Partnerships keep DGMC professionals primed for deployments

  • Published
  • By Merrie Schilter-Lowe
  • 60th Air Mobility Wing Public Affairs
TRAVIS AIR FORCE BASE, Calif -- At a moment’s notice, Air Force doctors, surgeons, nurses and medical technicians at Travis Air Force Base, California, must be primed and ready to deploy anywhere in the world to care for Airmen injured during combat operations.

So, how do these highly trained professionals at the David Grant USAF Medical Center maintain their critical wartime skills when they are not routinely treating victims of explosions, gunshot wounds and automobile crashes? By partnering with large civilian medical centers and hospitals that routinely care for critically ill and injured patients.

“Our enrolled population doesn’t always provide the cases our surgeons need to maintain clinical proficiency,” said Col. Derrick McKercher, 60th Medical Group hospital administrator. “We rely on external agreements to provide them with a certain acuity patient to keep their skills honed for deployment.”

DGMC has external resource sharing agreements with a number of hospitals and medical centers in Northern California, including the University of California at Davis, UC San Francisco and Children’s Hospital in Oakland.

“The ERSA allows us to send doctors and surgeons to another medical facility to treat our patients when DGMC does not have the capacity to do it in house,” said Barbara Erickson, 60th MDG director of medical education.

For example, DGMC cardiothoracic surgeons can perform surgery on their patients at NorthBay Medical Center in Fairfield, California, with NorthBay’s staff in support. NorthBay also provides labor and delivery training to DGMC nurses and final phase medical training for laboratory, pharmacy and radiology students.

The Air Force bears no cost for these agreements, patients pay only the TRICARE co-payment and DGMC’s credentialing office and its external partners ensure that physicians have the correct credentials to practice in the local civilian community. Both DGMC and the civilian entity benefit from these partnerships.

“We’re providing them a service by keeping their support staff fully engaged, plus getting some of our patients seen sooner,” said McKercher.

DGMC is a Joint-Commission-accredited teaching hospital with a robust graduate medical education program serving students from all over the world.

“In addition, we have physicians at UC Davis who teach certain specialties and capabilities,” said McKercher.
Providers also mentor military residents attending the school.

“UC Davis loves that our doctors relive their deployment experiences,” said McKercher. “They are sharing what they’re seeing in a war zone, how they treat casualties and how successful they are.”

In addition to ERSAs, DGMC has training affiliation agreements allowing residents, graduate and post-graduate students to train at various medical facilities and students from those facilities to train at DGMC. TAAs also enable surgeons to remain current in their fields.

“These are licensed physicians who don’t get enough of the type of cases they need at DGMC to maintain their skills to go to war,” said Erickson.

Three trauma surgeons, an orthopedic oncologist, a pediatric surgeon and two emergency medicine providers are embedded at UC Davis, which is one of the busiest Level 1 trauma centers in the nation.

A 2013 research study found that a Level 1 trauma center like UC Davis is similar to a NATO Role 3 medical unit in Afghanistan during the height of the war in terms of work schedules, number of trauma, resuscitations – methods used to quickly control surgical bleeding – and number of surgeries performed daily.

One of DGMC’s longstanding partnerships is with the Veterans Administration Northern California Health Care System, partly because so many VA patients are seen at DGMC, said McKercher.

The VA accounts for about 22,000 out-patient visits, more than 26,000 emergency department patients and 157 same-day surgeries annually.

“The agreement we have with the VA covers 11 programs, including the dialysis center, cardio vascular program, neurosurgery, radiation oncology and in-patient mental health,” said McKercher.

By combining services, DGMC and VA save an average of $9.6 million annually.

“We have about 117 VA physicians, surgeons, medical technicians and administrative staff at DGMC who provide care for DGMC, VA and Department of Defense patients,” said McKercher.

The VA reimburses DGMC about $30 million annually for patient care and DGMC reimburses VA about $17 million for staff salaries.

Partnering with civilian facilities to maintain surgical skills and to keep current in specialty fields is not unique to DGMC. Most major medical facilities in the DOD have similar agreements, said McKercher.