DOD’s Top Doc Outlines Medical Advances

By Terri Moon Cronk

American Forces Press Service

WASHINGTON, Mar. 6, 2014 – The Defense Department’s top doctor says the innovations and technology in military medicine derived from more than a decade of war in Iraq and Afghanistan have led to advances in caring for the sick and injured.

Dr. Jonathan Woodson, assistant secretary of defense for health affairs, told the Reserve Officer Association yesterday that in addition to the significant strides made in medical technology, other improvements in the military’s health care system such as a “data-driven, high-learning system that constantly improves and innovates,” have also made significant strides.

During the decade of war, medical data was “mined” from combat casualty care, which quickly transformed into strategies for well-functioning standards in military medicine, Woodson said.

The transformation from medical practices in a noncombat environment to working in theater with Army, Navy and Air Force medical personnel created more adaptive and agile military medicine, he said, noting that wars historically have been medical learning experiences.

The latest in combat trauma care, for example, begins at a service member’s point of injury with sophisticated care from well-trained medics, followed by paramedics and critical-care nurses who transport the patient by helicopter to a level-2 trauma hospital that offers “robust capabilities.”

There, basic procedures can be done to stabilize the patient, for air-strategic evacuation with onboard intensive–care units flying at 37,000 feet to get the patient to a level-4 or level-5 trauma medical center where advanced care is provided.

The trauma system and other key advances in the last decade of combat medicine have produced the lowest death rate in the history of recorded warfare, he said, while at the same time creating greater challenges in rehabilitation.

Combat care goes beyond healing wounds, Woodson noted, because other complications can exist and affect the rehabilitation process -- such as brain or spinal cord injuries, pain management issues and sensory loss.

“We need to customize the rehabilitation strategy to the individual,” Woodson said. “Our mantra is to ‘create the ability, not define disability.’”

DOD is looking at rehabilitation holistically, he pointed out. “It’s about rebuilding their bodies, minds and spirits, and making them economically whole and rebuilding family units.”

Improvements in prosthetic technology have also advanced, Woodson said, adding that implants for prostheses also are in the near future.

“{Prosthetic implants are] light years ahead of what we had and give much more functionality," adding that such technology would be particularly helpful for upper extremities.

“With [the newest technology in] prosthetics is earlier mobility and independence, which is vocationally and psychologically satisfying,” Woodson noted.

“There is a new type of wounded warrior,” Woodson said. “In the era of the all-volunteer force, wounded warriors see themselves as professional warriors and aren’t ready to divest themselves of that identity.”

Because of medical advancements, about 24 percent of wounded warriors stay on active duty and many have returned to combat, he said, adding in some cases, service members with double amputations, spinal cord injuries and sight impairment have remained on active duty.

“Some of those folks have been in command positions and are uniquely suited to command wounded warrior battalions, because it’s about their cognitive ability, their leadership and ability to role model that is so important in those positions.”