DEFENSE HEALTH HEADQUARTERS, FALLS CHURCH, VA -- On Jan. 10, Gen. David Perkins, Commander of the Training and Doctrine Command, met with public affairs staff of Army Medicine for a conversation on training healthy Soldiers.
Although TRADOC has many command functions, Perkins focused on its role in running basic training and developing healthy, fit recruits.
"TRADOC faces challenges to ensure the Army has quality recruits. Among the general public there are fewer healthier Americans, in terms of cardiovascular capability and strength. The American diet is going in the wrong direction." Perkins said.
It's a challenge, he said, that manifests itself in our attrition rate in basic training. We want to reduce our rate of attrition, not by lowering standards, but by training to help Soldiers achieve the standards.
We are trying to do two things, Perkins said. We are trying to get them through basic training and drop excess body weight. The body weight issue compounds many health issues. Too much weight strains joints and contributes to musculoskeletal injuries.
Musculoskeletal injuries during training are a big problem, he said. We work with Army Medicine and have done a number of things. We no longer take the approach that, if a recruit can't do enough pushups, we have them do more pushups. The result can be injuries as a result of overuse.
We are being more realistic about how much strength you can gain every week of basic training, he said.
"We want to prevent injuries by adjusting the way we do physical training and using a more sophisticated approach to strength training," Perkins said.
Another challenge TRADOC faces with recruits are issues with body mass index, or BMI. "Here we are focusing on nutrition, one of the key parts of the Performance Triad," he said.
The Performance Triad--sleep, activity, nutrition-- is considered the health foundation of a ready and resilient modern force. It boosts military readiness and family well-being by encouraging a lifetime of smart choices to promote healthy behaviors.
"We've taken a hard look at the dining facility, Perkins said. "We expanded food options on the salad bar and try to de-emphasize sweetened, carbonated drinks."
"Basic training is not your grandfather's basic training," Perkins said. "Just walk into any dining facility and you'll see."
We want to teach recruits lifelong habits that promote fitness and health, he said. We teach that the Army demands a great deal of you physically, so you have to take care of your body.
Once they are out of basic training, Perkins said, soldiers should have better habits. "We have dramatically changed how we bring people into the Army."
Perkins has been one of Army's top guns in promoting the multi-domain battle concept--land, air, maritime, space and cyberspace domains. "One of the biggest challenges will be how to include medical support," he said. "Dispersed operations will be common. How will you deliver medical care when forces are more widely dispersed, especially for injuries?" he asked.
In a linear battlefield, we have grown accustomed to the medical evacuation guys meeting the golden hour and getting the injured to the forward surgical team, Perkins explained. "That may no longer be possible," he said.
The medical care we are going to have for regular forces will need to be more like the medical care we have now for Special Forces, Perkins said.
Medic training right now is "phenomenal," but the demands on medics are going up. The individual Soldier will have a bigger responsibility for medical care then they have in the past. The importance of buddy aid will go up, he said.
Perkins commented on medical care that might need to be delivered remotely in the multi-domain battle. Soldiers are very adept at remaining linked and can connect wirelessly back to the base for guidance. Connectivity and sustainment will be the key factors for medical care remotely, he said.
Perkins connected medical care training to the synthetic training environment or STE. "It's not possible to replicate the training environment of a real city of millions of people," he said. "We can't take all the real risks that the real world might present. You can do much riskier training virtually than you can in real life. You can also do repetitions more often to get things right."
Perkins said STE should apply to the medical community as well. Virtual training with frequent repetition should enhance training for the medical environment. In addition, he said, it's just of matter of time before devices such as surgical robots are remotely operated by a surgeon, not in the room next to the OR, but a thousand miles away.
"This is the sort of thing we have to think about in the future." he said.
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