WASHINGTON — When Brig. Gen. W. Bryan Gamble took his first assignment at Bassett Army Community Hospital as a general surgeon in 1987, little did he suspect that nearly 25 years later he would be helping to coordinate healthcare for 9.6 million uniformed servicemembers, retirees and their families worldwide.

“It is interesting, because so many of the opportunities come up that you could never imagine, and I think that best describes my career,” he said. “ As I look back, some of it you can’t plan, or you don’t really anticipate, until an opportunity or phone call comes your way.”

Gamble became the deputy director of TRICARE Management Activity (TMA) in October 2011 and said he plans to continue focusing on the Quadruple Aim. With the Quadruple Aim, the Military Health System (MHS) seeks to improve readiness and overall population health while managing per capita health costs and improving the care experience for patients.

“Everything else really needs to be framed in that context. From that, we look to improve the safety, quality and access and communications with our patient population to make sure they have the best healthcare opportunities available,” Gamble said.

Another priority for Gamble is increasing the use of preventive medicine and the patient-centered medical home concept.

“It is a holistic approach, not just a symptoms-based approach,” he pointed out. “We are truly bringing the components of care to the patient, rather than having the patients go to those components of care and really integrating the preventive aspects that we need to do. … It is better to prevent things and less costly to prevent health issues than it is to address them when they become acute in the latter stages.”

Encouraging beneficiaries to use mail-order rather than the retail-pharmacy option will also continue to be important, he said.

“I think that Navy Rear Adm. Christine Hunter [the former TRICARE deputy director] really kicked this off in large part, and it is actually picking up steam. From what she told me, you can save $1 billion a year if people switch to mail-order pharmacy.”

One of Gamble’s most immediate concerns when he took his new position was the TRICARE data breach involving personal health information of an estimated 4.9 million beneficiaries in September.

“It happened before I got here, but it has been very much on my desk since I arrived,” he said. “I think the critical thing to make sure people realize is that we have taken some fairly strong steps to make sure that privacy of the breach was taken seriously.”

Gamble is no stranger to TMA. In 1999, he served as medical director and director of clinical operations for TMA in the Office of the Assistant Secretary of Defense for Health Affairs.

Most recently, before his current assignment to TMA, Gamble commanded the Dwight D. Eisenhower Army Medical Center at Fort Gordon, GA, from July 2009 to October 2011, and served as commander of the Southeastern Regional Medical Command from July 2009 to October 2011. According to his biography, in that position, he increased patient satisfaction and improved support for the rehabilitation of wounded, ill and injured servicemembers.

In collaboration with the VA, he also established a pilot site for reserve component integrated physical disability processing and established an integrated approach for inpatient drug/alcohol rehabilitation, pain management, post-traumatic stress/traumatic brain injury care and physical/occupational therapy.

Gamble graduated from the U.S. Army Medical Department Advanced Course, Command and General Staff College and the Senior Service College. He earned the Flight Surgeon and Expert Field Medical Badges and is board certified in both general surgery and plastic surgery.

He earned his medical degree from Jefferson Medical College, Philadelphia, in 1982 and completed a residency in general surgery at Saint Elizabeth's Hospital of Boston in 1987.

His entrée into the Army came through the Health Professions Scholarship Program.

“When I got into medical school, I had been looking at the health professions scholarship to continue to finance my education and serve. So that is how I entered it,” he said. “After I looked around and did my training and took care of my patients and their families, [I found that] military and military medicine just allowed so many opportunities and perspectives to grow professionally and serve our nation, and so here I am a couple of decades later.”

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