Labor Day is unique among Federal holidays in that it doesn’t honor a historical event or a person or a people, but rather, an activity: work, or, the struggles of work. The holiday was borne out of a recognition of the struggles of the American worker at the height of the Industrial Revolution.
This year, Labor Day reminds me of work that was hardly recognized in the late 19th century: the solemn work of caring for and saving lives. In the midst of the continuing COVID-19 pandemic, I am intensely aware of the work you do and the physical and mental exhaustion many health care workers are experiencing. I am deeply appreciative of the labors and sacrifices each and every one of you make in order to provide world-class care to our Service members, retirees, their families, and to the Nation.
We did not expect that this pandemic would rage on for as long as it has, with an end not quite in sight thanks to the Delta variant, and many not accepting the gift that are the COVID-19 vaccines. Our nation has called upon you again: to fully vaccinate our Service member population, to treat the influx of COVID-19 patients, to surge to hotspots around the country to ease overburdened local healthcare facilities, and to bring forward and care for tens of thousands of Afghans in their new home, our United States of America.
Countless healthcare workers are burned out and leaving the workforce. Their labor, our labor, is often thankless and heartbreaking, causing them to step away. Not so for the Military Health System.
We continue to call upon you, to ask for your tireless effort. Know that it is deeply appreciated by the Secretary, Deputy Secretary, the Chairman and all our other senior leaders. For those of you working this weekend: thank you. For those of you who are not, I hope this holiday brings you some rest and time for reflection.
Your labor has saved and will continue to save many lives. Our nation is grateful and healthier for it. Please let me know how I can support you as we continue our shared work.
Terry Adirim, M.D., M.P.H., M.B.A.
Acting Assistant Secretary of Defense for Health Affairs
Department of Defense
As events continue to unfold in Afghanistan, I want to take a moment to acknowledge your tremendous service and sacrifice over the past two decades. I know the challenges of the past week have impacted many of you on a personal level.
When called, you served with honor, courage, and commitment, and represented the very best of our Military Health System. You never failed in support of our combatant commands around the world, always serving with distinction, and despite what may have felt like insurmountable challenges.
You should be incredibly proud of all that you’ve accomplished. As medical professionals, your success is largely measured in human terms, by the countless lives you saved and the many more that you touched. It’s a legacy that will be felt for generations to come by your fellow service members, your civilian partners, as well as the people of Afghanistan.
As you’re reading this, I also know that service to mission remains top of mind. Our colleagues are working around the clock to provide care to the Afghanistan people being evacuated by the U.S. military. Thank you for all that you continue to bring to these critical efforts.
Finally, in the days and weeks ahead, be good to yourselves. The physical and emotional toll of this work is heavy. Please take the time to get any help you may need. Our resources are here for you as well.
On behalf of your MHS colleagues, thank you again for representing the very best of us and job well done.
Terry Adirim, M.D., M.P.H., M.B.A.
Acting Assistant Secretary of Defense for Health Affairs
Office of the Assistant Secretary of Defense – Health Affairs
Department of Defense
Here are all the Memorial Day messages from our senior leadership:
Assistant SECDEF for Health Affairs
This Memorial Day weekend represents both sadness and hope. We recognize the service of our fallen heroes, those who have made the ultimate sacrifice in defense of our nation. This solemn remembrance comes on the heels of another type of war, the fight against COVID-19, which has taken the lives of service members and millions of others. Thankfully, we have made incredible progress against COVID-19, and much of the nation is beginning to return to normal.
That return to all the activities and events we have put on hold for so long comes with great risk if we don’t continue to exercise good judgement and keep safety top-of-mind. For that reason, I ask that you be mindful of your actions and take appropriate safety measures to protect yourselves and your loved ones from injury, illness and COVID-19. If you have teammates who may be alone or feeling isolated, please reach out to them, and make sure they’re taking care of themselves.
I know the last fifteen months have been trying and difficult for all of us. It’s why the vaccination campaign has been so important. It will save more lives and protect us, our friends, and family against hospitalization and death. It has enabled us to get back to normal. So, please consider getting vaccinated if you haven’t yet. They are widely available, they are safe, and as a doctor, I have the utmost confidence in each of the vaccines.
Thank you again for all your hard work, for helping the Military Health System fulfill its mission, for protecting our Department and our nation against COVID-19, and for ensuring we all have a bit less to mourn and remember.
I hope you all have a safe, restful and reflective Memorial Day.
Terry Adirim, M.D., M.P.H., M.B.A.
Acting Assistant Secretary of Defense for Health Affairs Office of the Assistant Secretary of Defense – Health Affairs Department of Defense
This weekend, our nation pauses to remember all military personnel who have died while serving our Armed Forces. Their sacrifice is a true testament of selflessness. Before embarking on this long holiday weekend, let us reflect on why Monday is a federal holiday and a day off for many of us. The Old Farmer’s Almanac captures how and why we as a nation celebrate Memorial Day:
“The custom of honoring ancestors by cleaning cemeteries and decorating graves is an ancient and worldwide tradition, but the specific origin of Memorial Day-or Decoration Day, as it was first known-is unclear. In early rural America, this duty was performed usually in late summer and was an occasion for family reunions and picnics. After the Civil War, America’s need for a secular, patriotic ceremony to honor its military dead became prominent, as monuments to fallen soldiers were erected and dedicated, and ceremonies centering on the decoration of soldiers’ graves were held in towns and cities throughout the nation. After World War I, the day expanded to honor those who have died in all American wars.”
As we pause and give thanks to those who have gone before us, and gave their life to support the cause of freedom that we enjoy today, I am excited to share that Navy Medicine reached a significant milestone this past Tuesday when NMRTC Camp Lejeune administered the one-millionth vaccine across our Navy and Marine Corps sites. This milestone demonstrates the hard work, resilience, and dedication of our One Navy Medicine Team. Since the start of vaccination operations, more than 60% of Naval personnel have received at least one dose and more than 50% tare fully immunized. Thank you for rolling up your sleeve and contributing to our defense against this virus.
COVID continues to be a force readiness issue and there is no better protection for our people, their families, or communities than getting vaccinated. For those that have not vaccinated, I ask that you pause and reflect on the dedication of those who have come before us and then reconsider your reservations. Rededicating yourself to the health and protection of yourself and those you serve with is one great way to honor their sacrifice. In the words of President John F. Kennedy, “As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.”
Thank you for all you continue to do to take care of our Sailors, Marines, and their families. I am humbled and honored to work with you, the incredible Navy Medicine professionals who ensure our warfighters are ready, healthy, and mission-ready.
With my continued respect and admiration,
Bruce L. Gillingham, MD, CPE, FAOA
RADM, MC, USN
Surgeon General, U.S. Navy
Chief, Bureau of Medicine and Surgery
Defense Health Agency
The freedoms we enjoy in this country were not given but earned – generation after generation – through the courage of many Americans who took great risks, who fought for a cause in which they believed, who put service above self. As a nation, we ask our men and women in uniform to be prepared to make these sacrifices every day. Sometimes, that sacrifice is borne by a family in mourning, creating an irreplaceable void in lives, and acknowledged by a carefully folded flag handed down with reverence. This coming Monday is Memorial Day, a time set aside to honor and remember those military members who gave what Abraham Lincoln described as “their last full measure of devotion.”
To the families and friends of those who have lost loved ones, thank you. Many of us will all be setting aside time this weekend, thinking of you, and praying for you. To our medical professionals who have been there to witness service members take their last breath, thank you for being there and giving your all.
This Memorial Day weekend is accompanied by signs of hope and recovery from the pandemic that has changed our lives. As we get vaccinated, we’re looking forward to family gatherings, sporting events, vacations, and other freedoms some of us previously took for granted. We have a range of emotions, including a little worry and perhaps a lot of excitement!
It’s important that we don’t forget the fundamentals as we venture outside. Stay hydrated, use sunblock, remember common-sense safety tips in the water activities, and be mindful of the potential dangers of alcohol. If you’re jumping in the car, make sure it’s service is up to date, and pay extra attention to the other drivers who might not be paying attention to you. This is the time of year when motorcycles are out in force and most fatal motorcycle accidents happen because motorists don’t see them. The DHA is kicking off our summer safety campaign and there are many resources to help you have a safe and happy summer. To see some of the summer safety resources, visit https://www.health.mil/Military-Health-Topics/Total-Force-Fitness/Environmental-Fitness/Summer-Safety .
And while we can see a future where the pandemic is officially declared over, we aren’t there yet. The best protection is vaccination. But, depending on your location and vaccination status, modified masking and physical distancing guidance still apply. Let’s stay on track to defeat COVID.
I wish all of you a safe and peaceful Memorial Day.
Ronald J. Place, MD
LTG, US Army
Director, Defense Health Agency
Military Health System Colleagues,
My name is Terry Adirim and I am the new Acting Assistant Secretary of Defense for Health Affairs. It is an honor and a privilege to be back among you. Many of you know me from my time as the Acting Principal Deputy Assistant Secretary and as a Deputy Assistant Secretary. I’m honored to be back and see so many familiar faces. For those who may not know me, I am a physician and a scientist, data driven but people focused. I pledge to bring that ethos to my work as a Military Health System leader.
I returned to Health Affairs because my time here was the best job I ever had. We are a mission driven organization that cannot fail because we serve our Nation’s service members, their loved ones, and the entire DoD family.
The Department is a vital force in supporting the national COVID-19 response and the roll out of the vaccine. I commend your steadfast approach to our response to COVID-19 and your dedication to our service members and their families. Continuing these efforts and ensuring that our troops, their families, and DoD personnel are vaccinated rapidly so we can defeat COVID-19, is my top priority. Thanks to your dedication, the end is within sight.
You are also shepherding and managing a tremendous healthcare transformation. We are making significant progress in this massive undertaking. The end result will be better healthcare for our beneficiaries and improved training opportunities for our uniformed medical providers. As we continue this transformation, I will do my best to smooth the way.
Finally, what drew me back to Health Affairs was its supportive, inclusive, and result driven culture that prioritizes service member and family readiness. Under my leadership, this organization will continue to focus on diversity, equity, and inclusion, because that’s the kind of culture that yields the best results for our service members, their families, and retirees.
I look forward to reengaging with many of you and meeting new faces. I am here to support you, so please reach out to me whenever you need me.
Terry Adirim, M.D., M.P.H., M.B.A.
Acting Assistant Secretary of Defense
for Health Affairs
Office of the Assistant Secretary of Defense – Health Affairs
Department of Defense
As I wind down my last day with the Department, I want to thank everyone throughout the Military Health System (MHS) for the distinct privilege of working with you these past three and a half years. I am grateful for all you do day-in and day-out to support the MHS and advance its mission to ensure the U.S. Military deploys a “Ready Medical Force” and a “Medically Ready Force”. Each day I have watched so many do whatever it takes to complete that mission and to do so with passion, honor, integrity, and an extraordinary work ethic.
Together, we have accomplished incredible things while experiencing the most transformational changes the system has seen in over 30 years. We launched the deployment of a truly enterprise-wide electronic health record. We began execution of the plan to completely overhaul the manner by which DoD operates and manages its hospitals, outpatient facilities, and dental clinics. And, during these past 11 months, we have effectively and quickly marshalled the enormous assets of the MHS to support the Department’s and the Nation’s efforts to combat the COVID-19 pandemic.
I am deeply proud of all that you have accomplished and am truly honored to have been given the opportunity to be part of your MHS team. My time with the Department and with the MHS has been the most fulfilling of my professional life, and I am grateful to each of you for that. Thank you for your service to the MHS, to the Department, and to our Nation, and thank you for the privilege of allowing me to serve with you. I wish you all the best for 2021 and beyond!
Assistant Secretary of Defense for Health Affairs
1200 Defense Pentagon
Washington, D.C. 20301
Every year on November 11, we pause to show our admiration and appreciation to our veterans — both living and deceased — for their bravery, loyalty, and sacrifice. Many veterans walk among us, as colleagues and friends, as partners in bringing world-class health care to our nation’s veterans, service members, and their families. Thank you once again for taking the time to celebrate them and to thank them for their service. November is also Warrior Care Month, a time to contemplate the perseverance and strength of our wounded and injured service members. I met some of these amazing men and women, and the people that care for them, when I visited the Center for the Intrepid in San Antonio. As you know, caring for these service members is a top priority for the DoD. The resources available for our wounded warriors goes far beyond their immediate health needs. From adaptive sports to education and employment resources, there are many ways that we support these wounded, injured, and ill service members.
Our mission requires an array of dedicated men and women at the top of their profession. This month, Dr. David Smith, Deputy Assistant Secretary of Defense for Health Readiness Policy and Oversight, was named Healthcare Government Executive of the Year at the Pinnacle Awards, an annual program that highlights successful executives and businesses saving money and fostering innovation across the DC region. Dr. Smith spearheaded DOD’s change management effort to reform the Military Health System (MHS) developing 11 comprehensive initiatives resulting in sustained improvements in readiness, patient outcomes, and taxpayer savings of over $1 billion in 2019 alone. I would like to give a shout out to the MHS Communications Team for winning two awards at last month’s Public Relations Society of America virtual awards ceremony.
The 2019 Infectious Disease and Summer Safety Campaign called “Bug Week” received the Silver Anvil in the category Events and Observances, and the team also received a runner up Award of Excellence for their content marketing program. The Silver Anvil is recognized as the Oscar in the Public Relations career field. This is the second straight year the MHS has received a Silver Anvil. Congratulations to the entire communications team for this great achievement. As you know, each year on the 4th Thursday in November, Americans take a collective breath to celebrate the blessings of the last year. While 2020 has been a challenging year for all of us, much occurred that reminded us how grateful we should be, especially the dedication of our nation’s health care workers and our MHS colleagues who have passionately supported the nationwide response to COVID-19. As we pause to celebrate on November 26th, I sincerely hope that your table will be filled with loved ones, whether in person or virtually, and filled with gratitude for our many blessings in this trying year.
Finally, please see attached, my November Monthly Newsletter:
Here is the message from the ASD(HA):
As you know, we have been on a temporary pause in our implementation plan to transition the administration and management of military medical treatment facilities from the Military Departments to the Defense Health Agency. Yesterday, the Secretary lifted this pause and directed that we continue implementation of the transition in accordance with Section 702 of the FY2017 National Defense Authorization Act. Attached you will find yesterday’s guidance from the Secretary (note that I did not attach this as I was uncomfortable putting a SECDEF memo on a blog, but you can see it here if you have a CAC reader and can log onto MilSuite).
I am confident we will achieve this important Military Health System milestone through collaboration between the DHA and the Military Departments with a continued focus on sustaining a ready medical force and a medically ready force while supporting our 9.6 million beneficiaries across the globe.
Here is the message from DHA:
This week we received guidance from both the Secretary of Defense and the Assistant Secretary of Defense for Health Affairs to resume the transition of MTF administration and management from the Military Departments (MILDEPs) to the DHA in support of our implementation plan. Paraphrasing the Secretary, he charged DHA with three priorities: ensuring the delivery of high-quality health care, utilize the MTFs as much as possible for readiness workload, and ensuring the medical readiness of the force. We must work collaboratively with our colleagues in the Services to implement a smooth and successful transition while ensuring safe, high-quality care for our 9.6 million beneficiaries. You can read the complete memorandum from the Secretary of Defense here:
Over the past month, our Military and the Nation has continued to respond and meet the unique challenges presented during the COVID-19 pandemic. The Military Health System (MHS) has been central to this effort in numerous ways, both as an organization and through individual accomplishments. And while supporting the pandemic response we also have continued to advance an array of other MHS initiatives. Updates on a few of these efforts include:
MHS GENESIS Go-Live. The rollout of MHS GENESIS continues to make enormous strides leveraging lessons learned from the previous execution of the Initial Operational Capability sites on the West Coast and Wave Travis. On September 26, 2020, the Nellis Wave went live at the following bases: Beale AFB, Edwards AFB, Los Angeles AFB, Nellis AFB, Vandenberg AFB, Fort Irwin Army Base, and the United States Marine Corps Air Ground Combat Center. The volume of WAVE Nellis requirements was two times the size of any previous roll out. Leadership at each facility reported no show stoppers and provided positive feedback. Lessons learned from previous sites were instrumental to a seamless release and resulted in a significantly reduced number of initial trouble tickets requiring action. The next deployment will be WAVE Pendleton and the “Go-Live” is 31 October.
National Influenza Vaccine Modernization Strategy (NIVMS). To help ensure we are prepared to address the impacts of seasonal and pandemic influenza viruses, DoD and HHS co-hosted a series of stakeholder listening sessions. I had the chance to provide a welcome video for those attending these virtual sessions. This effort is a collaboration among industry, academia and government to support the strategy released 8 June to implement the Executive Order to modernize the flu vaccine and promote national security and public health. Exciting advances will most certainly result from this enlightened collaboration. We discussed the role of federal and non-federal partners in NIVMS, and solicited feedback and viewpoints from external stakeholders. I’d like to thank COL Jennifer Kishimori, Director, CBRN Medical Countermeasures Policy of Health Readiness Policy and Oversight in Health Affairs, for representing the Department during this effort. Anything we can do to increase the effectiveness of flu vaccine development and distribution will improve military readiness and capability.
Speaking of the flu vaccine, we are in the beginning of the 2020-21 flu season. Flu vaccination will help reduce the overall impact of respiratory illnesses on the population and decrease the burden on the health care system during the COVID-19 pandemic. We encourage all of you to get the flu vaccine. Beneficiaries can also get a flu vaccine at no cost by visiting a TRICARE participating network pharmacy. Visit www.tricare.mil/flu to learn about TRICARE coverage and the flu vaccine.
COVID Convalescent Plasma: At the onset of the pandemic, the DoD developed a convalescent plasma (CCP) collection strategy to ensure we were able to independently support advanced COVID-19 illness within the force. We were charged by the Secretary of Defense to collect 10,000 units by September 30, 2020. Thanks to our dedicated Service members, their families, and our beneficiaries, we exceeded our 10,000 unit goal by collecting 10,745 units by the close of the fiscal year. Critical research continues to study the science on the impact of CCP on moderately and critically ill patients and how the DoD can protect our operational forces with the availability of CCP for use in remote locations. Thank you to everyone that made this possible, especially those working with COL Audra Taylor in the Armed Services Blood Program.
AMSUS Update: We are working with AMSUS representatives to support this year’s virtual conference by planning to highlight the MHS pandemic response through participation in the plenary session and breakout presentations. The conference will occur virtually 6 – 10 December, and the MHS Plenary will be held on 8 December. We are excited to announce that Deputy Secretary of Defense HON David Norquist and Dr. Matt Hepburn, JPEO CBRN and SME on vaccines for Operation Warp Speed will both be speaking during the plenary. Please save the date!
Women’s Reproductive Health Survey: The DoD Women’s Reproductive Health Survey is available for female active-duty Service members. The survey assesses reproductive health and well-being and examines behaviors and experiences that may impact readiness. The survey is voluntary, confidential and .anonymous and takes about 15 minutes. Participation is by invitation only, so if you were invited to participation please take a few minutes to complete this important assessment. The results will be used to improve policies, programs and services. This is the first time in nearly 30 years that a DoD-wide study of only female service members’ experiences has been completed. Some service members may have seen some of these questions on other surveys in the past. But because those studies were of limited groups of women, and because of confidentiality protections, that information cannot be used to provide a complete picture of service women’s experiences, reproductive health and well-being. Please visit the site before 3 November and use your military email to determine your eligibility to participate: https://dodwomenshealth.com.
National Physician Assistant’s (PA) Week. The US Military played a critical role in the development of the PA profession. The vision of Dr. Eugene Stead Jr, a doctor who served in WWII, to solve a growing shortage of primary care providers in the 1960’s led to the launch of the profession. The first graduating PA class, created at Duke University in 1967, consisted of three former US Navy corpsmen. I had the opportunity to visit the Fort Belvoir Community Hospital to celebrate National PA Week and personally thank the 14 PA’s assigned to the hospital and recognize all active duty, reserve, civil service and contractor PAs serving our military, their dependents, and all beneficiaries. Thank you to CAPT Cynthia Judy, Director of FBCH and CAPT Saira Aslam, Chief of Staff of FBCH, and their incredible staff for their hospitality in giving me a chance to highlight the remarkable work of our amazing MHS corps of PAs.
MHS STAFF IN THE SPOTLIGHT
On 15 October, during a Health Affairs Town Hall, I had the honor to present the Secretary of Defense Medal for Meritorious Civilian Service to Dr. Mark A. Hamilton, recognizing his exceptional leadership, invaluable contributions, and extraordinary performance across the MHS as Health System Transformation Office, Chief of Staff, for the Office of the Assistant Secretary of Defense for Health Affairs from October 2017 until October 2019. Well done, Dr. Hamilton!
COL(Ret)/Dr. Paul Pasquina, Professor and Chair of the Department of Physical Medicine & Rehabilitation (PM&R) at the Uniformed Services University of the Health Sciences, is the 2020 recipient of the AMSUS Lifetime Achievement Award. Congratulations Dr. Pasquina!
As we head into the final weeks of 2020, I want to say how proud I am of this remarkable team and all we have accomplished together, especially amidst the challenges faced operating in a Covid-19 environment. Thanks for all you do for the Military Health System and those we serve.