With only a handful of military treatment facilities with dedicated staff judge advocates (SJAs), there aren’t many judge advocates with medical law experience. Fewer have to deal with the mix of medical law with a layer of foreign national law and a Status of Forces Agreement.
Facing a range of issues from medical malpractice, to patient disclosures, to misconduct, the legal staff at U.S. Naval Hospital Okinawa (USNH Okinawa), the largest overseas Navy hospital, led by Lt. Bob Liu, serves to provide legal support for the primary casualty receiving hospital in the Western Pacific.
As the legal support staff for USNH Okinawa, stationed on a Marine Corps installation, Liu, along with master labor contractor Ms. Riyoko Kinjo, provide a range of services to the members of the hospital.
“Our daily job is to assist and advise the commanding officer on issues that arise and provide legal guidance throughout the command regarding the myriad of questions that pop-up,” said Liu. “Different queries come up throughout the day to include how to handle parents that want to leave with their minor children against medical advice to responding to patient complaints to whether certain medical records can be released.
In addition, Liu has the opportunity of assisting other judge advocates with related medical questions. “As the only dedicated hospital SJA in the area of responsibility, I’m often asked about issues ranging from obtaining medical records to hospitalization processes.”
An additional wrinkle to being on Okinawa is that “there are only three Navy judge advocates on the island, Lt. Rachael Baker at Commander, Fleet Activities Okinawa, and Lt. Cmdr. Andrea Leahy at Expeditionary Strike Group 7, so we’ve developed into a tight group that meets up whenever we can.” In addition, there is a large presence of Marine Corps judge advocates, “and they’ve been wonderful to work with and learn from as well.” Though the island is about 70 miles long and 7 miles wide, all services are represented. “A fun part about working at the only military hospital on the island is that you’re the point for the Army, Air Force, and Marine Corps judge advocates for medically-related questions.”
Some of the challenges at USNH Okinawa come from its unique practice area in medical law.
“Medical law wasn’t really something that the first tour judge advocate program focused on, so it was a steep learning curve in the beginning” according to Liu. However, “the other SJAs and civilian attorneys throughout the Navy Medicine enterprise have been a great resource. Region Legal Service Office Japan has also been integral to my success out here. The Command Services department and the legal team at Commander, Naval Forces Japan have given me constant support and guidance. Furthermore, by providing me opportunities for training, either in person or telephonic, I still feel connected to the JAG community thanks to the professional development officer, Lt. Cmdr. Andrew Clayton.”
Liu admits that there are challenges to being the sole judge advocate. “There are so many smart people in the hospital that they want to know the sources of authority from where you’re deriving your legal advice, and they aren’t afraid to do their own research. At the end of the day, they value your expertise and what you bring to the organization in a way that I don’t think you’ll get in many other commands.”
In addition to expanding his legal expertise, Liu has also taken the opportunity to get some non-legal training. Liu completed the Tactical Combat Casualty Course, Basic Life Support, First Responder’s Operations Training. The next thing Liu is aiming for is Lean Six Sigma training. “It’s important to get ideas from other communities so that our own community can improve.”
Service at USNH Okinawa doesn’t come without fun. “There are so many things to do and see on Okinawa: nine world heritage sites, World War II historical sites, scuba, snorkeling, food, waterfalls, parks, gorgeous beaches, you don’t have to leave the island at all.” In addition to exploring Okinawa, Liu has taken opportunities to check out Australia, New Zealand, mainland Japan, South Korea, Singapore, Taiwan, and Thailand.
“I’ve loved my time here at USNH Okinawa and the island itself. I would definitely recommend going to a hospital if you get the opportunity. You get asked some very difficult questions that directly impact people’s life. I’m also glad I got to see the inner workings of Navy Medicine and it gave me a greater appreciation of what they do day to day. Finally, I hope I can get stationed on Okinawa again!”