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John McCabe

Dear Fellow Nobles:

For some time now Shriners Hospitals for Children (“SHC”) has been working with the Department of Defense (“DOD”) in an effort to share our expertise to help the wounded warriors. For the last eight (8) months, Chairman Douglas Maxwell, Chief Medical Officer Dr. Ken Guidera, Director of Research Dr. Ray Novak, and I have been laying that groundwork for the “building” plans to go forward. Since day one of the planning between the DOD and SHC it has become obvious that both entities have great and deep commitments to help their respective patients and their families. Each mission is incredibly similar. That similarity has brought both groups to the same mindset - - “We can help each other”. Each organization brings something special and unique to the field of medicine and research. This will benefit both groups. As we have all become aware, the devastating injuries that are sustained during warfare may include both a burn injury and a neuromuscular skeletal injury. SHC has “world class” expertise in both of these areas, which the DOD recognizes as a benefit to them. Shriners Hospitals and Shriners International also have a significant geographical reach which the DOD feels will help lessen the travel burden and cost of the their patients. However, like with many undertakings, you need to have a good plan. The same is true with this arrangement with the DOD. We need this plan of action before we can start providing care. Right now we are in the beginning stages of putting that plan together with the DOD. The question becomes how do we get these two world-class organizations to efficiently and effectively work on the same page. The goal of both groups is in developing this plan to provide superior care for our soldiers with the least amount of inconvenience on them and their families, and to improve SHC’s medical capabilities. Both sides understand that caring for our children comes first. The roll out of this plan will be in many stages and will change over time. Here is what is happening now The first phase is currently underway which includes: Our physicians are visiting the DOD’s facilities to lend a hand in the direct care of our service men and women. They are consulting on cases, and, where appropriate, lending a hand in the Operating Room or Clinics held within the DOD facilities. Our doctors are bringing their expertise and sharing it with the DOD’s doctors. We are likewise learning from their doctors. We are arranging to have select members of the DOD’s medical staff visit our facilities to observe our medical techniques and protocols so they can take them back to their facilities. We are combining our research efforts and sharing our respective knowledge with each other. We are inviting the military’s medical school’s Residents and Fellows to do clinical rotations at our various Hospitals to be trained in our latest techniques. Soon to Come Telemedicine and follow up clinics. We are talking with the DOD about establishing telemedicine and follow up clinics to assist in the follow up care of our service men and women who do not live close to a DOD facility. This may involve using space at one of our Hospitals, an affiliate Hospital or a Shrine center. It is anticipated we will use SHC’s doctors and nurses to staff the clinics and lend their expertise in the follow up visit. But before this can happen, the DOD needs to do an assessment of its needs and logistical requirements. They are determining what areas of the country this Shrine medical coverage is needed and what those needs will be. This is taking the DOD some time to develop, so we need to be patient. Inpatient Care at an SHC facility Many have asked when the inpatient care will start at SHC facilities. As I mentioned before, at this time, the DOD is not looking for this type of help. They want to maintain the continuity of care for their patients as we do our patients. Our doctors will help our soldiers, by doing our Shrine Care while they are visiting the DOD’s inpatient facilities. That being said, we definitely see a situation arising where a surgical need cannot be filled at a DOD facility. To that end, we have been asked by President Doug Maxwell to put together contingency plans for us to lend our help if these situations arise. We are doing just that. One alternative is to have our physicians who have privileges at our “affiliated Adult Hospitals across the street”, admit the Wounded Soldier for the needed care there. We are also looking at other alternatives and referral capabilities so that we will be ready when called upon. Going forward As we go forward with developing the plan with the Department of Defense we will keep you posted on our progress and how we have been asked to help. We look forward to helping the DOD in any way we can because we realize these individuals are not only the DOD’s patients, but they are OUR service men and women and we thank them for all they have done and are doing for our country.

Thank You,

John McCabe

John McCabe
Executive Vice President

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