Air Force Surgeon General’s priority is creating high performing Airmen, Guardians (Part 1) Published March 25, 2022 By Shireen Bedi Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- The Air Force Surgeon General’s top priority is creating and sustaining high performing Airmen and Guardians who are medically ready for the future fight. Led by U.S. Air Force Lt. Gen. Robert I. Miller, Air Force and Space Force Surgeon General, the Air Force Medical Service is transforming and developing advanced training and specialized care experiences tailored to meet threats outlined in the National Defense Strategy. The Air Force Surgeon General’s top priority is creating and sustaining high performing Airmen and Guardians who are medically ready for the future fight. (U.S. Air Force graphic by Lindsay Mahon) Photo Details / Download Hi-Res “There is nothing more important than giving Air Force medics the best skills and training possible to enable them to keep warfighters ready and healthy, whether it's Airmen flying aircraft or Guardians operating satellites,” said Miller. “These are the two critical components of our medical readiness mission.” Human Performance Miller’s approach when it comes to improving human performance is prevention programs aimed at surpassing expected readiness levels. To bring preventive care closer to operational units, Miller is expanding the Operational Support Team concept, a program where medics rotate through units, coordinate with leadership, identify core issues affecting readiness, and develop and implement evidence-based interventions to improve overall readiness. Operational Support Teams consist of a program manager, physical therapist, exercise physiologist, psychologist and social worker. These specialists integrate into units for three to four months. So far, bases with Operational Support Teams have seen a 25% reduction in military treatment facility appointments for musculoskeletal issues. “What we have learned is that this concept works,” said Col. Richard Wallen, Chief, Integrated Operational Support, Air Force Medical Readiness Agency. “We have heard back from unit leadership and they are seeing improvements in mission effectiveness. It is important to make sure that our medical Airmen are engaging proactively with our operational units.” Mental Health Miller is improving access to mental health care through a new Mental Health Targeted Care concept. He aims to get Airmen and Guardians to the right service the first time, for their specific needs. “We have seen an increase in use of our mental health services over the past year, so we are optimizing our resources,” said Miller. U.S. Air Force Maj. John Doleski discusses the importance of mental health treatment with a technician. Leadership plays a key role in eliminating the stigma around seeking mental health treatment within the Air Force. A new Air Force Materiel Command initiative aims to better equip leaders to support Airmen during times of crisis and need. (U.S. Air Force photo by Airman 1st Class Michael Bowman) Photo Details / Download Hi-Res Lt. Col. Aaron Tricht, a clinical psychologist at the Air Force Medical Readiness Agency, says targeted care helps maximize existing resources while ensuring Airmen and Guardians get the care they need. “We won’t meet forthcoming demands if we don’t change how we operate,” said Tricht. “With targeted care, we connect the patient with the most appropriate path for support.” Currently, the Mental Health Targeted Care concept is being tested at four bases. “While we are still in the early stages, we are seeing some promising outcomes,” said Chief Master Sgt. Julie Foreman, mental health technician career field manager. “We have seen improvements in access to initial and follow up appointments, and we have seen caseloads reduced by nearly half for our providers.” Training Platforms Miller is expanding training platforms to better prepare his medics for whatever mission comes next. “We have elite medics who have gone above and beyond in the last two years,” said Miller. “They have kept the Air Force mission going at bases, while also supporting Federal Emergency Management Agency missions at civilian hospitals. Now, I’m making sure my medics have what they need for the next fight.” Miller has focused on enhancing how the AFMS uses military treatment facilities since becoming the Surgeon General. With more than 85% of medical Airmen working in MTFs, Miller is ensuring medics are at the right locations to treat the necessary patient mix and caseload to sustain their skillsets. “We need to continue maximizing the opportunities we have at our MTFs,” said Miller. “It is my job to ensure our medics continue practicing and perfecting the skills needed by our combatant commanders.” While MTFs remain the Air Force’s key training platform, the AFMS must also rely on partnerships with civilian and Veteran Affairs hospitals to get exposure to highly complex medical cases. The AFMS has more than 1,500 agreements with civilian facilities across the country. The Center for the Sustainment of Trauma and Readiness Skills, or C-STARS, program provides the advanced medical training capabilities required in deployed environments, such as trauma care, critical care and infectious disease. A cadre of Air Force medics integrate with civilian providers, and work as instructors for Airmen who rotate through the program. The Air Force has four C-STARS programs, the newest being the University of Nebraska Medical Center in Omaha, which focuses on caring for and transporting patients with highly infectious diseases. Senior Airman Caleb Harlon, 60th Operational Medical Readiness Squadron licensed vocational nurse technician, center, briefs U.S. Air Force Lt. Gen. Robert Miller, Air Force and Space Force Surgeon General, right, and Chief Master Sgt. Dawn Kolczynski, medical enlisted force and enlisted corps chief, on the process of hyperbaric oxygen therapy inside a hyperbaric chamber at Travis Air Force Base, California, July 27, 2021. Hyperbaric oxygen therapy is a medical treatment in which patients inhale intermittent 100 percent oxygen through hoods or masks in chambers pressurized to greater than one atmosphere absolute. (U.S. Air Force photo by Lan Kim) Photo Details / Download Hi-Res “We know that many combat casualties are non-trauma related,” said Miller. “The partnerships we establishes with civilian hospitals are integral in exposing medics to a variety of complex cases they may not see within the MTF.” Increase Capacity Miller is requiring all AFMS Airmen to maintain a baseline level of medical skills obtained through a program called Medic-X. In wartime or crisis situations where capacity is strained, he believes every Airman has a role in saving lives. “In a crisis, we need all hands on deck, including those Airmen not routinely engaged in patient care activities. We know administrative or non-clinical staff can help with basic patient assessments, so the clinician can focus on treating patients,” said Miller. The program is piloting a set of 58 skillsets, including patient IV measurement and patient assessment, at 15 facilities. The concept proved beneficial to the COVID-19 response. Non-medical Airmen were integrated into basic medical roles at facilities with increased caseloads. Miller’s next step is identifying ways Medic-X can be integrated into existing readiness training platforms. “We know the future fight will be different, and so will the idea of what it will take for us to sustain readiness,” said Miller. “I believe we have been taking the necessary steps to do just that.” Editor’s Note: This article is part one of a three part series highlighting Lt. Gen. Robert Miller’s priorities for the future of the Air Force Medical Service.