Founded in 1891 and chartered by Congress in 1903 as the Association of Military Surgeons of the United States, AMSUS later retained the acronym but officially renamed the organization The Society of Federal Health Professionals to reflect its wider reach and concerns in the 20th century.

In 2016, AMSUS marked 125 years as a permanent organization, its unofficial roots can be traced back to 1863 and formation of the Confederate Association of Army and Navy Surgeons. Both groups shared a common concern: how to retain and disseminate the medical knowledge and lessons learned in combat both during and between wars, as was the case in 1891, and help facilitate and spread dramatic changes and advances – medical, technical, operational, and philosophical. An organization like AMSUS had to be created to document and preserve the perishable medical knowledge gained in war as well as in natural disasters and epidemics.

“I don’t think there is any other medical meeting that brings all these agencies together in one place or a journal that has all the different disciplines and agencies and partnerships together in one place. Through our annual meeting and the journal, we provide others the opportunity to gather and share information.”

“There was a need to gather and maintain some of the lessons learned from previous wars on how to treat battlefield injuries so we don’t have to learn the same lessons over and over again,” said Cmdr. John Class, USN (Ret.), AMSUS Deputy Executive Director and a former Medical Service Corps health care administrator. “Because of the time frame [between wars], a lot of the physicians involved in previous combat care were retiring or dying and that knowledge base was getting lost. And once you lose those with experience, then the next generation of physicians has to learn the same lessons all over again.”

From the beginning, AMSUS was set apart from other medical organizations by taking no advocacy role on any of those topics, but providing U.S. federal health care providers – both military and civilian – medical and pharmaceutical companies, state emergency health care providers, and, more recently, the international military medicine community with open forums to report new discoveries, discuss changes in emergency medicine, and exchange ideas and information.

“We’re more platform than activist,” Class said. “I don’t think there is any other medical meeting that brings all these agencies together in one place or a journal that has all the different disciplines and agencies and partnerships together in one place. Through our annual meeting and the journal, we provide others the opportunity to gather and share information.

“For instance, in Military Medicine, we publish a lot of supplemental issues on specific topics, such as women in combat. It’s a place where you have a number of different DOD [Department of Defense] and VA [Department of Veterans Affairs] authors of different articles and studies compiled in one place, making their own recommendations that both DOD and the VA can use to determine future issues and where they are going.”

At the same time as its founding, AMSUS began publishing the monthly Military Medicine journal and holding an Annual Continuing Education Meeting, both designed to build a new system of medical networks and provide forums for interservice and interdisciplinary exchanges, free from competitive or organizational “stovepipe” restrictions. Its members and beneficiaries of these efforts include DOD, the VA, and the U.S. Public Health Service (PHS).

“We help advance the knowledge of military medicine – and the realm we advance is readiness, which is totally unique in the federal environment. And, finally, but very importantly, we are the most prestigious recognizer of excellence. The AMSUS awards are the only accredited, recognized awards in military medicine.”

“We are a historical vessel, helping keep alive the traditions of the military. We support them through our awards ceremonies; we support fellowship between federal agencies that not only increases the satisfaction of being a health care professional, but I believe helps smooth the operations of organizations with others by providing professional social relationships in an environment where they are not separated by competition,” said AMSUS Executive Director and former Navy Surgeon General Vice Adm. Michael Cowan.

“We help advance the knowledge of military medicine – and the realm we advance is readiness, which is totally unique in the federal environment. And, finally, but very importantly, we are the most prestigious recognizer of excellence. The AMSUS awards are the only accredited, recognized awards in military medicine.”

In 1953, AMSUS assisted in the creation of the Sustaining Members (SM), comprising private-sector companies doing business with components of federal health. Representatives from the approximately 100 SM companies meet quarterly to interact with and learn from federal officials – and each other – on topics of interest to their industries. Those include management consultants, pharma, and manufacturers of both durable and disposable medical goods.

“We have almost no history on how that started. The evidence indicates that somehow people got together from industry – pharma, manufacturing, consumable and durable medical goods, etc. – and said they wanted to meet from time to time as an industry to develop networks, relationships, and mutual understanding,” Cowan said.

“They wanted acquisition and policy officials and leaders of military service medical elements [to] meet with them – not to try to sell anything to them but to exchange information. They needed a 501(c)(3) umbrella, so AMSUS became that for them – about 100 companies, mostly sales execs, who meet on a quarterly basis under the sanction of AMSUS.”

SM is not part of the Annual Continuing Education Meeting program and only a few AMSUS staff attend their meetings. However, SM companies get first shot at exhibit booths at the AMSUS meetings. Very few SM personnel would be eligible for AMSUS membership, which requires having served as a medical professional in a federal medical department. To be part of SM, companies have to be voted in by the existing members.

“We think AMSUS provides a service to our target audience – the military – who have so many ethical and regulatory restrictions that make it difficult to deal with their partners in the industry sector. So, once again, we provide a platform for them to come together, so long as they are not buying or selling. And we think that is a tremendous benefit to the government. So do the companies involved,” Cowan added.

The importance of industry to medical research and development requires strong communications with those who know the needs of military and federal medical services.

“Things change in government all the time. The health care industry is always dealing with change, not only government rules and regulations, but technology changes in health care itself. Sometimes government is a little slower at adopting new developments than private health care. So there will always be a place for the SM to help deal with that constant change through communication between industry and government.”

“Otherwise, industry doesn’t know where to put their R&D. So in recent years, a partnership between the agencies and industry has grown so they can use scarce dollars the best way they can, giving each group an understanding of their operations,” Class explained. “They represent all areas of industry, medical equipment and supplies, medical consulting, direct patient care, insurance, etc., so you have all elements of health care represented, working toward the overall goal of helping care for the patients.

“When the SM meets and talks to different agencies, they’re not there to sell a product but to make sure the process of getting their products out there is beneficial to everyone and satisfies each requirement. Sometimes government will say they have to put some rule in place, not realizing that would make it impossible for industry to provide a solution. So that exchange really makes that group click, helping each other bring out all these points.

“Things change in government all the time. The health care industry is always dealing with change, not only government rules and regulations, but technology changes in health care itself. Sometimes government is a little slower at adopting new developments than private health care. So there will always be a place for the SM to help deal with that constant change through communication between industry and government.”

For example, an AMSUS meeting might include a four-hour discussion, attended by senior leadership from DOD, VA, PHS, and all the military services, on high-reliability organizations.

“This is a cultural change to how hospitals are run right now, but is necessary to drive the error rates out of the practice of medicine. So to take military health care to the next level, including VA and PHS, they come to AMSUS to have a major interagency discussion, at both the worker and policymaker levels, about high-reliability organization,” Cowan said.

“These topics also are published in Military Medicine, so the dialogue and culturalization of new ideas, such as amputation over saving a partially functional leg, is facilitated. If you want someone to understand something, tell them seven different ways seven different times. So we are one of the ways, a very important one, that allows progress.”

“And as the U.S. has become more involved with global issues, our membership has started to reflect that as well. Because of our overall general mission of gathering information and keeping it all in one place, it interests a lot of groups, including our international partners. The goal of not repeating lessons learned also extends to other nations; the U.S. shares medical information with everybody as much as possible.”

Another operation that has benefitted from AMSUS as a platform for information exchange and discussion is the Military Health System (MHS) strategic planning process. MHS 2020 engaged national and international health care experts to envision the practice and delivery of health care in the year 2020. The health futures group’s mission was to synthesize future health care directions and integrate military health functions, ranging from individual fitness to war zone operations, including IT and electronic health records.

“Again, we provide a platform for information to be gathered in one place and easily accessed. When you look at some of the benefits of our membership, we’re one of the only organizations out there that is going to provide appropriate information, education, repositories applicable to a number of government agencies, both U.S. and international, such as DOD, the Public Health Service, international medical care organizations, etc.,” Class said.

“When we start to look at where health care is going within the U.S., within the DOD, VA, etc., we are a single location platform for that information and partnership opportunities within the profession and with industry. It’s one thing to get everyone together in a meeting, but if you don’t have a place for all that information to be housed and accessed, you have to start over and over again. So DOD may examine what’s of interest to them in particular, but we also provide information for a host of other groups.”

While AMSUS has maintained the same basic approach to aiding the military medical community since its founding, it also has evolved along with medicine, warfare, and society, starting with its membership.

“Originally, I’m sure they were primarily physicians, but as the health care profession began to expand and specialties were formed and a lot more non-physician providers [nurse practitioners, technicians, etc.] began to become more involved, our membership started to change along with that,” Class said. “Overall, our membership base has moved in the same direction as health care. We have a lot of researchers, in particular, and we have a lot of industry involvement through our sustainment group.

“And as the U.S. has become more involved with global issues, our membership has started to reflect that as well. Because of our overall general mission of gathering information and keeping it all in one place, it interests a lot of groups, including our international partners. The goal of not repeating lessons learned also extends to other nations; the U.S. shares medical information with everybody as much as possible.”

As new agencies and organizations were created, such as the VA and PHS, they also were folded into the AMSUS membership.

“What I’ve seen start to really grow is international involvement. A couple of years ago we had 35 countries represented at our meeting, which is a terrific way to share information and build relationships. Last year, a lot of our international groups gave presentations on how they have responded to Ebola; the world was divvied up, with different countries having responsibility for different geographic areas,” he added.

“This was a great opportunity for those countries to describe how they set up and what they did in their different areas. Watching that sharing of information and how representatives reacted to what other nations were doing was great. And I’ve seen that evolve, I think, into one of the biggest changes that has occurred.”

“We’re here to communicate [information] as best we can, using the best – and most economically feasible – ways to do that. But there is so much information out there now and so many places people go to look for it, it can be hard to pinpoint just where we need to go.”

Despite all those expansions and changes, the majority of AMSUS members still come from the U.S. military, although the uniformed PHS has maintained the highest rate of retention and activity.

“We also appeal to a subset in the VA – those in surgical or rehab-intensive fields, especially those who tend to have prior military service themselves. The VA writ large is mostly an academic or training hospital and we don’t play in the minds of most of those people. And we don’t try to. Our subject matter is those issues that revolve around medical support for deployed and combat forces,” Cowan said.

“That’s still a pretty wide swath, going all the way from fitness and resilience – both psychological and physical – preventive medicine, the maintenance of healthy families, keeping the force fit and healthy on and off the battlefield – all of which are just as important as medevac and all the other things we think of as combat medicine. Battlefield medicine doesn’t start and stop at the edge of combat; it extends on to those who have served and retired.”

Nevertheless, cultural and administrative changes within the military have restricted uniformed membership. For example, Cowan noted that until the early years of the 21st century, a young medical officer entering the military would be advised by his or her commander to join a professional organization in the officer’s specialty – and AMSUS. However, the interpretation of rules on ethical conflicts of interest has become so restrictive, no commander today would even consider telling a young officer to join a private membership organization.

That has not prevented them from benefitting from the constantly updated database AMSUS maintains, because the association has always made the information it gathers freely available to anyone who needs it. Large turnouts at the annual meetings also helped offset any loss of new membership income. But with the government now restricting travel to and attendance at such events, the organization is evolving once again.

“Even as AMSUS continues to provide platforms looking at the use of new technologies, the way we deliver those platforms will need to change. But our overall mission of providing platforms remains the same and will not go away. We just need to keep getting better at it,” Class acknowledged. “We’re here to communicate [information] as best we can, using the best – and most economically feasible – ways to do that. But there is so much information out there now and so many places people go to look for it, it can be hard to pinpoint just where we need to go.

From an idea that sprang up in the midst of the bloodiest conflict in American history to an organization created during a period of peace, from state National Guard Surgeons General to combat physicians to a wider membership that includes civilian and non-physician health care providers, AMSUS has evolved with the times. And it will continue to do so in the decades to come.

“In the past few years, we’ve really started to use some social media a bit more to get people to look at things every day. We have a Facebook page where we put all kinds of information to let people know about new journal articles or things happening within DOD or the VA they should be aware of. As that evolves, we will have to evolve with it. Within the next 10 or 15 years, most things will not be in print anymore and we’ll have to look at how to deal with that. Meetings also are changing and as technology allows it to become more economically feasible to live-stream things, we will look at that, too.”

From an idea that sprang up in the midst of the bloodiest conflict in American history to an organization created during a period of peace, from state National Guard Surgeons General to combat physicians to a wider membership that includes civilian and non-physician health care providers, AMSUS has evolved with the times. And it will continue to do so in the decades to come.

“AMSUS today is best described as a communications platform for federal health professionals. Our annual meeting is where leadership has its only real opportunity to have fellowship and communication with each other – military, VA, etc. – in an open environment where they are not competing with each other. And where physicians from other nations also can come together to build relationships with one another,” Cowan concluded.

“So it’s not just those in the trenches learning about the latest and greatest in military medicine – blood products, non-opioid pain treatments, health information technology, global health, etc. There is an education component, fellowship component, networking components, and health system recognition awards.”