ACC medics discuss growing global challenges during Fall Command Surgeon Conference

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  • By Jasmine Braswell

Group commanders and senior enlisted leaders from 11 medical treatment facilities (MTFs) across Air Combat Command came together in mid-October for the Fall Command Surgeon Conference at the Creech Conference Center. 

The conference focused on preparing the future medical force through training, readiness, and connectivity and helping medical leaders gain a better understanding of what the next 30 years will look like.  

Discussion of growing global threats was a key component of this year’s conference.  

In the Pacific theater, “…the U.S. is facing an adversary where we will have more casualties in the first three hours than we have seen in the past 30 years in the Middle East,” said Gen. Mark Kelly, commander ACC. 

Brig. Gen. John R. Andrus, Joint Staff Surgeon, emphasized that nesting with military strategy will strengthen the future medical force and that increasing threats like China and Russia, cybersecurity challenges, antibiotic resistance, and homeland defense all reflect an escalating dynamic.  

Health services doctrine guides strategic planning for translating military medical strategies into actionable outcomes. To strengthen the military, the National Defense Strategy (NDS) calls for a foundational transformation that incorporates policy, technology investments and adaptability in defense systems, Andrus said. All planning is guided by an awareness of geopolitical, economic, medical and military trends. 

To improve the readiness of medical Airmen, the Defense Health Agency (DHA) will implement a new training program called MEDIC-X. 

MEDIC-X will equip medics with prolonged casualty care and life-sustaining skills for use in a contested environment. Affiliated medical personnel, whether working in health administration or clinical practice, can provide prolonged care with these new abilities. 

 “Forging success in a time of unprecedented change is always a bit difficult,” said Capt. Hershell Gaffney-Witherspoon, Chief of Training and Exercises in the office of the Command Surgeon at Headquarters ACC. “As the Command Surgeon directorate, we want to make sure the 11 MTFs we support have the information from the horse’s mouth.” 

The MEDIC-X policy and implementation plan was approved in April 2023, giving Air Force Medical Services a head start in implementing 13 of 52 skills from the first module. 

“When it comes to dealing with someone’s life, we don’t want to place our medics in a position of, ‘I can’t do that, or I don’t know how to do something.’ MEDIC-X training can help with saving or prolonging someone’s life,” said Lt. Col. Jasmine Cook, Chief of Nursing at the 20th Medical Group at Shaw Air Force Base, South Carolina. “We’re not looking to do anything super specialized with MEDIC-X. [The intent is] to provide basic skills that can go across the entire spectrum of medicine to prolong a person’s life until a medic of a higher level can get to them.”

Most clinical skills would be completed after module one. Tactical Combat Casualty Care, or TCCC, and MEDIC-X are foundational trainings.  

“TCCC comes in at the start of care—the point of injury—where someone is shot, stabbed, blown up or burned,” said Cook. “This is where you’re stopping the bleed, providing care under fire and potentially in a hostile environment, or doing actual lifesaving care. Meaning if this care is not provided to someone, they may die.”

Once the patient is stabilized, MEDIC-X begins to prolong the life of the patient. 

“[MEDIC-X] is a mentality, culture, or a highway to the future because these prolonged casualty care skills will become mandatory in a joint environment,” said Cook. “There will be people providing burn care or more incision-based care in the future. We are already ahead of the game regarding tracking and getting those skills accomplished.”  

On day two of the conference, a non-governmental organization called Global Response Medicine provided examples of their work from 2022 as a small medical group in Ukraine where medical processes and technology from the Soviet era remain. 

In Ukraine, acceptance of new medical technology is often resisted, said Michael Hetzler of the GRM team. Plans outlining routes to specific rehabilitation centers, and locations where casualties were sent and the units receiving them were outdated. In Europe, the culture of medicine and how it is applied often differs for each country, from traditions, ethics, and legal applications to scope of practice and medical protocols. 

In one example Hetzler provided, two heart surgeons and an oncology surgeon in Ukraine needed to perform surgery but could not touch the patient unless they had approval from a higher authority. 

Understanding allies as much as enemies is a priority, Hetzler said. 

“I don’t think we’re going to be doing anything alone anytime within the next 30 years,” he said. “Understanding the culture and medical practice when you are working with Australian forces or with Vietnamese forces is important in the Pacific. You will find yourself working with allied providers that have different perspectives.” 

The future and strategic competition in irregular warfare or irregular activities will provide unique challenges and opportunities for Air Force medical providers. 

“There are going to be providers in the operational environment that are uncommon for us… we need to leverage them. We need to use them. We need to ally with them,” said Hetzler.