Document Page: First | Prev | Next | All | Image | This Release | Search

CATEGORY: Planning 
 
ISSUE ITEM #:
 
SUBJECT: Requirements Deviation 
 
BACKGROUND: The UTC and the plan for the contingency hospitals were predicated on a nuclear ground war in 
Europe. Contingency hospitals need to have flexibility and mobility not tied to one scenario. Staffing should be based on a 
realistic role of rapid medical stabilization of patients in the field, continued stabilization along medical evacuation routes 
and definitive care in the United States at fixed facilities. Modern medical technology limits the amount of pre-placement 
of medical equipment since equipment quickly becomes obsolete. Internist and family medicine physicians should out 
number surgeons and be the lead providers at out of theater contingency hospitals. The following specialties must be 
represented to support the internists and family medicine physicians. Those specialists include, general surgeons, 
orthopedic surgeons, ENT specialists, urologists, OB-GYN surgeons, psychiatrists, radiologists, and anesthesiologists. 
Physical therapists are vital for burn therapy and orthopedic injuries. Surgeons should predominate at the battle field 
medical treatment facility and at the fixed, state-of-the-art 4th echelon hospitals. Surgeons should be assigned only to 
augment other medicine physicians at medical treatment facilities located along the medical evacuation route. The UTC 
needs to have a feed back mechanism. The deployed unit needs to be able to call up resources based on actual need, not a 
manning document. The supplying MAJCOM needs to have direct communication with the deployed unit to fine tune 
staffing. Substitutions should not be made based on filling slots on a manning document. Substitutions should be based on 
real needs. Substituting OB-GYN physicians for surgeons when only a very limited amount of surgery could be done was 
not good management of resources. Psychiatric services are basic to any medical deployment. Psychiatrist deployed with 
contingency hospitals need trained nursing support to care for hospitalized patients.
 
DISCUSSION: Many providers of care deployed to contingency hospitals could have been better utilized at other 
locations (including their home unit). OB-GYN physicians, histo-techs, and cyto techs are some AFSCs we need to 
re-look. The mix of specialties at contingency hospitals was probably not the most effective for this war. 
 
ACTION RECOMMENDED: UTCs should not be the sole determiner for staffing contingency hospitals. Perhaps a core 
such as the ADVON team could be standardized. Then, based on an in theater assessment of the war scenario and 
location of the contingency hospital the remaining staff specialists could be determined. 
 
SUGGESTED OPR:  HQ USAF/SGHR 

Document Page: First | Prev | Next | All | Image | This Release | Search