WASHINGTON (Army News Service, Oct. 11, 2011) -- Decreasing the number of Soldiers who are medically unfit for deployment has become a major focus of the U.S. Army Medical Command.
It was the topic of discussion by a panel of senior medical officials Monday at the 2011 Association of the United States Army Institute for Land Warfare annual meeting and exposition at the Washington, D.C convention center.
Army Surgeon General Lt. Gen. Eric Schoomaker, who heads MEDCOM and led off the discussion, said that since the drawdown, the Army has seen a growing population of medically "non-ready" Soldiers. Currently the Army's mission readiness stands at just 85 percent according to one of the panelist, while the Guard and Reserve deployability level is much lower at 70 percent.
Schoomaker pointed out that the reserve-component number is actually up 30 percent from three years ago. Nonetheless, these numbers have brought concern, Schoomaker said, adding that having so many Soldiers unfit for duty is beginning to burden unit readiness.
Schoomaker said with the loss of the Army temporary end strength, "We begin to see a growing number of medically non-ready Soldiers with a smaller population of Soldiers overall available for continued demand for deployment."
"Every Soldier that's added to the pool of medically non-ready Soldiers taps into the availability of Soldiers to deploy and be part of the force, and this has begun to erode the readiness of the Army as a whole," Schoomaker said. "Its an issue the leadership of the Army has identified as a major problem for us, and turned to us and the personnel community, and all commanders in the force to come up with a solution."
Maj. Gen. Richard Stone, deputy surgeon general for mobilization, said the Army currently has as many as 40,000 active, Guard and Reserve Soldiers recovering from wounds or transitioning out of the military through Warrior Transition Units across the country.
"It is clear that whatever end-strength increase that we've been given, we've used up in wounded, ill and injured and transitioning Soldiers through a cumbersome bureaucracy," he said. "And we have continued to see escalating numbers of medically non-deployable Soldiers, with as much as 14 percent of the force unable to deploy when a brigade combat team moves forward. You began to understand the scope of the problem that we are faced with."
Brig. Gen. Brian Lein, command surgeon at U.S. Forces Command, Fort Bragg, N.C., explained that over the past four years, the percentage of medical non-deployable Soldiers has remained steady at 35-38 percent.
Lein explained that non-deployable Soldiers fall into three profile categories: Those who have permanent profiles who are going to the medical evaluation or physical evaluation board that are not complex enough to go into a Warrior Transition Unit. Those who are returning from deployment who have medical issues to be taken care of. And Soldiers who are available for deployment by Army regulation, but who have a medical condition that prohibits them from entering a combat theater.
The general warned that if the non-deployable status remains at the current level, the Army would find it difficult to maintain unit-manning levels in the future.
"If we don't get our arms around the non-deployable population, and the biggest population is the medically non-deployable population, we're going to have a significant problem manning our units to get them to go downrange," he said. "The Soldier is the center of our formations, so if the Soldier is not ready to go, then the unit is not ready to go."
Lein pointed out the new nine-month deployment cycle, although a welcome relief for Soldiers, will only exacerbate the situation for commanders trying to fill vacancies in the unit.
"This is just going to put more challenges onto the system because the AFORGEN cycle is going to be spinning even faster," he explained.
Although mental health care/treatment has gotten lots of attention by Army leaders looking to bring down the suicide rate, it's only the second-leading cause for non-readiness status among Soldiers.
According to Stone, musculoskeletal injuries are the main reason that Soldiers must remain behind. Stone said each year the Army diagnoses and treats more than 1 million Soldiers with such injuries, which equates to more than 25 million limited duty days, and the equivalent 68,000 Soldiers on limited duty.
"The actual cost of health care to those 68,000 is half a billion," Stone noted. "And the cost of salaries just under $6 billion annually in salary given to Soldiers who cannot deploy and are not ready."
The good news is that the Army may have found a way to determine which Soldiers are prone to musculoskeletal injuries. Stone explained researchers are studying new ways of measuring, among other abilities, a Soldier's agility, strength, arch, height, sprint and endurance.
"You can actually predict, based on the upcoming mission, what the potential is for injury would be," he said. "In about a five-day period you can test an entire brigade combat team and then predict for the commander their injury rate."
"The work that we have done over the last six months has predicted, in one unit, as high as a 40-percent musculoskeletal injury rate. And in the first six-month deployment of that unit, they had a 39-percent musculoskeletal injury rate. It's very accurate," he added.
Armed with that information, Stone said that he soon expects to see changes in everything from the way Soldiers train for deployment, to the types of boots they wear. Any of these improvements can lessen the impact of musculoskeletal injuries to Soldiers' health and readiness.
MEDCOM has already begun implementing a solution to some of medical readiness issues plaguing the Army. Schoomaker said a "top ten" campaign the command put together targets everything from good eating habits that emphasize less consumption of sugary drinks, to resiliency and comprehensive soldier fitness programs, and better medical recording keeping.
MEDCOM began tracking Soldier health and immunization through the Medical Protection System, or MEDPROS, in 2006. Now a new electronic profile allows commanders a means to easily track medical readiness through a database that provides information on the status of every profile in the unit. Schoomaker said this information would provide commanders greater visibility when assessing the medical readiness of a unit.
"Our goal, as it has always been the goal of Army medicine, is to preserve the fighting strength, it is to return the maximum number of Soldiers to be available in a deployable force," he said. "We feel this will be a successful campaign if all of us work in concert."
For Soldiers seriously wounded, ill or injured from combat, Brig. Gen. Darryl A. Williams, assistant surgeon general for Warrior Care, and commander of the Warrior Transition Command, spoke about the various levels of care and the "way ahead" his staff helps provide.
Williams said no WTU Soldier is ever forced out of the military. "It is the Soldier who must make that choice." Williams reminded the audience that "If you take nothing away about the Warrior Transition Command, its about how we keep our commitment to Soldiers and their families," he said. "We can't break faith with the Soldiers and their families. That's how we do it everyday."