Achieving Medical Currency via Selected Staff Integration in Civilian and Veterans Administration Medical Facilities

In Operations Iraqi and Enduring Freedom (OIF/OEF), the Air Force Medical Service (AFMS) has contributed to the lowest died of wounds rate in history. The demise of the Soviet Union led the Department of Defense to reduce the military size and budget. In the process, the AFMS military treatment facility (MTF) inventory was cut 31 percent leaving 75 MTFs (four medical centers and ten hospitals). The in-patient capacity was slashed from 6,000 to less than 1,000 beds. Concomitantly rising medical costs prompted civilian and military medical systems to adopt managed care tactics and create Tricare. Tricare was designed to out-source medical treatment of dependents and retirees into civilian networks and allow AFMS staff to focus on active duty members and the readiness/wartime mission. The unintended consequences of these changes were to dramatically reduce the patient volume and complexity to which Air Force (AF) surgeons and medical specialist were exposed.

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