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Female Wounded Warriors

I am a proud University of Arkansas alumni. The current issue of the alumni magazine has a short segment on Janet Cater and her work with female wounded warriors. Her research on military women amputees earned her a doctoral degree in rehabilitation counseling.

I did a Google search and was happy to find she has a blog: Female Wounded Warriors Posterous. There were only four entries but they allow an understanding of her research project.

The first one, Institutional Review Board Information (November 10, 2009), lays out the goal:

I am seeking to understand the psychosocial adjustment issues experienced by women veterans who have had a traumatic amputation. I am interested in your life experience.

The second one, Volunteer To Help Future Wounded Women Warriors, presented the goal and method again:

My study seeks to understand the adjustment issues faced by American women warriors who experience a traumatic amputation. At the present time there is no published research. As the number of women warriors returning with physical disabilities increases, it is vital that medical and mental health support staff understand the unique challenges these women face. Over 220,000 female soldiers have been deployed to Iraq and Afghanistan for one or more tours of duty. As of August 2009, a total of 121 women warriors have died, and it is estimated over 620 have received serious injuries. This study will use internet interviews using Skype to understand this life experience. Each woman will be invited to tell her story of how she adjusted to life as an amputee with the assurance of confidentiality. Read more »

*This blog post was originally published at Suture for a Living*

Military Plastic Surgery: Using Liposuction To Make The Weight Cut

The Orange County Register blog posted on military plastic surgery and mentioned liposuction:

Army Times reports that soldiers are turning to liposuction to remove fat if extreme dieting, laxatives and other methods fail to get them under the Army’s weight limit for their height, age and gender.

“Liposuction saved my career. Laxatives and starvation before an [Army Physical Fitness Test] sustains my career,” a soldier told the periodical. “Soldiers are using liposuction, laxatives and starvation to meet height and weight standards. I did, do and still do.”

I am well aware of the military patient looking to stay within military parameters to stay in the service as my San Clemente office is quite close to Camp Pendleton, and I give military discounts. I have seen several of these patients in my decade in San Clemente. Surgery for wives still outnumbers surgery for soldiers, though.

As some of these clients have explained, the Marine administration requires active duty soldiers to have certain measurements at a certain weight. Those who do not fall within these expected norms are first warned and then penalized. Liposuction has worked at times to keep some of these soldiers in the service.

- John Di Saia, M.D.

*This blog post was originally published at Truth in Cosmetic Surgery*

Underwear 2.0: The Military’s Vital-Monitoring Briefs

You just can’t make this stuff up:

The underwear project, spearheaded by the nanoengineering professor, was funded by the U.S. military and its effectiveness will likely be tested on the battlefield.

“This specific project involves monitoring the injury of soldiers during battlefield surgery,” Wang told Reuters. “The goal is to develop minimally invasive sensors that can locate, in the field, and identify the type of injury.”

Ultimately, the waistband sensors will be able to direct the release of drugs to treat the wounded soldier.

I wonder what other creative uses our men in uniform will find for this? I can hear it now: “It’s not the size of the device, honey, it’s the metronome that’s in it!” (Heh.)

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

A Hero In This World: SSG Matthew Kinney, Flight Medic Of The Year

[img20.jpg]Recently SSG Matthew Kinney was named Flight Medic of the Year at the DUSTOFF Association and AMEC Conference for his actions on Oct. 16, 2008, for which he was also awarded the Silver Star.

Wow. Just reading the citation impressed me. There are heroes in this world.

Via Mudville Gazette

*This blog post was originally published at GruntDoc*

What Can We Learn From The Military Health System?

jeffgruenheadshot2Together the Department of Defense and the Department of Veterans Affairs have the largest and most advanced IT infrastructures in US healthcare. As the Obama administration ramps up funding for electronic medical records and other IT initiatives, one might ask what the public and private sectors can learn from the military IT systems (aka AHLTA and VISTA).

I interviewed Dr. Jeff Gruen about the upcoming Military Health Summit at the World Health Care Congress, April 14-16 in Washington, DC.  Jeff is Head of the Global Healthcare Practice at PRTM, a management consulting firm and a Chairman of the Military Health Summit.

You may listen to our conversation by clicking the arrow button, or read a summary of our conversation below.

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Dr. Val: To set the stage, tell me a little bit about the World Health Care Congress, and what the Military Health Summit hopes to achieve.

Dr. Gruen: This is the 6th annual World Healthcare Congress (WHC), and the first year for the Military Health Summit. We expect 1500 to 2000 participants – the WHC is the premiere event for healthcare services and the healthcare system at large. It brings together people from across all sectors of healthcare and in addition to the general summit events we have this exciting Military Health Summit track.

Dr. Val: What does the healthcare system at large have to learn from the military health system?

Dr. Gruen: Three things: first, we can use the military health system as a case study for IT initiatives, since they’ve already achieved broad adoption of an EMR. It’s not perfect, but it’s used widely and is getting better. The DOD and the VA are working hard to make their systems interoperable.  Second, because the military health system is both a payer and a provider, it serves as a wonderful laboratory for inventing new ways of delivering care. Realigning incentives between inpatient and outpatient care or primary and specialty care can be achieved nicely in the military system, which is like a giant, international Kaiser Permanente. Third, the military has developed very advanced battlefield techniques and devices for saving lives – including telemedicine. So it’s fun to hear about these advances.

Dr. Val: How will healthcare reform impact the Military Health System – do you have any predictions based on what you’ve heard on Capitol Hill?

Dr. Gruen: It’s impossible to know exactly, but let me offer a couple of observations. First, there’s a sense of national patriotic commitment to make sure that our service men and women (and their dependents) get the very best care possible. There’s a real desire to apply the best practices from the commercial sector to the military. PRTM feels very passionate about this, especially since one of our own is currently serving in Iraq right now.

There are a few core problems in healthcare, and they all fall under the rubric of “the right care delivered in the right environment by the right provider at the right time.” These problems may be addressed with interventions including providing point of care decision support, tools that would decrease provider practice variation, and connected convergent care – the idea that we have to move from a system that is designed for acute care to one that is very good at managing chronic care. We also need to move to a system where all the data is present in a very transparent way across environments to allow us to apply the same protocols regardless of whether someone’s in the hospital, or at home, or in a nursing home.  The military health system could get these systems in place in a faster and broader way than the general healthcare system.

Dr. Val: Who should attend the Military Health Summit? How do they register?

Dr. Gruen: Those who should attend include: 1) People actively involved in the Military Health system because it offers an opportunity to interact with their luminaries. 2) Anyone on the commercial side of healthcare who’d like to do work with the military 3) Anyone who is interested in health reform 4) People with a particular interest in health IT (disease management and telemedicine in particular) 5) Anyone who wants to hear about the coolest new things coming out of battlefield medicine.

To register, one need only go to the World Health Care Congress website and follow the prompts for the Military Health Summit.

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