A Proposal for the Consolidation of Dermatology Services of Walter Reed Army Medical Center and the National Naval Medical Center

Abstract

Abstract : The purpose of this project is to determine if consolidating dermatology services of Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC)at one location will lead to increased efficiency for those beneficiaries seeking dermatological care. Visits to WRAMC for the 12 month period ending June 30th, 1998 totaled 18,937 with anaverage cost per visit of $138.55. Patient visits for the same period totaled 15,108 at NNMC and averaged $238.05 per visit. Though both clinics are cost-effective, more can be done to improve efficiency. Performing a cost-effectiveness analysis allowed other factors such as staffing requirements, Graduate Medical Education, and access to care to be considered in the examination. The studys recommendation is to merge WRAMC and NNMC clinics at NNMC to form one department solely responsible for providing dermatological care to military beneficiaries. Despite the studys overall recommendation, a successful consolidation will be difficult to achieve without major changes to intangible factors that currently exist within the two separate services. For consolidation to succeed, the rigid, service focused cultures must be replaced by philosophies that value flexibility, forward thinking, and the processes for delivering high-quality, cost-effective patient care. All stakeholders in this effort must be susceptible to change and the higher authorities must be willing to accept a level of risk and change the ways of the past. Consolidation efforts are doomed to fail if those entering the mergers lack a clear understanding of why they are doing it. Armed with a willingness to compromise and share accountability, consolidating dermatology services in the National Capital Area is attainable.