The 2005 Base Realignment and Closure, or BRAC, process has created opportunities and challenges for the military community, and specifically the military medicine community, the commission's chairman said here Feb. 2.

Four BRAC actions affect large medical facilities. At least four more affect medical research and management activities, and seven outpatient hospitals will convert to clinics with ambulatory surgery capability, said Anthony J. Principi at the State of the Military Health System 2006 Annual Conference.

The BRAC-mandated changes will help the military health system become a more modern, joint force capable of dealing with the changing environment, Mr. Principi said.

"The worlds of national defense and of medicine are changing ever more rapidly and ever more profoundly. And just as chance favors the prepared mind, change favors the prepared organization," he said.

The decision to realign Walter Reed Army Medical Center here into a multiservice facility upset many people, Mr. Principi said. They perceived it as the loss of a facility with rich heritage and a world-class reputation. But the BRAC commission agreed the change will "transform a legacy -- an aging medical infrastructure -- into a premier, modernized joint operational medicine platform," he said.

Another example of transformation is the decision to establish a joint medical facility at Fort Sam Houston, Texas, and to convert nearby Wilford Hall Medical Center on Lackland Air Force Base into an ambulatory care center, Mr. Principi said.

The BRAC addressed many infrastructure issues, but the top priority for health care leadership is providing quality care for servicemembers and their families, Mr. Principi said.

"Those men and women look to you -- the health care professionals in this room -- to provide them and their families with the medical care they need," he said.

Change will be painful at first, as it is in all organizations, Mr. Principi said, but it is necessary to keep up with a society and an environment that will continually evolve.

"Over the long run, the status quo and a dynamic environment are incompatible," he said.

The BRAC results will make the military health system able to adapt to this changing environment and continue to be relevant to its beneficiaries, Mr. Principi said.