Deputy SG talks about change,
future of AF medicine

Maj. Gen. (Dr.) James G. Roudebush

By 1st Lt. John Severns
55th Wing Public Affairs

OFFUTT AIR FORCE BASE, Neb. -- Reshaping the medical career fields as lean, efficient tools for providing 21st century healthcare was the focus of the United States Air Force deputy surgeon general during an interview in early May.

Maj. Gen. (Dr.) James G. Roudebush, who was at Offutt for the 2006 NOVA conference, an annual gathering of senior leaders in the Air Force medical career fields, also spoke about practicing medicine in a deployed environment, and the use of partnerships to improve healthcare at home.

But the main topic of discussion at the conference, according to the general, was the Air Force Smart Operations 21 program. AFSO21 is being used by the Air Force to streamline operations through process changes to improve efficiency and reduce waste.

"The path to Smart Operations that the secretary and the chief of staff have put us on is both necessary and very useful," the general said.

"As medics, these Smart Ops will make us effective in supporting both the Air Force expeditionary mission and the joint mission. Using process analysis and lean thinking will be essential in making sure that we're relevant to the mission today and tomorrow."

The effects of Smart Operations will be visible over the coming years to both patients and the medics themselves, the general said. Patients will notice the change in the improved healthcare they will be receiving no matter where they are, be it as a warfighter in Iraq or at home in the United States.

For medics, the changes will be more profound. AFSO21 will allow them to better perform the mission they've been assigned, while walking unnecessary work out the door, the general said.

In the field

Another topic the general discussed was deployed medicine. He noted that the Global War on Terror and Operation Iraqi Freedom resulted in several major medical undertakings, including the stand-up of the largest theater hospital since the Vietnam War at Balad AB, Iraq, and the use of a reengineered aeromedical evacuation to transport wounded service members from Iraq to treatment centers in Germany and the United States.

"The medical mission in Iraq is truly a Total Force and joint mission," General Roudebush said. "We are blessed by a reserve force that has been a wonderful partner in the aerovac arena, which allows us to recover wounded service members and safely bring them home.

"In some cases we are able to take a recently resuscitated patient and put them in the aerovac system and actually improve their condition on the way to their next destination," he continued.

The general referred to testimony by Secretary of the Air Force Michel Wynne to the U.S. Senate, where he stated that one of the miracles of the Iraq conflict is the aeromedical process that sees patients from the front lines to Germany and then back to Walter Reed medical center in just a few days.

The general also noted many of the Air Force's deployed medical capabilities found use in the United States during the response to Hurricane Katrina in New Orleans and Hurricane Rita in Florida.

"It was Air Force medical capabilities being leveraged by our ability to rapidly deploy that put us into the New Orleans airport, which let us process and triage literally thousands of patients and move them where they needed to go in relatively short order," he said.

Changes at home

The general also discussed a topic familiar to many members of Team Offutt - the relocation of medical resources around the Air Force to position them where they are most effective. In 2005, this reapportionment resulted in the Erhling Bergquist Hospital converting to a clinic.

The reason such a conversion can take place without impacting patient care, according to Roudebush, is the existence of a robust network of partnerships between the 55th Medical Group and the local network of medical providers.

"I'm a Nebraska native," the general said. "I was educated at the University of Nebraska in Lincoln and the University of Nebraska College of Medicine here in Omaha. So I am very familiar with the University of Nebraska and Creighton" and the medical capabilities they have, he said.

Those medical capabilities, he said, are part of a larger relationship with local providers throughout the area. That relationship has enabled the 55th Medical Group to provide effective and efficient care to the entire beneficiary population.

The partnership also provides residency opportunities that benefit members of the Air Force family, according to the general.

"The partnership with the University of Nebraska gives us an opportunity to participate with and leverage one of the leading family practice programs in the country, and to be a part of their focus on rural medicine," he said.

"Rural medicine is a very hands-on, procedurally-oriented approach that really prepares our folks to take care of our Air Force members both at home and while deployed. It's a practical, thorough approach that sets our medics up to do well no matter where they may find themselves practicing medicine."

EDITOR'S NOTE: Since this article was published, the Senate has confirmed General Roudebush as the next AF surgeon general. See related article in this issue.