Lt. Gen. Mark A. Ediger, MD, is the surgeon general of the Air Force, Headquarters U.S. Air Force, Washington, D.C. Ediger serves as functional manager of the U.S. Air Force Medical Service. In this capacity, he advises the Secretary of the Air Force and Air Force Chief of Staff, as well as the Assistant Secretary of Defense for Health Affairs on matters pertaining to the medical aspects of the air expeditionary force and the health of Air Force people. Ediger has authority to commit resources worldwide for the Air Force Medical Service, to make decisions affecting the delivery of medical services, and to develop plans, programs, and procedures to support worldwide medical service missions. He exercises direction, guidance, and technical management of a $5.9 billion, 44,000-person integrated health care delivery system serving 2.6 million beneficiaries at 75 military treatment facilities worldwide.

Prior to his current assignment, Ediger served as deputy surgeon general, Headquarters U.S. Air Force, Washington, D.C.

Ediger is from Springfield, Missouri. He entered the Air Force in 1985 and has served as the aerospace medicine consultant to the Air Force surgeon general, commanded two medical groups, and served as command surgeon for three major commands. He deployed in support of operations Iraqi Freedom, Enduring Freedom, and Southern Watch.

 

Veterans Affairs & Military Medicine Outlook: What is the Air Force surgeon general’s role and in what ways, if any, does it differ from the other armed forces surgeons general?

Lt. Gen. Mark A. Ediger, MD: In Air Force Medicine, we have three primary roles. The first one is to support the Air Force operations and the operations of the joint team. Our second primary role is to sustain a ready medical force deployable and prepared to support joint operations anywhere in the world. Then our third primary purpose is to provide high-quality, safe medical care. My job as the Air Force surgeon general is to ensure that our medical professionals in our hospitals and clinics and at our deployed sites have what they need and are prepared to meet those three primary roles.

Now, my role differs a bit from that of my Army and Navy counterparts in that I am not in command of our medical forces. In the Air Force mission, it has always been the case that our medical force is under the command and control of operational commanders. In most cases, that’s a wing commander. That works well for our mission and continues to work well for us today.

I am an officer on the Chief of Staff of the Air Force’s staff. Then at each of our major commands, we have a command surgeon. I work in close coordination with the major command surgeons to ensure that our medical force is developed, ready, and has all the resources required to successfully support the mission.

 

Can you talk about the kinds of Air Force medical teams that you have out there and how many you have deployed?

Certainly. Our types of teams fall into two main categories. One category includes the medical teams that perform on the ground. We call them ground assemblages. This consists of our squadron medical elements. These are squadron flight surgeons and their technicians. They deploy with Air Force flying units and special operational units to ensure they have the medical support they need.

Then also, our ground assemblages consist primarily of our field hospital, which we call the Expeditionary Medical Support [EMEDS] system. That is our version of a field hospital. It’s [modular] and it can be deployed and established in a number of different configurations, which makes it flexible to meet the mission. Those are our ground assemblages.

The operational lessons learned that we’ve gained via the Joint Trauma System is one of the major advances that came about during the wars in Iraq and Afghanistan.

Within that EMEDS system, there are component teams that can be broken out and deployed separately. The most common is the Mobile Field Surgical Team [MFST], which is a very-much-in-demand asset in today’s U.S. military operations.

Then we have Aeromedical Evacuation Teams. As you might expect, their role is to provide something we call en route care. That is the movement of patients, some of whom may be trauma victims from combat trauma. Others may be patients with disease. They are prepared to move patients with whatever the condition may be and get them to a source for definitive care. In an aeromedical evacuation, we have the standard aeromedical evacuation crew, which consists of nurses and technicians, specially trained to provide care in flight.

We also have Critical Care Aeromedical Transport Teams. These are specialty teams with critical-care specialists, who can move patients who require critical-care support during transport. They are trained and equipped to move patients long distances as required.

Then for the more tactical environment where we have critical-care patients that need to be moved within a deployed theater, perhaps even from the point of injury, we have Tactical Critical Care Evacuation Teams. These teams, as the name implies, can provide critical-care support before the patient reaches their initial hospital to start the continuum of critical care needed for a patient with a significant combat injury.

 

How have the operational lessons learned allowed these teams to operate farther forward?

The operational lessons learned that we’ve gained via the Joint Trauma System is one of the major advances that came about during the wars in Iraq and Afghanistan. The Joint Trauma System operates a database called the Joint [Theater] Trauma Registry [now the Department of Defense Trauma Registry]. Data goes into that system from all of the trauma patients we treat in our deployed sites and includes data in regard to the outcomes for those service members all the way back through their definitive care in a U.S. medical center and their rehabilitative care.

That has produced a lot of opportunities for research and has produced a number of significant changes and gains in the way we handle trauma victims. The research based on those lessons learned and that trauma registry have led to multiple publications in U.S. and international medical journals and have led to significant changes and improvements in the standard of care for trauma victims in trauma centers around the world.