Mobilization

File: aaabf_47.txt
Page: 47
Total Pages: 51
CATEGORY: Planning 
 
ISSUE ITEM t: 
 
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