Pittsburgh, Pediatrics, and the People: Retiring AF-SG shares story, leadership ethos and personal growth

Story by Shireen Bedi

Air Force Medical Service

When Lt. Gen. Robert Miller became the U.S. Air Force Surgeon General in 2021, he committed to building and nurturing personal connections within the Air Force Medical Service. His priority was to ensure the AFMS remained the greatest ready medical force in world. Now, with his retirement ceremony in sight, Miller reflected on his career, discussing where it began, lessons he learned throughout his military career and the impact he hopes to leave on his fellow Airmen.

It’s well documented that many service members come from a military family. However, born in western Pennsylvania, that was not Miller’s experience.

“I was raised in a family of Pittsburgh steelworkers, so I didn’t have a big military background,” said Miller.

His motivation to become a physician, specifically, a family practice doctor, sparked from watching the 1970s television show, “Marcus Welby, M.D.” The show featured a wise, compassionate family practitioner who knew his patients on a first name basis and helped them overcome a variety of concerns.

While the TV series influenced his interest in the medical field, the Air Force provided the path.

“I could have gone to school at the University of Pittsburgh, but I just fell in love with the program at Uniformed Services University of Health Sciences.”

In addition to appreciating what USUHS offered, the program enabled him to pursue his goals. “I initially joined because I was concerned about the significant debt that comes with going to school,” said Miller. Students who attend USUHS don’t pay a tuition, instead, they incur a service commitment.

USUHS exposed Miller to multiple fields while he conducted medical rotations, but he quickly realized he was only interested in family medicine.

“I enjoyed interacting with kids and their parents much more than adult patients,” said Miller. “I ultimately got into developmental pediatrics as I really enjoyed working with special needs kids and their families.”

He has never regretted his decision to join the Air Force.

“While my mother initially did not want me to join the military, I am thankful that I made this career decision, wearing this uniform and serving our nation.”

Becoming a servant leader

Miller graduated from USUHS in May 1989. He was assigned to Wright-Patterson Air Force Base, Ohio, from June 1989 to June 1992 where he completed his pediatric residency.

He learned early in his career that being an effective leader means being humble enough to know your own knowledge gaps and when to ask for help.

“I naively thought that once I was done with residency that I would not go back for any additional learning outside of my medical role,” said Miller. “But taking on these leadership roles made me realize I had a lot to learn. That is where mentors and senior leaders became incredibly helpful.”

When assigned to a military treatment facility under the Air Education and Training Command, Miller recalled sitting with the command surgeon to discuss leadership styles.

“He mentioned that being a continuous learner opens doors and opportunities,” he said. “If I wanted to be an effective leader, I needed to take on this continuous learner mentality.”

The command surgeon also discussed servant leadership and gave Miller a book about it. He took his mentor’s recommendations to heart.

Nearly 10 years after graduating from USUHS, Miller earned his first leadership role as chief of medical staff at Aviano Air Base, Italy.

He said the lessons his mentor shared “paid off dividends whether it was when I was chief of medical staff or squadron commander or group commander.”

Miller learned effective leadership comes down to taking care of the people who take care of the mission every day. This is what drove his four action orders when he became surgeon general: Airmen; Balance; Currency and Competency; and Diversity, Inclusion and Belonging.

“Being an effective leader means being flexible to meet the needs of those you are leading,” said Miller. “At times, you are the military leader over the troops providing the mission and vision. At other times, you may need to function as a teacher educating the masses, or a chaplain providing spiritual support to those who are hurting. There is never a dull moment, and every day is different.”

Miller attributes his success to the people within the AFMS.

“I have been blessed to work with some amazing people,” said Miller. “I am most proud of what these leadership teams have accomplished in multiple jobs over the years. Any success attributed to me comes down to the amazing folks around me.”

Growing the AFMS for future success

Miller became surgeon general after Congress moved authority, direction and control of military treatment facilities to the Defense Health Agency, enabling services to focus on the readiness mission. Miller worked to develop the optimal structure of the AFMS to support evolving readiness demands, while also meeting the continual needs of the Department of the Air Force.

“With the incredible dedication of the people that make up our organization, we have been able to make a historical change to our structure,” said Miller. “The creation of the Air Force Medical Command is something I am most proud of. We are setting the AFMS up for success, ensuring we remain a ready medical force while supporting the needs at the military treatment facility level. It was time for this historic change, and I know it is the right decision for the AFMS.”

AFMED, as a field operating agency, reached initial operational capability in July 2023. In 2024, it will become a direct reporting unit called AFMED Command, or AFMEDCOM. Under AFMEDCOM, Air Force medical leaders will help balance readiness priorities driven by the Air Force and healthcare priorities driven by DHA.

“The challenges felt especially at the MTF level as they manage both readiness and the delivery of the health benefit demands that a new structure be set up to be effective,” said Miller. “These challenges only reinforce the need for strong leadership at all levels, beginning with the surgeon general. While the demands of AFMS leaders will change, we are in good hands as we have a strong bench of stellar medics at the helm.”

Miller encouraged medical Airmen to remained grounded and focused on the mission while the AFMS and DAF modernizes.

“In my 39 years of service, the core AFMS mission has never changed,” said Miller. “Putting on this uniform reminds us all that at the end of the day it is about serving our country and helping others. We are still about air power, aeromedical evacuation and providing the best care anywhere the mission takes us.”

Gratitude, continuous learning and what’s next

Miller thanked the AFMS community for their role in shaping him as a leader and an individual, acknowledging that positive change happens through collaboration.

“I have learned to fully appreciate the value of focusing on those I have the privilege to serve and not be concerned about self-centered goals,” said Miller. “It’s one thing to say this is how you function; it is much more important that others see it and feel it based on your actions. What I have learned over the years is that it is imperative to lead with humility, ask good questions and listen more.”

He attributes his success to the people around him.

“It’s all about the amazing people I am surrounded by and the relationships I’ve developed over the years” said Miller. “I will miss the staff more than anything else as I transition from the military to civilian life.”

He said the list of people he would like to thank is countless, but as a senior leader in the Air Force, he relied heavily on his senior enlisted leaders, deputies, executive officers, executive assistants, and personal mentors.

“I also can’t stress the importance of the Total Force, which to me include Guardsmen, reserves, civilians and contractors. Wearing my pediatrician hat, I do believe that ‘it takes a village to raise a child,’ and I think this applies to more than children.”

Upholding his duties as a fellow Airman, pediatrician and senior leader, Miller strives for balance and implores others to read and grow in all areas of their life.

“It is so important to find balance in your life, valuing how you spend your 24 hours every day,” said Miller. “I love and appreciate everyone’s dedication to the mission, but it can’t be all about work. You are at your best when you have balance, finding time for family, social life, fitness, spiritual growth, and sleep. I am still working that balance myself.”

When asked to reflect on his career, and whether he would change anything, Miller said he wished he started a reading program earlier on.

“I started reading books that only focused on my job, but I quickly went down a path where I read to fill my own knowledge gaps, something we all have,” said Miller. “I read a lot on leadership and that led me to read other books. These could be about interests of yours, hobbies, or things you want to work on like how to be a better spouse or parent.”

Miller also encouraged medics to give feedback to senior leaders.

“I hope that a young medic would know that leadership cares deeply. Leaders are listening to their concerns and are always trying to make the best decision for the good of the AFMS,” he said. “Young medics don’t always get ‘the rest of the story’ for why things play out the way they do. But I hope there is trust, transparency and ongoing communication to clarify their important role in making the magic happen and living by the core values. There is much to be proud of being an AFMS medic, and this is an exciting time to be in the Air Force!”

As for retirement plans, Miller will explore new ways to make an impact.

“I’m still trying to figure out ‘what I’m going to do when I grow up’ as I’m not ready to retire,” said Miller. “I will be working somewhere in a leadership role, and the next job will determine where Laurie and I will hang our hats for the next five to 10 years. I’m excited about what the future holds for us!”