From turning a corner in the pandemic and Military Health System transformation, to readying his medics for the next major threat, Lt. Gen. Robert I. Miller, U.S. Air Force Surgeon General, knows the key to the Air Force Medical Service’s success comes from its most important asset - its people.
Miller became the surgeon general on June 4, having previously served as the Director of Medical Operations. He also held senior leadership positions at military treatment facilities, major commands, combatant commands, and in the Defense Health Agency. For Miller, those experiences prepared him to take on the role of surgeon general at a time the AFMS is undergoing significant changes.
“It has been a year of unprecedented challenges for the entire Military Health System,” said Miller. “Not only are we dealing with the massive impact of COVID-19, we are also finalizing the transition of treatment facilities to the Defense Health Agency.
“These are significant muscle movements for our organization and we are asking a lot of our Airmen to continue maintaining the current level of effort. So, my priority is our people and making sure they have what they need to thrive and accomplish the mission.”
Proactively lead change… and win
Miller’s predecessors saw the AFMS at a crossroads as they began implementing several seismic transformation efforts. Now, as Miller sees it, the AFMS has an opportunity to finalize those realignments and refocus on the operational readiness mission and modernize capabilities.
“Readiness is the primary job and has been since the creation of the Air Force Medical Service,” said Miller. “Despite the ongoing pandemic and Military Health System changes, it is necessary we proactively lead change and win. In the short term, we need to complete our transition activities.”
For the last three years, as the Director of Medical Operations, Miller had been leading the Air Force’s transition of treatment facilities to the DHA.
“At the end of the day, it is about taking care of our patients, whether it is in the facility, downtown or downrange,” said Miller. “October 1 of this year is a key milestone as our direct support to the Defense Health Agency will end. We need them to be successful and I’m confident they will be, based on our close collaboration.”
As Miller explains, a successful transition is vital to effectively transforming the AFMS. His intent is to ensure the AFMS aligns closely to the strategic initiatives outlined by the Air Force Chief of Staff, Gen. Charles Q. Brown Jr., who stresses the importance of being ready for the next high-end fight.
“We have always determined to be proactive and not fight yesterday’s war. We need to ensure our capabilities remain on the cutting edge for the next major threat. The pandemic served as a stark reminder how we must continuously evolve our medical capabilities,” said Miller. “Our joint capability niche is aeromedical evacuation and aerospace medicine, and we have done a lot of amazing things with our teams…moving more patients and saving more lives. When COVID-19 happened, it drove home the need to hone in on the specialized skills and equipment required to move patients with highly infectious diseases.”
The AFMS is also evolving as it takes on the responsibility of maintaining the medical readiness of U.S. Space Force Guardians. Guardians and the Airmen assigned to Space Force units operate no-fail, 24-7 missions. For Miller, supporting the Space Force requires a close examination of the needs of this new military branch.
“We need to better understand the requirements of Guardians, and how the AFMS can best provide that support,” said Miller. “Do we have the right structure? How are Space Force requirements different from Air Force? Does it call for different training or additional medical specialties? Will we need to expand specialized training in the years to come? There is still a lot of work to be done and it requires asking difficult questions.”
Prioritize people - prioritize the mission
In an effort to evolve the AFMS, address the challenges ahead and meet future operational readiness requirements, Miller said it is necessary to first prioritize the people who are supporting the Air Force medical mission. Miller identified four action orders that further clarify his priorities in order for the AFMS: Airmen; Balance; Currency and Competence; and Diversity, Inclusion and Belonging.
Airmen: Miller’s first action order, Airmen, specifically centers on the idea of medics taking care of medics and ensuring all AFMS personnel, including those who do not directly care for patients, have what they need to do their jobs.
“For the past year and a half, our medics have worked tirelessly on the frontlines of the COVID-19 response, in addition to supporting our AFMS mission,” said Miller. “If we want to take care of the mission, we need to take care of the people who are doing the tough jobs. I could not be more proud of what our medics have done and that is why my priorities are centered on supporting them.”
Balance: Miller explains the importance of his medics finding balance, looking beyond their professional life and making time for one’s personal, fitness, and spiritual life. His philosophy is that making time for life outside of work will make them better medics and more well-rounded Airmen.
“We could easily spend all of our time working and I think that is a huge mistake,” said Miller. “Is the mission important? Yes. Is spending time with family or taking time for yourself important? Yes. And on any given day, one may be more important than the other. As an organization and as leaders, we play a part in that journey in supporting that balance.”
For Miller, finding balance means waking up early to exercise, trying to limit taking work home, having dinner with friends and family, and setting aside time for hobbies and his spiritual life.
Currency and Competence: Part of prioritizing medics means ensuring they are equipped with the skills and training required to do their job, both stateside and while deployed. In this effort, Miller wants to ensure medics are positioned to have the right clinical caseload they need to retain their skills, whether that means ensuring they are at an MTF that supports their specialty or setting up training partnerships with civilian hospitals.
“During my time at the Medical Education Training Campus, there was a saying, ‘Train for the mission, educate for a lifetime.’ This resonates with our medics because while operational readiness to support the mission is our bread and butter, we also want them to excel in their medical profession,” said Miller. “I think we are effective in targeting the training through our day-to-day duties, readiness skills, and assignments to a deployment team. But, we also have opportunities to continue to grow our training and ensure our medics are set up for success for tomorrow’s mission.”
Diversity, Inclusion and Belonging: For Miller, the strength of the AFMS is found within the diverse group of medics who bring with them unique perspectives, experiences, backgrounds and professions. To foster this, it is important to identify gaps and barriers, work to address them, and find opportunities to do better.
“If we truly want a diverse Air Force Medical Service, we have to start early,” said Miller. “I think it is great we are having open discussions, but we need to work on what we can do to actively make a difference, build opportunities, and ensure not only are we supporting a diverse AFMS, but one that makes every Airman feel valued. I think it is important to build this into our culture early and at every level of our AFMS.”
Miller stresses that these action orders can serve as guide to better understand what is important to him and the ways he will strive to support his medics during his tenure as surgeon general.
“I am proud of everything our medics have accomplished, but our work is not done and challenges still continue,” said Miller. “My commitment is to our Airmen and I want them to know that their leadership truly cares about them. Our strategies may evolve as the needs change, but at the center of it is our people. They are our most valuable asset and they are what makes us a premier military medical force.”