In 1942, 15 bombers crashed off the coast of China following the Doolittle Raid on mainland Japan. Most of the men in those bombers survived; one, 1st Lt. Tom Lawson, suffered a severe laceration to his leg. Lt. Thomas White, a flight surgeon on the mission, amputated the leg after it became infected. Lawson survived, made it home, wrote a book, and lived for another 50 years because there was a medical Airman integrated into the mission.
This is one of the earliest examples of Integrated Operational Support, something the Air Force has continued to develop and evolve over the years.
“If he hadn’t been there to provide that care, there’s a high probability Lawson would have died. If he hadn’t been integrated into what was a highly classified mission that type of care would not have happened,” said Col. Bill Nelson, who facilitates the IOS working group, headed by Brig. Gen. Mark Koeniger, commander of the 711th Human Performance Wing at Wright-Patterson Air Force Base, Ohio. “74 years later, we’ve got air evacuation nurses and technicians integrated into AMC’s (Air Mobility Command’s) global reach mission.”
When you think of medical Airmen you probably picture the doctors, nurses and technicians needed to run the Air Force Medical Service’s military treatment facilities. But Nelson said of the 39,000 medical personnel in the Air Force, about 3,500 of them are integrated directly into line organizations, units executing an operational mission. Some integrated personnel provide appropriate levels of medical or mental health care and some provide medical advice at Major Commands, Combatant Commands, Air Force, and Department of Defense Headquarters.
“These Air Force medical personnel are not working in medical groups,” Nelson said. “They are serving in line units so that together with the other members of the team they’re accomplishing Air Force missions more effectively.”
One example is integration of medical Airmen within Intelligence, Surveillance, and Reconnaissance units. These units conduct missions which can result in mental and physical health challenges for ISR Airmen. But they can’t talk about those challenges with medical personnel who do not have the appropriate security clearance because the missions are classified at a high level.
Nelson said, “By integrating AFMS medical personnel within ISR units they’re readily accessible to the Airmen as they’re doing their time-sensitive mission, and they are able to discuss medical issues related to classified missions with those Airmen. They can also provide well informed medical advice to ISR commanders.”
He added the 711th Human Performance Wing has used occupational psychological health surveillance to document a 30% reduction in stress since medical personnel were integrated into the units.
Nelson and the rest of the IOS working group are working to envision the future of IOS. They want to answer the question, “How can IOS be most effectively and efficiently provided?”
He said, “We’re also considering what the appropriate metrics and measures are to ensure we’re enhancing Air Force mission execution as well as injury prevention and efficient injury treatment when it’s necessary.”
The advantage of IOS is medical Airmen can be integrated anywhere they’re needed to support the Air Force mission. Right now, medical Airmen support pararescue teams, special tactics units and even support combatant commanders with medical advice for policy or operations.
Nelson said the IOS goal is to optimize execution of the Air Force mission, and that means analyzing the best ways to medically support Air Force units as they change the ways they operate in air, space, and cyberspace.
He said, “No one would’ve guessed 25 years ago we’d have Airmen dealing with issues related to unmanned aerial vehicles and today’s ISR capabilities. Who knows what new issues Air Force medics will be dealing with 25 years from now? However, IOS will continue to support the mission in the best way possible. We’re developing recommendations for Brig. Gen. Koeniger and AFMS leadership to ensure we are positioned to integrate operational support where the Air Force needs us to fulfill the mission of ‘Global Vigilance, Global Reach, and Global Power’.”
Integrated Operational Support is one of the four focus areas for the Air Force Medical Service along with Full Spectrum Readiness, the Air Force Medical Home and Trusted Care.