New Defense Health Director Pledges to Focus on Patients as 'Human Beings'

As the Army's deputy surgeon general, Lt. Gen. Telita Crosland managed the deployment of U.S. military personnel to field hospitals, civilian medical centers, parking lots and public buildings nationwide to help combat the COVID-19 pandemic.

And in the midst of that global health crisis, she was handed the task of overseeing health care for evacuees from Afghanistan, working with the departments of State and Health and Human Services to care for thousands while providing medical care that ranged from delivering babies to treating measles.

All this, while unexpectedly raising her son as a single mom, having lost her husband before lockdown in 2020.

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"It was a sporty three years, to say the least," Crosland said during an interview with reporters before her promotion to lieutenant general on Jan. 20. "I'm just extremely proud of the team, the entire military health system team. That's the Army, the Navy, the Air Force, Coast Guard, the Department of Defense, public health, all the medical entities in the United States came together."

As of Jan. 3, Crosland is the new director of the Defense Health Agency, responsible for the health care of 9.6 million patients in the military health system, including Department of Defense hospitals and clinics and the Tricare health program.

She said her experience working with every service as well as her work as a family physician will shape how she does her new job.

Crosland explained that family practice physicians tend to look at their patients through a holistic lens, concerned about their living situations, their nutrition, their fitness -- their whole health. She said that ultimately, health care is about improving the lives of service members and their families.

"I think folks will see that come out as the director. I'm very focused on the patient in the center. I'm very focused on the human being," Crosland said.

Crosland takes leadership of the Defense Health Agency as it nears completion of reforms built into the fiscal 2017 National Defense Authorization Act, shifting management of the military's 51 hospitals, 424 health clinics and 248 dental clinics to the Defense Health Agency, and changing the focus of the Army, Navy and Air Force's medical commands to providing combat and in-garrison care for military personnel.

A 1989 graduate of the U.S. Military Academy, Crosland entered the Army in 1993 after earning a medical degree from the Uniformed Services University of the Health Sciences. A board-certified family medicine physician, she has served in numerous clinical settings and managed clinics across the Army, from South Korea to Texas, from Fort Lewis, Washington, to Grafenwoehr, Germany.

She has master's degrees in public health and national resource strategies, attended jump school, and has numerous awards and medals. She is the third Black female to be promoted to lieutenant general and the second Army officer to lead the DHA.

She is, according to her former boss, Army Surgeon General Maj. Gen. Scott Dingle, "the baddest woman in the Army."

"Anything she sets out to do is going to turn to gold, because she has the Midas touch," Dingle said during her promotion ceremony at Fort Myer in Arlington, Virginia.

In addition to the handover of military medical facilities to her new agency, the Defense Department is also moving to a new electronic health record system, MHS Genesis, designed to communicate with the Department of Veterans Affairs' new system once both are completed. That record system is due to be operational in 138 military health facilities by the end of the year.

And in 2024, Tricare, the program that oversees private care for military beneficiaries, retirees and their families, is expected to undergo changes as the next generation of contracts, worth up to $136 billion, take effect, including one that was awarded to a new regional contractor, TriWest, shifting health care for up to a million beneficiaries.

Crosland said the transition for the military medical community, with DHA taking over management of facilities, has been "tough," though most of the painful work has already been done. But she learned throughout the pandemic that the services, which each have their unique cultures, also have more in common when it comes to providing medical care to their patients.

"We're still a military health care system that has to take care of the force and the beneficiaries [that] we're privileged to serve. That ground truth, that true North, never changed," Crosland said.

Among the first items Crosland is looking at is the reduction of network pharmacies by Express Scripts, the pharmacy benefits manager for Tricare.

Tricare lost nearly 15,000 retail pharmacies from its network when the stores declined to stay after receiving renewal contracts that offered lower reimbursement rates than they said were economically feasible.

Following a backlash and facing the loss of a major chain of pharmacies in the Kroger grocery store family, Express Scripts offered a new contract and received responses from roughly 2,000 pharmacies to rejoin the network.

Still, hundreds of thousands of Tricare beneficiaries remain affected, with many saying they now face long wait times for their prescriptions or long drives to a network pharmacy.

According to Crosland, the DHA has "gone back to the contractor for a relook" at the situation.

"We're down literally to the individual human beings that are being impacted," she said.

Crosland acknowledged that the enormity of her job at the DHA could make it all-consuming, but she has priorities that will keep her grounded, like plans to stay in touch with beneficiaries, medical leadership and staff through in-person meetings in the Washington, D.C., region and virtual meetings across the system.

"I'm going to be tired trying. ... I think it's important to make the effort even though I won't get to every place. It helps me stay current. It helps me stay relevant," she said.

And she has her son Jackson, now 12, who keeps her real, she said. According to Crosland, Jackson's resiliency and positive attitude allows her to keep serving in a high-stakes job without having to worry about him.

"I keep waiting for the other shoe to drop. He went to middle school and I said, 'OK, here it comes,' and he's still just, it's all good. He's happy. He's not perfect, but he's my perfect," she said.

-- Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime

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