Lawmakers concerned about closures of medical facilities

With hundreds of injured soldiers returning from Iraq and Afghanistan, some lawmakers are concerned that some of the U.S. military’s medical facilities and universities may be targeted by the impending base realignment and closure process.

Sen. Barbara Mikulski (D-Md.), at a Defense Appropriations Subcommittee hearing yesterday, said she was worried about the Uniformed Services University of Health Services (USU) and Walter Reed Army Medical Center’s being “rumored of closing.” USU is based in Bethesda, Md.

USU is the only U.S. military medical school that trains physicians and advanced-practice nurses and has a large graduate education program, according to USU spokesman Peter Esker.

“We should not close the USU,” urged Mikulski.

USU officials are familiar with the rumors of a closing but said they “can’t speculate whether or not they will be closed,” Esker said. “We provide great value to the nation. We appreciate Senator Mikulski’s concern and support.”

Walter Reed calls itself the “clinical center of gravity” for military medicine. The hospital did not return calls by press time. Walter Reed maintains 40 medical-specialties programs, said Lt. Gen. Kevin Kiley, the surgeon general of the Army.

“It is the linchpin for medical professionals,” he said in testimony in front of the subcommittee, chaired by Sen. Ted Stevens (R-Alaska).

Ongoing conflicts in Afghanistan and Iraq and contributions to natural disasters, such as the South Asian tsunami relief, are taking a toll on military medical personnel. More than half of the members of the military medical corps are on their second, or even third, deployment in the past few years.

While the Army is reaching its goals with enlisted combat medics, it is facing shortages in recruitment and retention in the professional medical corps. The Army is close to 200 physicians and 200 nurses short, Kiley said. “There is a nationwide shortage of nurses,” he said in testimony in front of the subcommittee yesterday.

He said recruitment and retention of both physicians and nurses is a “mixed picture” that the Army is watching closely. “We do not have the final answers, but I am concerned,” he added.

In the face of the rumored closing of USU, Mikulski, along with Stevens and Sen. Daniel Inouye (D-Hawaii), wanted confirmation that military medical officers are trained in the military’s medical system. According to Kiley, they are.

Stevens urged the services to give Congress their plan for how to entice physicians to join the military so that lawmakers could financially support it. “We’ll call it the Barbara Mikulski plan,” he said jokingly.

The Defense Department and lawmakers need to take another look at scholarship programs, Mikulski said. The Department of Veterans Affairs can pay its physicians more than the Pentagon, she said. The Defense Department is competing for manpower not only with civilian academic centers of excellence but also with Veterans Affairs, she added.

For the Army in particular, a series of initiatives is creating temporary and permanent population changes on installations. These are pre- and post-deployment health issues related to the war on terrorism, training-base expansion and BRAC 2005, the base realignment and closure process, Kiley said.