Dual mission, single focus: Military medicine strikes balance between readiness, healthcare

Story by Elaine Sanchez

Defense Health Network Central

Military medicine is a unique profession. Rather than one oath, military providers swear two – one to support and defend the Constitution and the other to “first, do no harm.”

To successfully navigate these dual priorities, the Military Health System is finding innovative ways to balance critical readiness requirements with the delivery of safe, high-quality care to ensure mission success both on and off the battlefield.

“In this increasingly complex and dynamic strategic environment, this balance is crucial, as a healthy and medically ready force is essential to our mission success,” said Air Force Maj. Gen. Thomas Harrell, director, Defense Health Network Central, and commander, Medical Readiness Command Alpha. “We also have a sacred commitment to deliver safe and effective care to all who serve and their families.”

Within DHN Central, a network of 39 military medical facilities, leaders are achieving this balance through collaboration and innovation, the general said.

Whole-of-team effort
As one of many examples, he noted, the 2nd Medical Group at Barksdale Air Force Base, Louisiana, recently launched a civilian-run clinic to sustain continuity of care during combat readiness training days.

One day each month, civilian providers deliver care to patients while military medical personnel focus on honing their skills for the battlefield. Prior to launch, the main clinic was closed on training days.

“By centralizing care into a dedicated clinic, staffed entirely by civilian employees, we’re able to provide continuity of care to our patients without disrupting military training requirements,” explained Air Force 1st Lt. Jonathan Tapia, 2nd Medical Group’s group practice manager. “This innovative approach allows us to maintain access to care, even during periods when our clinic would traditionally be closed.”

The centralized clinic, staffed by an all-civilian team of doctors, nurses, technicians and support personnel, offers acute, primary and some specialty care, as well as radiology, pharmacy and laboratory, to both walk-ins and scheduled patients. Since the centralized clinic stood up Aug. 14, 2024, providers have conducted more than 300 appointments, completed 350 lab tests, and filled over 1,600 prescriptions.

“It’s been very successful and truly gratifying to see the results,” said Air Force Lt. Col. Jennifer McAndrews, 2nd Medical Group’s chief nurse executive. “Within the first hour of opening the clinic, we received several patients in need of acute care, which validated the importance of this initiative. I take this very personally; we need to be here for our service members and all of our patients.”

Patient feedback has been positive, Tapia noted. “The availability of morning appointments during training days has provided a convenient option for beneficiaries, reducing wait times and enhancing their overall experience.”

The clinic also frees up military personnel to focus solely on training, rather than try to divide their time within in the clinic, and the group is taking full advantage of the opportunity, McAndrews said. The medical group recently partnered with a local simulation laboratory, where military nurses and technicians hone their skills using virtual reality and other innovative tools.

“As medics, we need to be using our skills to the top of our scope,” she said. “In a deployed environment, our medics will be called on to make decisions, and they need to be able to do so confidently and deliberately, and potentially without higher level support. We need to be here to take care of our service members, not just from a healthcare perspective, but from a readiness perspective.”

Civilian providers are reaping benefits from this clinic as well, noted Patrick Hickey, 2nd Medical Group physician assistant. “This clinic gives civilian providers and nurses an opportunity to work beyond their usual scope of practice to evaluate and treat a broader age group, with an increase or change in complexity of disease, to the betterment of the individual provider or nurse and group,” he said.

Readiness in action
The 19th Medical Group at Little Rock Air Force Base is also working to ensure continuity of care while sustaining critical readiness training. As the only military treatment facility in Arkansas, the clinic receives patients from across the state and its neighboring states.

With a busy C-130 pilot training mission, the group is also charged with the care of trainees and support personnel. With the high operations tempo at Little Rock AFB, medical leadership identified the need for dedicated readiness training for their military medics. To minimize closure hours and in collaboration with installation leadership, the group launched a weekly, three-hour combat readiness training earlier this month.

“We have incredible medical personnel who are devoted to patient care,” said Air Force Col. Elizabeth Anne Hoettels, group commander and clinic director. “This initiative enables us to carve out dedicated time for training, but without compromising our ability to focus on patients.”

Thanks to leadership support across the board, she added, “We’re now able to offer realistic, hands-on combat training in the morning, while still ensuring continuity of care for our valued patients.”

During training hours, military personnel focus on medical and combat readiness during training sessions and military exercises. This dual focus equips medics with critical lifesaving skills while also preparing them to support warfighters with tasks such as field communications and generator operations. A recent exercise focused on cold-weather operations and how to safely operate in these conditions.

“As leaders, it’s our responsibility to ensure our medics are competent and confident in what they’re doing,” Hoettels said. “I won’t always be there, but I can help ensure they can think through challenges and steps that need to be taken. Realistic training is critical to this effort. We must set our medics up for success in any setting, no matter how remote or austere.”

The clinics at Barksdale AFB and Little Rock AFB are just a few examples of how the Military Health System is working to enhance readiness and healthcare delivery in today’s dynamic strategic environment, Harrell noted.

“In this era of Great Power Competition, change is not an option, but a necessity,” he said. “We took an oath to support and defend our Constitution and nation; and, as medical professionals, to provide the highest standard of patient care. We have a dual mission, but a singular focus. These innovative solutions demonstrate our unwavering commitment to mission success, while always keeping our patients’ well-being at the forefront.”