Devil Dog Top Doc visits Naval Hospital Bremerton team

Story by Douglas Stutz

Naval Hospital Bremerton/Navy Medicine Readiness and Training Command Bremerton

U.S. Navy Rear Adm. Pamela Miller, medical officer of the Marine Corps was hosted by Navy Medicine Readiness and Training Command Bremerton of a familiarization visit and tour, April 4, 2024.

Miller first stop was Navy Medicine Readiness Training Unit Bangor clinic, which provides operational readiness care for active duty Sailors and Marines with primary care, dentistry, physical therapy, chiropractic, optometry and pharmacy services.

The number of primary care encounters for active duty personnel in 2023 was over 12,700 along with providing dental operational needs for a population of approximately 7,600.

The vital importance of the Personnel Reliability Program was explained, where every personnel – approximately 1,500 Sailors and Marines – assigned to duties involving nuclear weapons meets the highest possible standards of reliability.

The full scope of dental services at the clinic was highlighted, which includes comprehensive and general dentistry, oral and maxillofacial surgery, endodontics, periodontics and hygiene, prosthodontics, and oral maxillofacial radiology totaling nearly 28,000 patient encounters in 2022 in the nation’s third largest fleet concentration.

The dental team has also been able to leverage updated advancements in virtual surgical planning and 3D printing to perform full mouth rehabilitation. The development has reduced the number of surgeries required for each case down to one, increased surgical predictability, and minimized Sailors’ time away from their deploying operational platforms.

The dental team’s classification system set up to screen large populations and predict dental emergencies that might occur in the next 12 months drew impressed endorsement from Miller.

“It shows using excellent decision making to focus efforts on operational readiness,” said Miller, advocating all along the tour the importance of access to care.

That principal concept was showcased during specific tour stops at Family Medicine, Urgent Care Clinic, Mental Health department and Patient Administration department for a preview of the integrated disability evaluation system, as well as a number of other important programs handled by the Medical Board physical evaluation board liaison officers.

The Med Board team handles the Disability Evaluation System Counsel Program, VA military service coordinators, command deployability coordinators, Navy and Marine fleet forces leadership, branch service headquarters and the Physical Evaluation Board in Washington, DC.

Compiled data helps explain the demanding workload for them. Caring for a catchment area of the western third of the U.S. for active duty, reservists and even recruiting needs in Fiscal Year 2023 resulted in the Medical Evaluation Board staff managing 712 LIMDU cases, with an average of 307 open cases each day being actively processed. Combined with the approximately 250 Disability Evaluation System open cases to determine a servicemembers fitness for duty, that was nearly 560 open cases being tracked.

With all the work accomplished with a fraction of other similarly sized command teams by April C. Dinucci, Medical Board department supervisor and her staff of medical care managers, Physical Evaluation Board Liaison Officers, limited duty coordinators and fleet liaisons, who all collaborate closely with fleet assets and Navy Region Northwest Wounded Warrior recovery care coordinators.

“The dedication and diligence are amazing. Great work supporting such a large case load,” remarked Miller.

Miller also came away impressed by Mental Health department’s commitment to patients and outreach emphasis in ensuring a wide array of outpatient behavioral health services such as individual psychotherapy, operational and readiness-related psychological evaluations to Sailors, Marines and Coast Guard across approximately 300 tenet commands in the Pacific Northwest and as far afield as Naval Air Station Lemoore.

The Mental Health Department has pioneered a high level of clinical involvement behavioral health technicians [hospital corpsmen with specialty training], characterized by their engagement in 198 safety checks, 1,092 access-to-care appointments, and 130 group therapy sessions as well as individual patient follow-up care.

“We’ve also supported and coordinated [as part of] 18 events recently with embedded providers in the fleet. Having our behavioral health techs also engaged in clinical logistic support, underway for fleet requirements, helping with self- and command-referrals and clinical placement is huge,” cited Lt. Cmdr. Trinity Dunham, Mental Health department division officer.

“Finding new and better ways to execute the mission for our Sailors and Marines is really taking care of our own,” said Miller, who also serves as vice chief of Bureau of Medicine and Surgery Reserve Policy and integration. “The open and transparent commitment to ‘Get Real, Get Better,’ is apparent.”