USAFP Is Connection Point for Military FPs Worldwide

On March 22, during its annual meeting in Las Vegas, the Uniformed Services AFP (USAFP) installed its new president via the Internet phone service known as Skype. The Las Vegas ballroom was packed with USAFP chapter members and their families who exploded in applause and rose to their feet cheering when they saw Col. Michael Place, M.D., on an enormous screen at the front of the room.

Place was sitting in an army tent with an American flag placed strategically behind him. It was the middle of the night somewhere in Afghanistan when AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., stepped to the stateside podium to administer the oath of office to Place.

And then Stream turned his laptop around so the webcam atop the computer scanned the audience.

"When Dr. Stream turned the camera to the members of the USAFP during the installation, I was absolutely overwhelmed," said Place in an e-mail to AAFP News Now. "The USAFP annual meeting is not only a CME extravaganza and a display of some of the finest clinical research in primary care, but truly is a reunion of friends who span the globe in service to our nation."

Place said he's only missed a few chapter meetings during the past 17 years. "I was trained as a family physician by members in that room, and both saved lives and lost lives in combat with others," he said.

"Some of my closest friends were there. For that group of people to give me a standing ovation was profoundly humbling."

Place made it clear that the chapter would carry on just fine during his deployment. "The duties of the president are officially transferred to the vice president when the president is unable or unqualified to serve," he said. Even so, Place is able to participate in much of the chapter's routine business via e-mail, telephone and the occasional teleconference.

Those few moments in a Las Vegas hotel ballroom exemplify the uniqueness of a chapter that binds together family physicians serving in all branches of the military: Army, Navy, Air Force and Coast Guard.

"We share a culture, not a location," said Col. Mary Krueger, D.O., M.P.H., one of several attendees who stopped to share their stories with AAFP News Now during meeting breaks.

Indeed, the 588 USAFP members who flocked to the chapter's 2012 annual meeting hearkened from 41 states and the District of Columbia. But the registration list revealed that many of these family physicians had traveled from far more distant places than that, flying in from at least 24 countries, including Iraq, Afghanistan, Germany, Japan, Guam, Italy, Korea, Portugal and the United Kingdom.

What is it about the USAFP that compels its members to travel great distances for an annual meeting?

"It's the camaraderie," said Capt. Michael Dickman, D.O., who flew to the meeting from Stuttgart, Germany. "It's that bond that we share; we're all physicians and we're all military. And so when we come together, as we do for chapter meetings, it reinforces our sense of purpose."

According to Dickman, the meeting "allows us to recharge and reconnect and reminds us of why we're here."

Maj. Julie Hundertmark, M.D., said she'd only missed one chapter meeting since joining the USAFP in 2006, and that's because she was deployed. "It was like missing the family reunion."

Family physicians in the military are unique, said Hundertmark, "because we take care of (basically) the same populations of people, but it's across the globe."

"You know from the beginning, even in medical school, that the reason the Army employs you is to make sure soldiers are ready to fight and that their families are taken care of," she said, adding that military men and women can't perform at their highest levels when they're worried about their loved ones back home.

According to Hundertmark, chapter meetings provide another service that is crucial to military FPs. "There are a lot of challenges to navigating your career as a military physician, and the networking and mentoring that connect chapter members help physicians discover the career paths that are available and show them how to get there," she said.

During the past four years, Hundertmark has been the medical director of a troop clinic, a battalion surgeon in a deployed environment, an officer in charge of a family medicine clinic and a family medicine educator. She called hers a very normal progression.

"It is not necessarily about what I want to be, but what I need to be as a family physician to support the mission," she said.

Krueger, a past president of the USAFP, noted that relationships between physicians in the various military branches are formed and nurtured at USAFP chapter meetings. "We see each other at this meeting, and the next time I see that colleague might be crossing the street in Bagram, Afghanistan; on the deck of a Navy ship evacuating our soldiers; or on an airfield offloading patients from a helicopter to an Air Force jet for evacuation back to the states," said Krueger.

"It makes a really big difference when that person you see across the airfield is a friend, because then you know you are handing off your patient to someone you can trust. And when I move to a new location, the chances are I already know the other family physicians there," said Krueger. "I may be moving to a new geographic area, but I already have some family on the ground."

Capt. Maureen Padden, M.D., M.P.H., recently turned the reins of the USAFP presidency over to Place. Padden is the director of the medical home for all of Navy medicine, and has been to all 27 Navy military treatment facilities.

She said "medical home" means something different to the operational forces. "We have to make soldiers, sailors, airmen and Marines fit to fight and get them back to work," said Padden. "Downtime from work can affect the mission of the operational forces commanders," she added.

The USAFP chapter helps military physicians fulfill that duty.

"It's hard to find CME on combat trauma, traumatic brain injury and post-traumatic stress injury," said Padden. "The chapter has a unique mission in that it provides relevant CME and up-to-date information and training."

Padden added that military research and the development of treatments for battlefield injuries translate back to the civilian world. "The rise in survival rates for civilians often can be traced back to experiences in the military," she said.

Another of the USAFP's missions is to help train members to be leaders. "We fine-tune leadership skills so that military FPs are able to perform in stressful environments, maintain their composure and lead their teams when others likely would crumble," said Padden.

"Military physicians lead teams in caring for patients, but they also are 'sage advisers' to military line commanders," said Padden. It's the physician who advises senior military officers about whether to stop a mission and transport a patient to a facility or stabilize the patient on the ship and continue the mission, she explained.

"We make split-second decisions regarding active military operations," said Padden, adding, "There is no greater duty than taking care of operational forces."