Airman Spotlight: An Air Force physician’s experience amidst COVID-19, squadron reorganization & working on the flight line Published April 29, 2020 Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- To say these are unprecedented times is an understatement. Air Force Medicine was already in the midst of several organizational reforms when COVID-19 was declared a pandemic. All medics across the force quickly pivoted to what is now called the “new abnormal.” Airman Spotlight: An Air Force physician’s experience amidst COVID-19, squadron reorganization & working on the flight line To keep the Air Force a ready fighting force, providers like Capt. Michael Ferraro, a family physician at Holloman Air Force Base, New Mexico, are contributing in unique ways. Ferraro spoke with Air Force Surgeon General Public Affairs and shared his perspective on current events and reforms revolutionizing the Air Force Medical Service. (U.S. Air Force graphic) Photo Details / Download Hi-Res 1. What are you and your team doing in response to COVID-19? At the 49th Medical Group, I am a clinical team lead directing personal protective equipment policy. We also developed a drive-through clinic and screening process for patients, establishing protocols for restriction of movement and testing. I also work with a strategy team developing innovative solutions for COVID-19 mitigation and response. We are building on established relationships and processes across the base to take care of every single Airman in a timely manner. One member of the strategy team developed a computer model to track interactions and identify potentially high-risk locations or individuals. We are sharing this data with the public health team and providing recommendations to the wing commander. This is just one example of ‘thinking without the box’ we relying upon to keep Airmen safe. 2. How has the Operational Medical Readiness Squadron initiative, physicians assigned to a dedicated squadron for active duty Airmen, proven successful? When we consider second, third or fourth level details as far as disease trends or understanding what is going on in a particular unit, all of that was challenging to see and understand because our focus wasn’t on the unit 100% of the time. All of this is now completely in focus in our new model. A good example of this was during sick calls this past winter. We had a sudden uptick in gastrointestinal illnesses one day. In the old squadron model, these acute visits would have been broken up across providers throughout the day and we would have never talked about it. Because we were all focused on our active duty patients, we noticed many were experiencing similar symptoms. We got together and contacted the public health team. Ultimately, the findings were reported the same morning we were seeing the patients, and we were able to respond quickly and resolve the issue. 3. What is “Airman Medical Readiness Optimization” and how does it improve readiness? Airman Medical Readiness Optimization improves readiness by providing a big-picture view of a unit’s health. It identifies health trends and opportunities for intentional care. AMRO has allowed us to do a number of things. First, it gives primary care managers dedicated time to get out of the clinic and interact directly with Airmen. Having that time set aside addresses the challenge of working around schedules to better support those Airmen and address their needs. It also allows us to reach out and work with other units within the medical group, like bioenvironmental engineers and public health. Working with the BEEs has been an eye-opening experience. Recently, I went out to the flight line with the BEEs, so it was a dual-hatted visit. We were able to see exactly what environmental exposures they were testing and the list of hazards that they are looking for to ensure Airmen don’t approach critical levels. Knowing specifically what a unit is exposed to helps me understand the unit and its needs better. Seeing Airmen’s work environments has changed my thought processes about potential causes of conditions and injuries. Another benefit of AMRO is having more time to review all of the patient profiles. We review those bi-weekly, which keeps us on top of monitoring patients. It also allows us to look for trends. For example, we noticed a subjectively higher number of asthma cases in one unit. That took time to find the clues to put the pieces together. We presented the information to the commander to better understand if there is something specific to that unit, its mission or environment that could contribute to these cases, so that we could get ahead of it as early as possible. Without that dedicated time, we wouldn’t have been able to identify that level of detail. AMRO is helpful in figuring out trends, which then helps us identify root causes and work towards prevention of major injury or illness. If there is something that could negatively impact our Airmen, we can advocate for changes to safeguard their health and readiness. Getting out to our units and understanding what everyone does is a huge win. 4. Can you share a memorable moment in your career? One of the coolest things for me was becoming more familiar with the F-16. As an osteopath, I conduct a neck and back clinic for pilots to do maintenance and preventative care. The clinic helps mitigate the strain that years of flying has on the body. Pilots are under high stress and the conditions they work in are equivalent to a high performance athlete. To see and feel what they actually go through really helped me be a better osteopath. It was eye opening to realize what they go through four times a week. 5. What advice do you have for other medical squadron leaders? Go experience your installation’s operational missions. Get out to where your Airmen work and learn about them and their needs. Doing this will help you improve your understanding about injuries and other pathologies you are seeing. This has been especially important in response to the current pandemic. Our medical group was already familiar with the different squadron commanders, the different parts of the wing and their mission. We leveraged those relationships and the ‘there is no box’ thinking to keep the mission going while keeping our members as safe as possible.