Man­ag­ing a vi­tal mis­sion

Modern Healthcare - - SPECIAL FEATURE -

Dur­ing the decade-plus that Ma­jor Gen. David Ruben­stein has served in a se­ries of se­nior lead­er­ship po­si­tions in the U.S. Army’s med­i­cal op­er­a­tions, he and his col­leagues have faced a se­ries of chal­lenges re­lated to the wars in Afghanistan and Iraq.

As the first non­physi­cian com­man­der of the Land­stuhl (Ger­many) Re­gional Med­i­cal Cen­ter from 2001 to 2003, Ruben­stein con­verted a peace­time ter­tiary-care re­fer­ral cen­ter to a re­ceiv­ing hospi­tal for ca­su­al­ties from both fronts. “We kept the peace­time mis­sion go­ing while adding the wartime mis­sion,” he says. “We didn’t stop one (func­tion) to start the other.”

As Army deputy sur­geon gen­eral from 2008 to 2010, Ruben­stein es­sen­tially served as chief op­er­at­ing of­fi­cer of an $11 bil­lion global health­care sys­tem. In his cur­rent role as com­mand­ing gen­eral of the Army Med­i­cal Depart­ment Cen­ter & School, as well as chief of the 23spe­cialty Army Med­i­cal Ser­vice Corps, based at Fort Sam Hous­ton in San An­to­nio, Ruben­stein, 57, en­vi­sions and designs med­i­cal train­ing and bat­tle­field equip­ment.

The school of­fers seven doc­tor­ate pro­grams and six mas­ter’s de­grees, and the cen­ter has made ad­vances in care for ca­su­al­ties on the bat­tle­field, in­clud­ing “a new tourni­quet that is sav­ing limbs, new clot­ting ban­dages that save lives,” he says. “We’re adapt­ing to a dif­fer­ent kind of en­emy than we’ve fought be­fore; we’re adapt­ing to new ways to pro­vide be­hav­ioral health in the combat zone.”

This im­proved train­ing and equip­ment has brought the sur­vival rate for ca­su­al­ties in Iraq and Afghanistan to about 90%—well above the 70% to nearly 80% in con­flicts such as World War II, the Korean War and the Viet­nam War, Ruben­stein says. “It’s be­cause of how we train our combat medics, it’s be­cause of bet­ter body ar­mor and ve­hi­cle ar­mor, it’s be­cause of the abil­ity to move pa­tients very quickly to re­ceive so­phis­ti­cated care.”

For the Amer­i­can Col­lege of Health­care Ex­ec­u­tives, which has named him its Gold Medal Award win­ner for non­de­liv­ery health­care or­ga­ni­za­tions, Ruben­stein was a re­gent from 1999 to 2002, gov­er­nor from 2002 to 2006 and then served in the lead­er­ship track, in­clud­ing chair­man, from 2007 to 2010.

“I chal­lenged all of us in health­care to take a re­spon­si­bil­ity for men­tor­ing and coach­ing the next gen­er­a­tion of health­care lead­ers,” he says. “Those of us who have years un­der our belt have a moral re­spon­si­bil­ity to pre­pare the next gen­er­a­tion to take over for us.”


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