Writing an OPORD for Your Healthcare

Healthcare for Warriors in Chapter 3 of our life, post-Service, is likely one of the most challenging aspects of our transition out of Chapter 2, our service. Whether you served 4 years or over 40 years, like my Dad, SGMB1, particularly if you were combat arms and /or deployed, you are likely facing many healthcare issues that the average citizen will not face. Add to this the challenge of living in rural areas where access to the VA is a day-long event or simply not a possibility due to work or family requirements and you have a recipe for physical and mental disaster.

How are we going to address all the issues we face as we age? Who is going to help us diagnose and treat our boo-boo? How are we going to plan and manage all the different treatments, medicines, physical therapies along with our normal life? Simple, we write an Operations Order (OPORD) like we did throughout our military career. The OPORD told us what the problem was, what we were going to do, where we were going to do it, why we needed to do it, when we we were going to do it, and who was going to do the what, where and when of it.

Let’s break down the basics of the OPORD for our non-Veterans who have never seen or heard of one. First of all, the OPORD tells the who, what, where, when, why, and how of any mission we conduct. It starts at a high level of command and then passes down to the next level of command, with them rewriting it to reflect their part in the mission, all the way down to the lowest tactical level. It can be an extremely complicated and lengthy written or oral explanation of the mission and it usually includes some sort of pictorial display of the actions. Most times, at the lower levels, it is done surrounding a sand table, which is, in simple terms, like playing with army men and tanks like we did as a child, to represent all the aspects of the mission. It can be much more complicated at higher levels using technology with overlays, drawings etc.

The OPORD has five major parts: Situation, Mission, Execution, Sustainment (formerly Service & Support) , and Command & Signal. This process has numerous sub-paragraphs and is always written in the exact same format including information in each sub-paragraph. Let’s talk about how this pertains to Warrior Healthcare.

How does an OPORD pertain to the thread of healthcare? Simple. It is an all-inclusive, well thought-out, written plan.

First, we identify the issue up front in the Situation. If we don’t identify the situation (aka problem), then we will never get to the root cause analysis to be able to use the Military Decision Making Process (MDMP) to come up with Courses of Action (COAs) to solve said problem. The Situation might be as simple as: My physical health is declining due to degenerative arthritis, hearing loss, and my mental health is declining due to PTSD. These issues are causing me to have issues with mobility, social activity, employment, and relationships. Currently, I don’t have a medical provider but do have family support.

Second, the Mission. The Mission is the who, what, where, when and why, with anticipated outcomes. This is the over-arching, 30,000-foot level statement of the path you are going to take. For example, it might be something as simple as: I will engage my primary care provider to address arthritis, PTSD, and hearing loss, at the Mytown VA on Sep 99th, 2220, in order to improve my relationship with my spouse, improve my attendance and quality of work, and be more physically active. Note the use of active voice with terms like improve and be more. Active voice refers to you doing the action. For example; I will engage my doctor to fix me vs I will be fixed by my doctor.

Third, is Execution. Execution is the meat and potatoes of the process. The Execution will explain, in detail, exactly what will happen along the plan, the things that will happen if the plan must change, and the timeline of tasks tied to who is doing them. This includes scheduling appointments, follow-ups, referrals and coordinating insurance etc. It includes checkpoints along the way that can identify progress and verification that you are still executing the mission in accordance with your (the Commander) intent. These are validation points that keep you moving or may cause a Fragmentary Order (FRAGO) if the plan is not working and needs a shift in the attack. The details are very important. Knowing where you are going, how you are going to get there, and how to recognize when you are there, or close, is vital. Get the major parts written own first, then break down each part into more detail.

Fourth, is Sustainment. Sustainment is commonly referred to as “beans, bullets, and batteries.” It is all the supplies you need to execute the mission. That might include your properly registered and licensed vehicle, along with the budget for gas for all these appointments. Think about what else you need to go to the doctors. A map or GPS on your phone. Your ID card. Your insurance card. Proper clothing for physical therapy. A notebook to write everything down with. An app to track expenses. Insurance forms if you have to submit claims that way. Foam roller or rubber bands for physical therapy at home. All these things are important to your process and hence need to be planned for and budgeted for.

Fifth, and final, is Command & Signal. It includes a list of people who are providing support such as doctors, counselors, drivers if needed, family members who might be providing child care services, co-workers who can cover shifts. It includes their phone numbers and addresses as well.

So, there you have how an OPORD can help you with your healthcare. Does it really have to be an OPORD? Damn straight, Private! This ain’t Camp Do What You Want, young Specialist! You don’t live in Fort Freelance, big Sergeant! And get off my grass, Staff Sergeant! If God had wanted you to walk on my grass he wouldn’t have invented sidewalks.

I could go a lot more in depth about each paragraph and sub-paragraph but I think you get the idea. This OPORD is a little different than the normal OPORD as it will change, mostly through more detail, as time goes on, more appointments happen etc. Having it all written down in one place will make those changes nothing to worry about. If you don’t have it written down, changes will stress you out and cause your loosely-constructed plan to fall apart. For more details, pull out your copy of the Ranger Handbook.

In closing, plan your work and then work your plan. You will find that writing it all down, in detail, with all information in one place, your will reduce your stress which will allow you to focus on recovering more, your family, your job, and your health. Make it happen hooah!

—SGM DTB—