Roger Wicker Asks Experts: Why Have Our Military Surgeon Readiness Rates Dropped?

yesterday

During a Senate Armed Services Committee hearing held before the Congressional recess, Sen. Roger Wicker (R-MS) questioned experts about military surgery training and readiness.

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Transcript

00:00And I commend each of you for your excellent testimony.

00:04Let me just get quick answers here from all three of you.

00:09I think what I'm hearing from all three of you

00:11is that this is going to require more than simply

00:15good management of what we have on the books now.

00:18Each of you is recommending changes

00:22in the statute that need to come in this coming NDAA.

00:26Is that right, Dr. Robb?

00:28And Dr. Friedrichs?

00:30Yes, sir.

00:31And Dr. Cannon?

00:31Yes, Mr. Chairman.

00:32Okay, now let's talk about military surgeon readiness

00:36for combat care.

00:38There was a study out in 2021,

00:41it found that the population of military general surgeons

00:45meeting necessary readiness standards

00:48decreased from an already low 17% in 2015

00:53to about 10% in 2019.

00:59Why is that?

01:00We'll let all three of you take a brief chance

01:03at answering this.

01:04Why is this happening?

01:06And what specifically can DOD do to reverse this trend?

01:10And we'll just start with Dr. Robb and go down the table.

01:14I'll take a, we'll try to share different perspectives here.

01:18I think it comes back to the system to be able

01:23to resource the requirements that we need.

01:27And so, for example, if you want to look at,

01:30Dr. Cannon referred to the five to eight,

01:33what we call critical military treatment facilities.

01:37In order for us to provide a higher volume,

01:39high acuity care, they need to be resourced.

01:42And I think that's the challenge

01:43that we all face right now,

01:45is what's that strategic reserve

01:47with our military treatment facilities?

01:48And then how you augment that with the VA

01:51and the Department of Defense partnerships,

01:54and then how do you augment that with the military?

01:56Is that what he called the centers of excellence?

01:59So I would call them, that's one way to call them,

02:03but what I, coming from the airlifter world,

02:08in fact, General Friedrichs and I will say,

02:10follow the casualty flow.

02:13And the casualty flow comes in from Indo-Pecan

02:16to primarily will become in the two

02:18or three military treatment facilities.

02:20From South Com there will be coming

02:22into the National Capital Region.

02:24And then from Europe, CENTCOM and AFRICOM,

02:27they will be coming into primarily

02:29National Capital Region and with a pop-off at Portsmouth.

02:31Okay, Dr. Friedrichs, is this 10% number a concern?

02:38And why do we have a 10% of military surgeon readiness?

02:47Mr. Chairman, it absolutely is a concern.

02:49When I did my training in the military,

02:51I trained at the old Wolford Hall

02:53that was a level one trauma center.

02:54I took care of trauma patients

02:56because it was a 36 on 12 off schedule every other night.

03:00Or I took care of vascular surgery patients,

03:02or I took care of cardiothoracic patients.

03:05We've de-scoped our facilities to the point

03:07that they take care of low acuity

03:09community hospital patients, not trauma patients.

03:12So I would reiterate the point

03:13that you've heard all three of us make.

03:15We need our key hospitals to be level one trauma centers

03:19in partnership with the American College of Surgeons

03:21and the communities in which they're located.

03:23But to do that, we must address the elephant in the room,

03:26and that's resourcing.

03:27The medical inflation rate on average since 1938

03:31is 5.1% per year.

03:33And the military has seen a net 12% reduction in funding.

03:37There is no way to fix these problems

03:40if the military health system is viewed as a bill payer

03:43and not something worth investing in.

03:45The second point that I would make

03:46is we've got to reiterate the intent

03:49that you and the ranking member mentioned.

03:52I spent four years as the joint staff surgeon.

03:55Almost every meeting in which I participated in that role

03:58focused on roles and responsibilities and patches,

04:02not on patients.

04:03Please, again, I implore you,

04:06kill this narrative that somehow there's a belief

04:09that we can unwind things and go back to the good old days.

04:13We need to go forward towards a more integrated system

04:16that focuses on patient care and, as you said,

04:19on readiness, not continuing to focus

04:21on bureaucratic buffoonery.

04:23Dr. Cannon.

04:26Mr. Chairman, it's shocking, astonishing, and awful,

04:30and it has to be reversed.

04:32That 10% number results from inadequate,

04:36actually, grossly inadequate patient numbers, volume.

04:40They're not doing the cases,

04:42they're not doing the procedures,

04:43they're not doing what they were trained to do.

04:45And that's because they don't have the patients

04:47in the facilities.

04:48They're, in many cases,

04:50not designated or verified trauma centers,

04:54so they're scrounging around trying to get cases,

04:56and it's been, frankly, an uphill climb.

04:59So we've got to provide them the patients,

05:01the cases, the experience to write that 10% number.

05:06Thank you very much, gentlemen.

Roger Wicker Asks Experts: Why Have Our Military Surgeon Readiness Rates Dropped?

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