title: Department of Defense medical transformation: a case for the Defense Health Agency.
abstract: What are the threats facing the military health system (MHS) in the first quarter of the 21st century? The Department of Defense has decided that the emerging threats of weapons of mass destruction, information and asymmetrical warfare, well-organized terrorist groups, and rogue nations are going to require a transformation in future force structure and operational concepts. Is the MHS continuing to train and equip itself for the battlefield casualties of the Korean and Vietnam conflicts, or is it truly prepared for the emerging threats of the 21st century? Reliance on gradual, incremental change will not be sufficient to combat new emerging threats to the United States. Transformation is a radical concept; it demands a wholesale review of how the MHS views and accomplishes the mission. It does not accept the comfort afforded by slow, gradual evolution in military doctrine and organizational structure that bureaucracy affords. The Department of Defense is transforming. The MHS also needs to embrace transformational restructuring; to train and equip for the war on the horizon, to keep pace with the warfighter, and to provide integration and interoperability with other federal, state, and local agencies in support of homeland defense. More than two dozen formal audits, boards, studies, and reviews have questioned the necessity, efficiency, and effectiveness of the three services medical departments; yet the MHS has undergone little transformational change since World War II. The transformational model that will best support the operational forces and the United States in the coming decades is the Defense Health Agency model.
authors.affiliation: College of Naval Warfare, Naval War College 03/03, 686 Cushing Road, Newport, RI 02841, USA.
authors.forename: Jack R
authors.initials: JR
authors.lastname: Rumbaugh
mesh_terms: D005544:Forecasting; D006772:Hospitals, Military / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D008887:Military Medicine / Q000458:organization & administration* / Q000639:trends; D023481:Terrorism; D014481:United States