When Army Lt. Gen. Ronald Place visits military hospitals and clinics and conducts town halls with staff, he introduces himself not only as the director of the Defense Health Agency, but also as an Army surgeon, a son, husband, father, and grandfather. For Place, all his roles influence his decisions.
Place admits it was easy to get lost in his role as a surgeon back when he began his residency training. “Yet I would still go home as a military spouse, or I would go home to my military children,” he recalled. “I would wonder, ‘What did I do today to make the system better for my spouse?’ or ‘What did I do today to make the system better for my kids? And often the answer to that, at least for me personally when I was a junior officer, was nothing.”
Today as the director of the DHA, Place is responsible for all the activities that happen in the DHA, most of which impact the 9.6 million eligible TRICARE beneficiaries who depend on the MHS for their health care. “I like everybody to consider all of their roles when they make decisions,” he said. “To me, it's a reminder from a decision-making perspective, who are we? And why are we there as a part of the Military Health System?”
As an integrated system of health and readiness, the MHS is a complex matrix of people and priorities with a unique role supporting the National Defense Strategy, said Place. “Much of what we do to measure ourselves, our productivity, and the quality of the work that we do [is] based on civilian standards and benchmarks,” he said. “Yet we're a Military Health System, and some of the things that are required for that balance between health and readiness don't earn productivity points in the same way they would in a civilian system.”
Place said the MHS isn’t where it needs to be in terms of defining the elements of readiness -- troops being medically ready and health care teams being proficient to perform their wartime missions -- or how the MHS measures productivity and quality in relation to readiness.
While the task at hand seems great, Place sees promise in the staff inside the DHA headquarters and at the military medical treatment facilities. “I see excellence. I see passion. I see dedication. I see desire for improvements in our system.”
Place has seen that passion showcased during the national emergency brought on by the COVID-19 pandemic. Through excellence, ingenuity and agility, health care providers continue to find ways to adapt how they deliver care without degrading the quality of care patients receive. Place cited the CAMIC invention and rethinking therapeutics such as the use of convalescent plasma for treating COVID-19 patients as examples of how passion and innovation have come together to create solutions that may have applications for years to come.
Place sees process standardization as a key to improvement. “Across the entire Military Health System, there are literally thousands of things that could be standardized to improve our system,” he said. It won’t be easy because there’s a lot of fear associated with change, he added.
But Place believes the DHA is primed for the challenge. “With the talent and passion and commitment of the entire team, at headquarters and at our health care delivery sites, I’m confident we can do it, but it's going to take a significant effort and it's going to take us some time,” he said.
Asked about his short-term goals, Place said he hopes to be able to cite examples of how standardization has improved the system. “That improvement might be quality of care or clinical outcomes for our patients; it may be the overall satisfaction of our patients,” he said. “I also hope we've done something to improve the system so that the staff, whether it's across the entire organization or even particular functional communities, have more joy in the work that they do and more fulfillment in their missions.”
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