training tomorrow’s doctors and scientists, decoding the fundamental nature of life, advancing patient care or improving health delivery systems around the world, we are never at rest. Allied with some of the world’s best hospitals, research institutes and a University synonymous with excellence, the School’s mission remains as ambitious as it is honorable: to alleviate human suffering caused by disease.”
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About Harvard School of Public Health (HSPH)
Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights.
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About Harvard University.
Established in 1636, Harvard is the oldest institution of higher education in the United States. The University, which is based in Cambridge and Boston, Massachusetts, has an enrollment of over 20,000 degree candidates, including undergraduate, graduate, and professional students. Harvard has more than 360,000 alumni around the world.
Harvard University is devoted to excellence in teaching, learning, and research, and to developing leaders in many disciplines who make a difference globally. Harvard faculty are engaged with teaching and research to push the boundaries of human knowledge. For students who are excited to investigate the biggest issues of the 21st century, Harvard offers an unparalleled student experience and a generous financial aid program, with over $160 million awarded to more than 60% of our undergraduate students. The University has twelve degree-granting Schools in addition to the Radcliffe Institute for Advanced Study, offering a truly global education.
‘Universities nurture the hopes of the world: in solving challenges that cross borders; in unlocking and harnessing new knowledge; in building cultural and political understanding; and in modeling environments that promote dialogue and debate… The ideal and breadth of liberal education that embraces the humanities and arts as well as the social and natural sciences is at the core of Harvard’s philosophy. ’/ Drew Gilpin Faust
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* The above story is adapted from materials provided by Harvard University
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