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Recognizing that leadership in the medical forces is critical to the overall readiness of combat units. General Colin Powell, just prior to his retirement as Chairman of the Joint Chiefs of Staff in the fall of 1993, bestowed the Chairman’s Award for Military Medical Leadership on three young medical officers. Selected by the individual services, the honorees represent the best of Army, Navy, and Air Force medicine.
From the Army, Lieutenant Colonel B. Wayne Blount is Chief of the Department of Family and Community Medicine at the Eisenhower Army Medical Center at Ft. Gordon, Georgia. Board certified in both family and preventive medicine, Colonel Blount is a Distinguished Graduate of West Point, class of 1972. Prior to graduating from medical school at the University of Miami, he served with the 101st Airborne Division as an infantry officer.
From the Air Force, Lieutenant Colonel Michael “Mick” Pietrzak
is Chairman of the Department of Emergency Medicine at Malcolm Grow Medical Center in Maryland, Director for Continuing Medical Education Programs at the Uniformed Services University of the Health Sciences, and a consultant for emergency medicine to the Surgeon General of the Air Force. A Phi Beta Kappa graduate from Iowa State, he earned his medical degree from the University of Iowa. Colonel Pietrzak holds a Senior Flight Surgeon Rating, is board certified in emergency medicine, and is a leader in military medicine education. Following early service in Korea, he has seen much duty in the Washington,
D.C., area.
From the Navy, Commander Robert Hansen serves with the Marine Corps at Camp Pendleton, California. He received his medical education at Georgetown University and preventive medicine is his field of special interest. Commander Hansen is credited with developing a comprehensive and deploy
able disease surveillance system, first employed on the battlefield when he deployed with Operation Desert Storm. He also served with Operation Sea Angel in Bangladesh and Operation Restore Hope in Somalia, where preventive medicine measures were most significant.
Despite their diverse backgrounds and interests, these three officers have at least two things in common. First, they all have been students, teachers, or both at the Uniformed Services University for the Health Sciences in Bethesda, Maryland. They are uniformly enthusiastic in their praise of that institution, emphasizing the motivation it provides for leadership. One officer noted that he considers the university to be a “force multiplier.”
A second characteristic they share has to do with their peers and subordinates. When you question their associates as to whether these officers are deserving of the Chairman’s Award, the response is uniformly positive, with the com
partments, particularly the medical corps, will face considerable downsizing over the next decade. Given the projections for total manpower strength, it seems exceedingly unlikely that the medical departments will remain at current levels simply to provide dependent and retiree care. It is impossible to anticipate the forces that will modify the scope, size, and mission of peacetime medical care, but something will happen. It is imperative that some plan for preserving operational military medicine be put in place before the press of events takes control.
A third assumption is that—even though the actual number of physicians employed in staff and command billets in any future deployment will be small compared to the total number of physicians deployed—it will be impossible, within the time constraints of most deployments, to hand-select the physicians for those staff and command roles. It follows that a sufficiently large cadre of trained military medical officers is needed in staff and command positions (and in leadership roles in clinical positions) so that people equipped for these assignments will be available at deployment time.
If these assumptions are correct, then the future need for naval medical officers with military training will in
crease, despite downsizing. And past experience strongly 1 suggests that under budgetary stress, the first thing to be ( sacrificed is the professional military education of med- \ ical officers. Unlike line officers, medical officers in peace- ' 1
time require extraordinary, civilian-dictated, continuing i educational efforts. Furthermore, the time of medical officers is—by the nature of the civilian profession’s com- | petitive market—more expensive than that of other officers. Their training in military professional education, therefore, must accommodate the realities of their med- , ical duties.
If the Navy is to have naval medical officers available to meet the needs of the Navy and the nation, extraordinary efforts will have to be made to preserve militarily educated physicians. The Uniformed Services University of the Health Sciences is valuable because it provides much of that education and socialization before the medical officer becomes useful to the peacetime health-care system. But there is no guarantee that USUHS will survive continued attempts to shut it down.
There is a heritage of officership in Navy medicine that dates back to Stephen Decatur’s 1804 mission to destroy the USS Philadelphia. When Decatur’s surgeon, Lewis
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Proceedings / June 1994
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mon word being pride—as in, “We’re so proud of him!” There is an old adage about leadership that states, “You can often con an admiral, but you can never fool the crew.” Colonel Blount, Colonel Pietrzak, and Commander Hanson obviously have passed this leadership test.
General Powell’s successor. General John Shalikashvilli, has agreed that the award should be given annually, and Mr. Zachary Fisher has enthusiastically agreed to support
the awards with financial grants through the Elizabeth and Zachary Fisher Armed Services Foundation. Each of this year’s winners was awarded a $50,000 grant by the foundation for application to the area of medicine of his choice. Colonel Blount has directed that his grant be channeled to research in military family practice medicine; Colonel Pietrzak’s grant will go to support research in military emergency medicine; and Commander Hanson has elected to use his
General Colin Powell presents the Chairman’s Award to doctors Michael Pietrzak, Robert Hanson, and Wayne Blount, with Leonard Marks, President of the Elizabeth and Zachary Fisher Armed Forces Foundation.
grant to fund equipment purchases to enable preventive medicine officers at each of the three Marine Expeditionary Forces to conduct field research.
Heermann, volunteered to accompany the mission, Decatur declared the mission was “too dangerous.” Heermann had a three-part response. First, doctors are not different: “My life is not more valuable than that of any. . . other.” Second, there were humanitarian obligations: his “presence ... to assist the wounded, might save . .. lives.” And, perhaps most important to the mission-oriented Decatur, the medical officer could contribute to the capability of the force: “will not sailors more regardlessly expose themselves, when they know . . . aid is near at hand? Should you have many wounded, would not some confusion arise, to impair your effective force?”12
Heermann went in and Navy doctors have gone in ever since; but like any other officer, they do better when they are properly trained. The health of the command is a command responsibility. If the Navy is to have the medical officers it needs, the line must maintain a sustained interest in their training.
'History of the Medical Department of the United States Navy, 1945-1955 (NAVMED P-5057), p. 144.
"Albert Cowdrey, The Medic’s War (Washington: GPO, 1986), p. 364.
’Hearings on H.R. 2 to establish a Uniformed Services University... (HASC 92- 27). See also F. Edward Hubert, Last of the Titans (Lafayette, La: Center for Louisiana Studies, 1976).
‘Ibid.
'Susan Straight, "USUHS: Its not just a medical school," Navy Medicine, 1992, 83(5), pp. 18-23.
‘Lt. Antony G. Massey, MC, USNR, “Intern Training for the Field,” Navy Medicine, 1993, 84(5), pp. 3-4. Lieutenant Massey has correctly identified the incompatibility of the GMO training and specialty training missions in the internship year. Medically, the military services are unique in credentialling as independent practitioners those who have completed only one postgraduate educational year. Discussions are ongoing in the medical departments on the problem, but the only real solution is to increase training time with an accompanying increase in costs. “‘Operation Desert Storm: Improvements Required in the Navy’s Wartime Medical Care Program,” GAO findings and recommendations to be addressed in DoD Comments, GAO Draft, 19 May 1993 (GAO Code 393504), p.3.
"The fitness reports of both alumni were provided by the officers, and they have given permission to quote them in this paper.
"Report of the Panel on Military Education, Committee on Armed Services, 101st Congress, Committee Print 4 (Washington, DC: GPO, 1989).
I!F. L. Pleadwell and W. M. Kerr, “Lewis Heermann, Surgeon in the United States Navy,” Annals of Medical History, 1923, 5, pp. 113-145.
'R. Marmion, "The United States Naval Medical School," Journal of the Association of Military Surgeons of the United States, 1906, 11, pp. 23-34 ’Capt. H. L. Pugh, USN, "The Naval Medical School in 1946," U.S. Naval Medical Bulletin, 1946, 46, pp. 1159-1169.
Dr. Smith is an associate professor and medical historian at the Uniformed Services University of the Health Sciences at Bethesda, Maryland.
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Proceedings / June 1994