Operation Just Cause... ...for as long as it takes
American Forces Press Service
FORT IRWIN, Calif. -- Hot. Dry. Dusty. Remote. "Halfway betweenHollywood and Hell," a soldier sitting on a curb outside thevisitors quarters muttered as she took a swig from a sweatingcola can in the meager shade of a scraggly tree.
If the Army's National Training Center comprises mostly hundredsof square miles of desert and mountains with not muchvegetation, the main post is a green and inviting oasis of neatbuildings and well-manicured lawns. It's here the soldiersreturn from field training, where they shop, eat and get their medical care. Some of them live here, although housing islimited and most married soldiers find homes off post -- quite adistance off post, considering it's at least 40 miles by car tothe nearest community.
Housing's a point of contention, but what can you do? You haveto go where the housing is and for most, that's in Victorvilleor Barstow, the nearest communities. Health care used to be one of the most contentious things aboutdesert life for these soldiers and their families. BeforeTRICARE, the DoD managed health care plan, arrived four yearsago, emergency and specialty care often involved extended traveland time away from home and work. It meant spending money forbaby sitters, hotels, gas and other necessities some of theyounger families couldn't really afford but had to, anyway.
But TRICARE came, and things changed. They got -- and keepgetting -- better. So much better that a 1998 patient surveyrevealed a 97 percent satisfaction rate with health care, 20points higher than the year before.
Today, a network of civilian primary and specialty health carecomplements the care given at the Weed Army Community Hospital,here. Instead of having to send people as far away as WalterReed Army Medical Center in Washington, the hospital supplementsits in-house care with civilian medical services available inSouthern California. That means less time away from jobs andhomes, a plus for families and commanders.
"Our current plan of health care at Fort Irwin and in the surrounding community has enhanced the readiness of soldiers,"said Brig. Gen. William G. Webster Jr., National Training Centercommander. "Our soldiers and their families know that ifsomething goes wrong, they will be taken care of.
"In October 1996, things went terribly wrong for Dian Bower.Doctors found cancer in her brain and scheduled her for surgery.She survived the surgery, but cancerous cells remained, and herArmy doctors referred her to a neurology clinic in Los Angeles.There, while she got the health care that would eventually freeher of the murderous cancer cells, the TRICARE Service Centertook care of her bills and helped her get around the congestedcity.
Bower wonders whether she'd be alive today without the benefitsof TRICARE. She knows she would have gotten expert care backEast at Walter Reed, but she's grateful she could remain nearhome, family and friends. "I firmly believe that I would not be here today if it were notfor the quick and correct response my primary care manager gaveme and the assistance TRICARE provided," said Bower, who recently moved to Oklahoma. "I'm thankful they took such goodcare of me. "Meeting patient needs is Army Dr. (Col.) Michael McCaffrey'shighest priority as commander of the Fort Irwin hospital.McCaffrey brought to the job a philosophy developed after yearsof private practice. "If the customer doesn't come through thedoor, you don't make any money," he said.
Although the Army hospital isn't in the health care business tomake money, McCaffrey saw that a large portion of his patientpopulation -- family members and retirees -- had health carechoices. They didn't have to enroll in TRICARE. But hospital capabilities, including equipment and staffing, are based on thenumber of patients they treat. So, to bring in as many familymember and retiree patients as he can, McCaffrey gave themappointments on the same day they call (or when it's convenientfor them) and made sure they see the same providers as much as possible.McCaffrey also responded to military readiness needs, reducingthe time soldiers spend at sick call from a half-day or longerto no more than an hour or two. Weed doesn't really have sickcall anymore; soldiers are enrolled with a primary care managerand receive short-notice appointments when they're feeling ill.
TRICARE also has brought more preventive medicine programs tothe fort, a move Webster said has made his troops healthier thanever. The center commander said soldiers score an average of 250out of a possible score of 300 on the annual Army physicalfitness test, and there appears to be less smoking and drinkingthan in the general population.
"Preventive maintenance in the medical area is paying greatdividends," Webster said.
In her role as "mayor" of family housing, Carol Reynolds alsohears good things about medical care at Fort Irwin. She said McCaffrey and his staff want to know about problems that surfaceand are quick to remedy them.
But Reynolds' experience with Weed is also personal. The wife ofan active-duty officer and mother of two children, she and herson, Robert, suffer from asthma and environmental allergies.Most important to her is seeing the same doctor -- they do --and not being treated as a number. They aren't.
"This has been a very favorable experience," she said of thehealth care at Fort Irwin. "The doctors don't mind talking withme, giving me literature. They want me to be informed, so I cantake an active role in my son's care.
"She likes being able to use the health care hot line here to getadvice any time of the day or night. "It doesn't matter whetherit's a cold or an emergency," she said. "The [on-call primarycare manager] will call you back quickly.
"Well-traveled as an Army wife, Reynolds has seen TRICARE'simpact here and at other bases. She likes recent changes to thesystem that allow members of TRICARE Prime, the plan's healthmaintenance option, to transfer from one region to anotherwithout having to dis-enroll at the old location and re-enrollat the new one. And she likes the improved relationships betweenpatients and their physicians.
"Doctors in the Army have become more aware of their patients,"she said.
"The primary care managers get to know their patients," Webster affirmed. "Our soldiers spend 14 days of every month in thefield. They know their doctors and know that their families willbe taken care of."
By Douglas J. Gillert
Sent in by Veterans News and Information Services
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