[CCM-L] ?? DMAT "Military" hospital and/or clinic

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Ken and Norman,

During my years at ACEP, I was immersed in the issue of federal responses to 
emergencies. As a historical point, the first federal program of this nature 
was rolled out in the mid '80's and called the Civilian-Military Contingency 
Hospital System (CMCHS), which was an attempt on the part of the DOD and HHS to 
cajole American hospitals and physicians into allocating beds and services in 
anticipation of receiving inbound military casualties from a war in the Middle 
East. This "program" was spearheaded by Tom Reutershan from HHS.

At its rollout meeting at the AMA in Chicago, most of the attendees concluded 
that to participate in such a venture would provide entree to US involvement 
in an overseas conflict, and thus the "program" was generally rejected by the 
hospital, surgical and medical communities. 

Only months later, the National Disaster Medical System (NDMS) emerged as the 
spawn of CMCHS, except its focus was directed toward domestic disasters and 
now acts of domestic terrorism. FEMA postulated that it would serve in the 
event of California sliding off into the Pacific, and more insanely in the event 
of a preemptive nuclear attack on the part of the Soviet Union - which by 
conservative estimates at the time would have killed 180 million Americans in the 
first 30 minutes post launch.

The majority of these federal response plans are disgorged from Washington, 
and by people whose apparent mission is to see who can create the most 
voluminous and convoluted doorstop in the office. I've witnessed it first hand.

You are both correct in recognizing that only local medical response planning 
and coordination will effectively mitigate local emergency conditions. The 
LSU hospital system has moved aggressively in this regard following Katrina. 

As renowned leaders in the world of trauma surgery, I believe that you have 
more authority to make demands than you might think - even counting the 
political consequences. The last thing that the disaster planners and elected 
officials would want to see is a televised interview by either of you describing your 
discontent. You're at ground zero during these events and because of your 
expertise and professional credentials, you should rightfully seize control of 
your surgical domain. And, the simpler the plan the better.

Bob Kellow


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