CHAPTER XIV

Summary and Conclusions

The thirteen preceding chapters in this monograph present a review of the major areas of Medical Department activity in support of the U.S. Army in Vietnam, as derived from a variety of official documents. This final chapter, on the other hand, includes value judgments related to these activities, their successes and weaknesses, and highlights some of the more significant lessons learned. These opinions are based upon extensive review of official records and reports as well as on my own experience and observations during two tours of duty as a senior medical officer in Vietnam, interspersed with two tours of duty in the Office of The Surgeon General.

Medical Command and Control System

The preferred organization for employing and controlling military medical, resources is the vertical medical command and control system which reached its epitome in Vietnam. Medical service is an integrated system, with its treatment, evacuation, hospitalization, supply service, and communications components. It is not a subsystem of logistics, nor is it a subsystem of personnel.

To achieve maximum effectiveness and efficiency in medical service support, with the utmost economy in the utilization of scarce health care resources, there must be strong professional medical control from the most forward to the most rearward echelon. The commander of the medical command, regardless of echelon, should function as the staff surgeon to the responsible supported commander. Medical capability must not be fragmented among subordinate elements but rather centrally directed and controlled by the senior medical commander. No nonmedical commanders should be interposed between the medical commander and the line commander actually responsible for the health of the command. Specifically, logistical commanders, with their broad materiel related functions, should not be made responsible for a task so critical and so uniquely professional as the provision of health services. The well-being and care of the individual soldier must not be submerged in, or subordinated to, the system responsible for the supply and maintenance of his equipment. The issues involved are too great to risk failure or marginal accomplishment.