Lessons On Medicine And The Military

Not far from Walter Reed and the National Institutes of Health (NIH), there’s a military base in Bethesda, Maryland, that houses another prestigious medical institution, the Uniformed Services University of Health Sciences (USU).

Established in 1972, USU trains the physicians who care for the troops protecting our country. The university’s motto is “Learning to care for those in harm’s way” and it was a privilege to speak with its dedicated, mission-driven students.

I arrived on Nov. 3 at the invitation of Second Lieutenant Christopher Husson (class of 2020), a West Point graduate now learning and under the auspices of USU School of Medicine Commandment Alexander Galifianakis, MD.

Like his classmates, Chris is not charged tuition. All students repay the nation through a seven-year commitment to their chosen service, be it Army, Navy, Air Force or U.S. Public Health Service. More than 60 percent of USU graduates willingly serve 20 years or longer and all are incredibly hard-working individuals.

My talk focused on the role physician leaders can play in addressing the shortcomings of the American healthcare system.

In August, I wrote in the New England Journal Medicine that too many graduating medical students lack the fundamental business and leadership training necessary to effect change in healthcare. In the article, I proposed that all medical students undergo a four-week “business rotation” during their fourth year. But during my visit to USU, I realized this very principle is embedded in the education its students receive.

Military institutions like the Uniformed Services University continuously teach students the core skills of leadership, team development and commitment. They train the next generation of physicians to be leaders, able to motivate others, able to achieve through collaboration and cooperation, and able to do more as a team than any one person could possibly accomplish.

In my presentation, I emphasized that completing difficult tasks – such as improving clinical outcomes, lowering healthcare costs and mastering information technology – require a higher level of organizational structure than is present in our fragmented system of care. I believe these students are among our nation’s most prepared to succeed where today’s medical culture has failed.

During Q&A, the students at USU asked insightful and important questions about the future of medicine: What will it take to make every patient’s data available to doctors, regardless of where their care is provided? How would a capitated model of payment impact patients and doctors? How might we consolidate hospitals to increase volume, improve outcomes and maximize efficiency? And what did I think of the quality of medical care provided by the military?

That last question was an easy one. The care provided to our soldiers is nothing short of world-class, with results matching the best trauma centers this nation has to offer. Today’s military physicians are reducing mortality on the battlefield to levels unmatched in world history. And it’s the dedicated physicians training at USU who are a major reason for this success.

In closing, I encouraged the students to become the best physicians they can be and to use their leadership skills to transform the American healthcare system. Military training isn’t for all physicians, but it is superb preparation for those who hope to be skilled clinicians, innovators and leaders.