The United States Army Medical Command (MEDCOM) celebrates its 18th anniversary on October 2. It all began with a ceremony held on the parade field at Fort Sam Houston, Texas on October 4, 1994. The establishment of the MEDCOM replaced the previously designated Health Services Command (HSC) which came into being in April 1973 under the command and control of Maj. Gen. Spurgeon H. Neel, Jr.

The intent behind creating MEDCOM was to establish a broader scope than HSC, clearer lines of authority, more manageable spans of control, and more efficient use of Army medical resources. It also provided then Army Surgeon General, Lt. Gen. Alcide M. LaNoue, control of all Army medical resources and matched his responsibility as senior medical officer on the Army staff. LaNoue commented, "This reorganization streamlined and flattened the command and control structure of Army Medicine. These changes were not undertaken for the sake of change; nor were they designed simply to create a smaller organization." The initiative also met the requirements for reducing the Army Staff and limiting the number of personnel in the National Capital Region.

LaNoue's goal for the reorganization was to produce an accessible, deployable, accountable and integrated Army Medical Department. The process began in 1993 when he assembled "Task Force Aesculapius," a group of officers that outlined the new structure. The design principles focused on: establishing a clear authority and alignment with responsibility; it would be organized around work; ensuring people work in the right tasks at the right level; eliminating duplication and redundancy; and that it be "value-added."

The task force recommendations were refined until they finally received approval from the Army Chief of Staff on Aug. 12, 1993.

Under this unprecedented reorganization, the Surgeon General's staff in Washington, D.C. was streamlined from more than 500 to about 100 personnel with about 400 at MEDCOM Headquarters in San Antonio, TX. This allowed the medical department to avoid necessary cuts in healthcare providers.

As part of the transformation, in November 1993, Dental Command and Veterinary Command were formed as provisional commands under the MEDCOM to provide real command chains for more efficient control of dental and veterinary units--the first time those specialties had been commanded by the same authorities who provided their technical guidance. In December 1993, seven Medical Center (MEDCEN) commanders assumed command and control over care in their regions. The new "Health Service Support Areas" (HSSAs), under the MEDCOM, had more responsibility and authority than the old HSC regions.

In March 1994, a merger of Medical Research and Development Command (MRDC), the Medical Materiel Agency (MMA) and the Health Facilities Planning Agency (HFPA) resulted in creation of the Medical Research, Development, Acquisition and Logistics Command (MRDALC), subordinate to the provisional MEDCOM. The MRDALC was soon renamed the U.S. Army Medical Research and Materiel Command (USAMRMC). Then, in June 1994, an additional HSSA was formed to supervise medical care in Europe, replacing the 7th Medical Command, which was inactivated. That summer, the Army Environmental Hygiene Agency formed the basis of the provisional Center for Health Promotion and Preventive Medicine (CHPPM) which is now known as U.S. Army Public Health Command (USAPHC).

Under current MEDCOM structure, the Surgeon General is "dual-hatted" as the Commanding General (CG) of MEDCOM and is also the Army Surgeon General. The Surgeon General (TSG) serves as the medical expert on the Army staff, advising the Secretary of the Army, Army Chief of Staff and other Army leaders and providing guidance to field units. As Commanding General of the MEDCOM, the CG commands fixed hospitals and other AMEDD commands and agencies. This dual-hatted role unites in one leader's hands the duty to develop policy and budgets as TSG and the power to execute them as the MEDCOM Commander.