Air Force Surgeon General eyes modernizing capabilities for joint commanders
US Air Force Medicine | 2022-05-23
FALLS CHURCH, Va. -- Since assuming his role of Air Force Surgeon General, Lt. Gen. Robert Miller has worked to advance the Air Force Medical Service’s capabilities, ensuring it is ready for an evolving joint fight.
One of his stated priorities is enhancing combatant commander capabilities, which focuses on modernization at every level of care, and increasing global health engagements.
“The combat environment will not be static,” said Miller. “As a result, we cannot assume we will always have air superiority…, [so medics may need] to hold and treat patients longer and closer to the front lines. Deployed capabilities and medical technology need to meet this potential new reality.”
Aeromedical evacuation has remained a staple life-saving capability since World War II and has grown to save more lives through humanitarian support, and amid a global pandemic. However, future conflicts will present new, unprecedented challenges.
“We have to be ready for… increasingly dispersed operations in challenging, contested environments,” said Col. Marilyn Thomas, Division Chief, En Route Medical Care, Air Mobility Command. “We may find ourselves having to move what we call ‘unregulated patients.’ That means when we have an aircraft approved for aeromedical evacuations and we are able to land, we may not know the exact number of patients or their exact diagnoses. Preparing for unregulated patient movement impacts the makeup of our teams and how we train.”
RESAn advantage Air Force medics have is they are ready to convert any approved cargo or tanker aircraft to transport a wide range of patients, including the KC-46A Pegasus, which completed its first aeromedical evacuation mission on July 10, 2020.
“The idea is we can adapt to almost any cargo or tanker aircraft, so wherever patients move, if we have an aircraft, we can team up with aeromedical evacuation crews,” said Lt. Col. Sarah Morton, Chief, Aeromedical Evacuation Standardization and Evaluation, Air Mobility Command. “What we are doing now is making sure we can integrate on whatever the next approved aeromedical evacuation aircraft will be.”
Air Mobility Command, which leads the aeromedical evacuation and critical care air transport missions, is continuously working to optimize equipment to become smaller and modular. Additionally, AMC is reviewing medical specialties to right size the makeup of AE and CCAT teams.
“We know patient loads could be larger in future conflicts, so we are taking another look at what type of clinicians and clinical support we need,” said Thomas. “We are looking at what the right mix of medical attendants would be to augmented support.”
Deployed ground capabilities
Miller has also directed a closer look at ground medical capabilities, including care delivered at the point of injury and in deployed medical facilities.
“The end goal is to provide commanders with greater flexibility and range of options that can bring advanced care that is highly mobile and ready to operate in the most demanding environments,” said Miller.
One of those options is the Air Force’s Ground Surgical Team, or GST, a six-member surgical team who can work in austere environments to provide damage control resuscitation, surgery, and critical care.
“Trauma care in austere, deployed environments is different than from trauma care in hospitals,” said Lt. Col. Christopher Mahoney, the GST consultant to the Air Force Surgeon General. “Resources and personnel are limited, and you often have little backup or access to a fully staffed, modern facility. GST members are trained for that environment to give patients the best chance of survival.”
RESGSTs are part of the Air Force’s Expeditionary Medical Support System, or EMEDS, which is a deployable, full-service medical facility. Since its first deployment in 1999, the EMEDS has played a critical role in every conflict and many humanitarian responses. However, as the nature of warfare changes, so to must EMEDS.
“Our EMEDS will need to become increasingly modular to function in contested, cyber-degraded environments for tans-regional, all-domain conflicts,” said Paul Clark, Expeditionary Medical Policy and Operations acting director, Office of the Air Force Surgeon General. “To meet these demands we are developing ways to modernize.”
The AFMS is working to increase the facility’s capacity to hold patients longer, or indefinitely, in degraded operational environments, as well as to grow relationships with partner nations.
Being medically ready for the future fight extends beyond the AFMS. The Air Force, along with the entire Department of Defense, relies on Global Health Engagement to strengthen partnerships with other nations. GHEs improve mutual capabilities through health-related exchanges and furthers interoperability with partner nations during contingency operations.
“The 2022 National Defense Strategy emphasizes the importance of working seamlessly with our allies and partners across domains to deter aggression and prevail in conflict,” said Col. Elizabeth Erickson, U.S. Air Force International Health Specialist Program director. “In the health domain, GHE is preparing for future contingencies where we may not have the full range of U.S. medical capabilities readily available. GHE programs will improve global readiness for future health security threats.”
GHE training programs and platforms are already evolving to ensure International Health Specialists who develop and execute GHE programs have the expertise necessary to continue strengthening partnerships. This includes creating a tri-service GHE orientation course, increasing training in security cooperation, and setting up a fellowship program set to begin this summer.
“Increasing the effectiveness of Air Force global health engagement is critical to supporting national security policies,” said Miller. “As a strategic goal of the Air Force Medical Service, it is important our internationally minded Airmen execute long-term, sustainable, and impactful medical security cooperation.”
Editor’s Note: This article is part two of a three part series highlighting Lt. Gen. Robert Miller’s priorities for the future of the Air Force Medical Service.
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