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Surgeons General Testify Before Senate on Budget Request

By Terri Moon Cronk
American Forces Press Service

WASHINGTON, April 9, 2014 – The medical capabilities honed from 13 years of war must continue to expand for future needs, the three military surgeons general told a Senate panel today.

Lt. Gen. Patricia D. Horoho, Army surgeon general; Vice Adm. (Dr.) Matthew L. Nathan, Navy surgeon general; and Lt. Gen. (Dr.) Thomas W. Travis, Air Force surgeon general, testified at a hearing on defense health programs.

Joint wartime military medicine has yielded significant gains, Horoho said. When the Army, Navy and Air Force began embedding behavioral health professionals at duty stations, for example, service members were able to access outpatient behavior health care more often, and fewer subsequent acute crises occurred, the surgeons general told Senate members.

“Since 2001, behavioral health care has increased from 900,000 encounters in 2007 to almost 2 million in 2013,” Horoho said of the increased number of service members seeking care.

“Psychological health is an important component of overall force health protection,” Nathan said. “We recognize that prolonged operational stress can have potentially debilitating consequences.”

Air Force mental health providers also are readily available at duty locations to “provide early intervention and care for those experiencing occupational stress that affects their performance,” Travis said.

In addition to psychiatric intervention and care for suicide prevention and various mental health issues, the services have made other gains in the medical arena.

“At Army wellness centers, 62 percent of individuals saw a 4 percent decrease in their body mass index and a 15 percent increase in their cardiovascular fitness,” Horoho said.

“[Such] successes are due to a comprehensive system of care that extends from a deployed environment across our medical commands and into the life space,” she added. “That translates to better health, better readiness, lower health care costs and a stronger Army.”

Wartime lessons learned led to more than 30 evidence-based military clinical practice guidelines that helped to save lives and improved medical outcomes, she said.

But more work must be done in Army medicine, Horoho told the panel members.

“We are more than health care providers in a hospital,” she said. “We are a robust, interconnected system that has accelerated research, academics and medical innovation for our nation.”

Military medicine is entering a time of “dynamic uncertainty,” she said.

“We must preserve these medical capabilities to meet our nation’s mission,” Horoho added. “What is at stake is not day-to-day care, but our ability to respond to future missions at the level we have over the last 13 years.”

Medical readiness must be aggressively sustained while maintaining trust with the American people, she told the panel.

“Though we live in uncertain times, one thing is certain,” she said. “A healthy, resilient and ready Army will be as it always has been: the strength of our nation.”

The Navy’s surgeon general echoed the mission-ready stature of his military service’s medical team in delivering world-class health care “anywhere at any time” for sailors and Marines.

“[Such] responsibilities require us to be an agile, expeditionary medical force capable of meeting the demands of crisis response and global maritime security,” Nathan said.

Remaining flexible in the face of changing operational requirements and fiscal challenges, in addition to effectively managing resources is critical to sustaining the medical readiness mission, he said.

Meanwhile, advances are taking place in Navy medicine, Nathan said.

“We’re moving more workload into our treatment facilities, growing our enrollment, rebalancing our staff and reducing overall purchase-care expenditures,” he said.

“These are transformational times for military medicine,” Nathan said. “There’s much work ahead as we navigate important challenges and seize opportunities to keep our sailors and Marines healthy, maximize value for all our patients and leverage joint [military medical] opportunities.”

Despite the war winding down and the fiscal challenges that lie ahead, military medicine has a “clear responsibility” to make sure its medics are well trained and prepared for any future contingencies, the Air Force surgeon general said.

Combat operations, stability operations, humanitarian assistance and disaster relief must be sustained by well-trained personnel, Travis said.

“[Medical professionals] must have robust opportunities to practice their skills [and we must] continue to pursue critical research and modernization initiatives in the future,” he told the panel.

“As the way we fight war evolves, the way we provide medical support to operators is also evolving,” Travis said. “Not only will access and care be more customized for the mission, but so will prevention. Even in the face of budget challenges, we have to be as ready for the next war as we are at the end of the current war.”

(Follow Terri Moon Cronk on Twitter: @MoonCronkAFPS)


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Army Lt. Gen. Patricia D. Horoho
Navy Vice Adm. (Dr.) Matthew L. Nathan
Air Force Lt. Gen. (Dr.) Thomas W. Travis

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