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State of medical care, training healthy again

  • Published
  • By Steve Pivnick
  • 81st Medical Group Public Affairs
KEESLER AFB, MISS --  Brig. Gen. (Dr.) Doug Robb led wide-ranging improvements to patient care since assuming command of the 81st Medical Group and Keesler Medical Center in July 2007.

The medical center continued its monumental recovery from the effects of Hurricane Katrina, increasing numbers and varieties of services.

The medical center -- once the Air Force's second largest -- again provides world-class care to the more than 27,000 currently-enrolled patients.

"We've spent a total of $183 million on past, present and future construction projects," the medical center commander said. "This includes more than $61 million to reconstitute our basement, which began in January 2006, and will be completed in April of this year. Additionally we've spent about $9 million to "move up" our high-value, state-of-the-art medical systems and irreplaceable medical records to upper levels to keep them safe from any future storm-surge damage. This effort, started in October 2006, will be completed this month.

To further protect our infrastructure, we began construction of an $8.6 million central energy plant in September 2007; it is scheduled to be finished this October. In addition, we're building a new radiation therapy center, with ground-breaking scheduled this spring. It should be 'open for business' in August 2009. And finally, we plan a $76.8 million inpatient medical tower to meet Base Realignment and Closure Commission guidelines. We have scheduled construction to start in March 2009, with completion in the summer of 2011."

General Robb stressed Keesler Medical Center's commitment to service.

"Although the staff will not have the same number of providers that we had prior to Katrina, the number of services the medical group can provide will almost equal pre-Katrina levels."

"Due to the loss of certain categories of patients, the Air Staff can no longer justify providing some manning. For example, we will not be able to offer cardio-thoracic surgery and neurosurgery at Keesler. Enrolled patients requiring these services will be sent to other medical facilities in the Tricare network, such as Ocean Springs and Singing River Hospitals and Gulfport's Memorial Hospital."

This brings up other areas the general is extremely excited about -- graduate medical education and the Gulf Coast Consortium.

"Keesler's general surgery and internal medicine residency programs were reaccredited and restarted in the summer of 2006. With a new partnership with the University of Mississippi and the continued return of airmen to Keesler, we expect to restart pediatric and obatetrics and gynecology residents' rotations in the summer of 2009."

In addition to the medical residencies, General Robb noted, "We have restarted the three dental residency programs at Keesler. Advanced education in general dentistry resumed in 2006. The general practice residency restarted in 2007. The third, endodontics, restarted in 2007."

One of the most significant impacts in the post-Katrina era on the "continuum of care" in this area is the Gulf Coast Veterans Affairs/Defense Department Joint Venture. As the result of an extremely close working relationship developed between General Robb and VA Gulf Coast Veterans Health Care System Director Charles Sepich, the two facilities have entered into several sharing agreements.

Among approved Joint Incentive Fund projects for the two medical centers are a joint angio/cardiac catheterization suite and a joint MRI center.

General Robb explained further, "Successful JIF projects are awarded 'seed money' to outfit, equip or staff a clinic or project. After two years, the clinic or project must recapture enough workload that formerly would have gone out to the civilian network to sustain the salaries and other costs associated to operate that clinic or project. The projects must benefit both the DOD and VA parties and support the VA/DOD Joint Strategic Plan. They must improve the quality and access to care for VA and DOD beneficiaries and also demonstrate a positive return on investment as they must be self-sustaining after two years."

The medical group commander stated, "The VA and the Keesler Medical Center have joined as 'Centers of Excellence.' While separate facilities, Mr. Sepich and I decided that we would look at each service we offer at each site and, where appropriate, realign and possibly consolidate services at the stronger site -- thus bringing together the best that both offer. Not all services lend themselves to centers of excellence, but where one facility clearly has the lead in terms of expertise, staffing and equipment and facility arrangement, then we look at creating that as a center of excellence. Women's health at Keesler and sleep studies at the VA are two examples."

The two facilities are cooperating in a number of areas. Under current VA/DOD sharing initiatives, Keesler Medical Center is providing care to VA patients in the inpatient and intensive care units. In addition, several outpatient specialty care services are available to VA patients. These include women's health, reconstructive surgery, neurology, orthopedics and dermatology and its specialized Mohs surgery (a specialized technique for the treatment of skin cancer using frozen sections that permits the highest cure rate possible).

Other sectors Keesler Medical Center affords are residency training, ancillary services (laboratory, pharmacy, diagnostic imaging), the genetics lab, mammography screening and diagnostic workups. Likewise, the VA medical center provides Keesler Medical Center beneficiaries OB/GYN ultrasound computerized tomography services, quality management, audiology, dental services and a sleep studies center of excellence. Future VA-KMC sharing actions include Keesler's genetics lab, cataract surgery and the start-up of Keesler's radiation-oncology center of excellence.

The continuum of care extends beyond the two Biloxi medical centers. Several other medical facilities, reaching from New Orleans to Pensacola, are included, such as two Navy installations in New Orleans, the Gulfport Construction Battalion Center, Naval Hospital Pensacola and VA-Air Force facilities at Eglin and Tyndall AFBs and Hurlburt Field, Fla. Finally, General Robb is especially proud of the role medical group members continue to play in the global war on terror as the second largest deployable Air Force Medical Service platform in the Air Force.

"Even following Katrina -- although on a reduced scale -- our medics deployed worldwide to care for war heroes wounded in the global war on terror," he said. "We take pride in knowing we contribute to the phenomenal success medics from all branches have had in saving lives of military members who, in past conflicts, would not have survived."