With the war on terrorism raging, the spotlight justifiably is on the Army's medics, evacuation units, surgical teams and field hospitals in the theater of war.
Yet the Army Medical Department is also a seamless chain of care stretching back to fixed hospitals in Europe and the United States, where soldiers receive state-of-the-art care.
Field medical units are under the command of the combat commanders, because their movements and work must be coordinated with those of fighting forces.
The fixed hospitals, on the other hand, are commanded by the U.S. Army Medical Command.
The challenge for Army medicine is (1) how to provide medical leadership for field units while respecting combat commander's "ownership" and (2) how to integrate the work of field and fixed units.
Back to Top
The AMEDD's answer is to "dual-hat" the top Army physician as both the Army surgeon general and the commanding general of MEDCOM.
As Army surgeon general, this lieutenant general is the medical expert on the Army staff, advising the secretary of the Army, Army chief of staff and other Army leaders. His position and expertise enable him to provide effective medical guidance to field units even though he does not command them.
As head of the MEDCOM, he actually commands fixed hospitals and other AMEDD commands and agencies. This system unites in one leader's hands the duty to develop policy and budgets (Army surgeon general) and the power to execute them (MEDCOM commander).
Back to Top
This unity is reinforced by the "one-staff" concept. This blends the Army surgeon general's staff, located in the Washington, D.C., area, and the MEDCOM commander's staff at Fort Sam Houston, Texas, into a single staff for both three-star functions.
Legally, OTSG and MEDCOM remain separate entities with different duties and powers (for example, OTSG explains the medical budget to Congress; MEDCOM oversees the spending). However, staff members are now dual-hatted like their boss, to cut duplication and improve communication. The staff totals less than 1 percent of AMEDD strength.
Three assistant surgeons general are dual-hatted as MEDCOM deputy chiefs of staff: a DCS for force management, a DCS for force sustainment, and a DCS for force projection.
Back to Top
Other features of AMEDD structure:
- Medical research is unified under a single major subordinate command, U.S. Army Medical Research and Materiel Command, Fort Detrick, Md.
- Eight Army medical centers, 26 medical department activities and numerous clinics in the United States, Europe and Japan are grouped under six major subordinate commands called regional medical commands.
- Dental facilities are grouped under U.S. Army Dental Command, a major subordinate command. DENCOM has regions called regional dental commands. DENCOM headquarters is at Fort Sam Houston, Texas.
- Veterinary elements are under U.S. Army Veterinary Command, a major subordinate command at Fort Sam Houston. VETCOM has regional veterinary commands, which oversee veterinary districts. VETCOM's Defense Department-wide mission supports the Army, Navy, Air Force and Marine Corps.
Other MEDCOM subordinate commands concentrate special expertise and resources for more efficient support of worldwide AMEDD missions.
- The Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Md., centralizes scientific experts and resources to efficiently support a worldwide preventive medicine, occupational health and wellness mission.
- U.S. Army Medical Information Technology Center, at Fort Sam Houston, centralizes life-cycle management of AMEDD information systems. It is the AMEDD's "one-stop shopping center" for computer and information-management expertise and services.
- The MEDCOM's Health Care Acquisition Activity provides worldwide medical contracting support for the AMEDD, through contracting centers located at four medical centers and at Fort Sam Houston.
Visit links to AMEDD subordinate commands.
Back to Top
A big business
MEDCOM has about 27,000 soldiers and 28,000 civilian employees. Another 20,000 active-duty medical soldiers are in field units. The National Guard and Army Reserve have over 30,000 medical soldiers.
The MEDCOM currently manages a $9.7 billion budget and cares for more than 5 million beneficiaries—active-duty members of all services, retirees and their family members.
Besides VETCOM support to all services, the AMEDD is engaged in many joint-service efforts. OTSG oversees joint field operating activities for the Secretary of Defense. AMEDD units participate in many multiservice deployments/exercises.
Visit links to some of OTSG-supported DOD executive agencies.
Back to Top
In Operation Iraqi Freedom, a war characterized by amazingly low fatalities among American troops, the fate of wounded soldiers has become a focus of intense interest for the American people. During the years following, the Army Medical Department and Medical Command have been increasingly involved and dedicated to providing medical support to our deployed Soldiers, returning Soldiers, and their Families.
To address this interest, media representatives have blanketed Army Medical Department facilities, from tent hospitals near the scene of action in Afghanistan and Iraq to the stateside Army medical facilities where patients are evacuated for recovery and rehabilitation.
What the media have seen and reported to the American public has been a heartening story of courageous young men, women and families adapting to often heartbreaking injuries, fighting to rebuild their lives with the same strength and heroism they applied to fighting for their country, and grateful for the dedicated and skilled ministrations of their AMEDD healers.
For 200 years Army Medicine has not only served U.S. forces but advanced the medical knowledge of all mankind and reduced human suffering in many lands.
The tradition continues. Even when not at war, over a thousand Active and Reserve Component medical soldiers are overseas at any time, serving in over a dozen lands, on real-world missions or training exercises. While deployed, they use their special skills and equipment to help local people, too.
- In the Balkans, Army medics treat peacekeepers of many nationalities. They also help out in civilian hospitals—giving care to those who need it, teaching local physicians and nurses, often donating badly needed equipment and supplies.
- In Latin America, Army medical teams make periodic visits. The visits are good training but also offer once-in-a-lifetime access to the miracle of modern care for poor people in remote villages.
- In Saharan Africa, U.S. Army dentists, veterinarians, preventive medicine experts and ophthalmologists coached local professionals and volunteers on modern medical methods while treating hundreds of local patients. This was during just one exercise.
- Other AMEDD teams have delivered surplus medical gear and coaching to former Iron Curtain nations striving to modernize health services after decades of stagnation under Communism.
- Army experts are often dispatched overseas to help local officials cope with disease outbreaks, such as a dengue fever epidemic in El Salvador in 2000.
- The U.S. Army Medical Research Institute of Infectious Diseases has helped overseas and at home to study and contain outbreaks of deadly diseases such as SARS and Ebola.
Through formal schooling, too, Army Medicine helps build medical resources in many nations. Scores of foreign military medical personnel train yearly at the AMEDD Center and School, taking back new ideas and skills not only to their armed forces but ultimately to their countries' civilian healthcare systems.