embed the medics right into the Coy's

[HItorMiss]

Not sure if this should really go here but I have thought long and hard about this over a 4 year period. I have been slowly formulating a proposal for my idea and since it envolves you medics I wanted true feedback on it before it goes from my head to a serious paper.


In my close to 6 years of experince  I have seen a lack of true medical support to infantry section/Pl/Coy/Bn's not through any lack of medical training for our Medics(who on a personal note I will add are generally excellent) but because of several reasons they are

1. lack of man power

2 because of above reason medics are not always there when needed

3. Trust (not that the average soldier doesn't trust a medic it's simply a familiarity thing I am getting at and will explain in detail later)

4 Training in Inf style operations

these are of course not a complete list nor are they 100% accurate for every unit.


Now I will address my reasons in a fashion that I belive would or could solve this situation following the numerical reasoning above


1. The obvious: the Bn's need more medic's attached posted into them. Now this may of course mean less medics at the home unit (eg 2fd Amb) however this could also be avoided with of course more medics in general (perfect world solution maybe?)

2. If the Bn's had more medics they could and should attach them right into Company's not the UMS, the medic or team of medics would be with the company HQ's and train with the soldiers of the company everyday. I am aware that medics are motional attahced to Company's but many times I have never seen my medic team not even on an Ex.

3.It is my belife that soldiers need to trust the medic to truely open up and let the medic know whats is going on, how many times in your career has a soldier said "no problem doc it's good to go" or simply avoided the medics so as to not have to show he/she is sickness or injured ( I have done this more then once in my time out of a need to be tough and because I didn't really trust the medic to take my word for what I could handle) with trust comes respect if the soldiers trusts the medic and respects the medic they will open up and allow the medic (in a day to day situation) do his/her job, I personaly have taken the word of a trusted medic one I knew would not steer me worng and knew that I never saw him without a real reason. The medic if employed right in the company would now be part of the team training everyday with the troops doing PT, locker security etc etc... nothing but good things can come from a closer relationship.

4. If the medics were training with the troops from the Companies this one take's care of itself, the medic would learn whats what, more then the basics and would fit into the force better and becuse of that be a force multiplier.

I have more specifics of course and could go on and on about what led me to start thinking this way from a personal basis and in fact would love to go further just let me know what you think about it now and see what you would to add or change in this idea.

 

[combat_medic]

I'm in complete agreement with you, however the higher ranking officers in NDHQ don't see why an infantryman would have need of a medic on a regular basis... apparently they don't injure themselves... ever. I've been fighting this same fight for 5 years now, and have been losing miserably, but if these officers ever see the light, I'll be the first one back on the integrated med support bandwagon, let me assure you.

 

[McG]

Does an infantry company require medics in garrison?  Would there be sufficient depth in a company for the medics to conduct thier own skills training & proffessional development?

The UMS is the lowest level the medics should be kept at.  From there, they can be tasked to support sub-unit training or operations as required.  They would also have depth to conduct thier own training (thus ensureing an even better quality of medic available).

 

[pbi]

Having had the priveliges of commanding a rifle company both in Canada and on operations, and having commanded the Admin Coy of a mech battalion, I have some strong feelings on this.

First of all, I disagree totally with the recent pillage of the Army's medical services by the CFMS: yet another "stove-pipe empire" in our tiny little force. Pulling the medics out of the field units (and then "re-attaching them") was IMHO a mistake.

In my opinion, (and I think that most Inf would agree with me...) the absolute minimum requirement is one MA per platoon, with Combat Lifesavers trained in each section. IV drips and morphine should be ready available, not locked up back with the MO where they are useless. At Coy HQ should be the senior coy MA. Two ambs of whatever type are also, IMHO, a minimum for a coy in today's dispersed ops. This is pretty well how we equip a mech rifle coy for ops now (give or take).

In garrison, the MAs should belong to Med Pl (Admin Coy) for tech trg and admin. For all exercises, ranges, and PT a couple of times a week at least, the coy MAs should be with their rifle platoons, either doctoring or training. MAs are like any supporters: they work best when they're a well-known and accepted part of the team. Any Inf soldier who has been on ops these days knows how important our MAs are.In my experience a good MA is a tight part of the team who is respected by the soldiers. Cheers.

 

[HollywoodHitman]

Very difficult to disagree with that Sir,

We have a couple medics who were re musters from the rifle company and their presence in the field as members of the team is missed.

TM

 

[combat_medic]

Gee, why would a badly injured soldier need an IV, chest decompression or morphine right away? Surely he can wait an hour until he gets to see the MO...  : What do you mean he'll be dead by then? Won't a field dressing keep him alive? Because that's all he's going to get!

/sarcasm

I'm of the personal belief that the CFMS was so focused on their own power and importance; getting high numbers in Med Coys and breaking off from the army that they completely forgot about patient care. I believe that the CF has suffered a great loss because of this, and will reap some significant reprecussions if there is ever a major conflict. This decision could cost a lot of lives in the long run, and I think it's sad that this is where their priorities are.

pbi: excellent points, all.

 

[Infanteer]

I will second PBI's assessment.

When I worked with the Brits they set things up in a similar fashion and it seemed to work well.   I got to do things with their "Infantry Medic" training that I never touched in the CF (morphine, IV, etc).   For some reason, when first aid is instructed to our Infantry soldiers, it is assumed that the greatest cause of death on the battlefield will be falling off a ladder....

Needless to say, the unfamiliarity between the medics who were jetted into our camp (they weren't even part of the battlegroup, they were NSE) led to a mediocre relationship on camp at best - not good considering that we depended on each other if the poop hit the fan (force protection - casualty care).

 

[HollywoodHitman]

NSE says it all....don't get me started!

 

[dutchie]

nse:

"Where's your rifle, Cpl Bloggins?"
"Well, I've got 'er broken down in the storage bins on the HL of course, Sgt."
"Hey, good idea! More room in the cab for your ghetto blaster and mondo coffe cup and no NDs!"

Sorry, didn't mean to interupt. Carry on.

 

[Armymedic]

Ho boy...(Armymedic taking a deep breath),

First off, medical assets attached to any operations in an element under the NCE and the senior medical authority (Task force Surg) answers to the Commander.

While I might personally disagree with decisions of my higher headquarters, those decisions are made well above my pay grade, and as a supervisor I must convey a positive outlook of changes....

So, CF H Svc Gp is currently undergoing changes in how it provides care. First of these is the "improvement" of in garrison care (Primary Care Restructuring Initiative). One advantage of PCRI is the centralization of all in garrison care so that rescourses like medical admin, pharmacy, and secondline resources such as lab and X ray are quick and easily accessible to all. Further it will reduce the problems of operational shortages by increasing the number of civilian full time providers, and pooling the higher first line medical pers (MO's) so that they can cover each other off.

Hence on of the first advantages. In the PCRI concept units are grouped together into Care Delivery units. These units will have a core civilian staff, Dr, Nurse, receptionist, and MOs, PA and Med Techs. Following the lessons learned from 1 Fd Amb CDU trial, it was found that the best use of med techs was to maintain manning at the UMS and surge a fration of those med techs to the CDU for sick parade DAGs etc. The remainder would be avail to do PT, courses and tasks at the will of the Unit (OPCON), and all could deploy to the field etc, while still maintaining in garrison care for the rear parties.

Med Techs will remain at the UMS to do tasks, courses, improve mil skills, etc. Also there will be requisite periodic maintenance training and up grading training to be undertaken. Also (down side for the cbt units) brigade level and higher tasks could be tasked to a UMS to fill vs the Fd Amb, thereby lessing the strain on the Med Coys who will be undermanned due to training.

The major disadvantage (to you as a non-medical) is that now your firstline care will be at some other central location. Hence you will experience more bureaucracy in getting OTC medications longer waits for sick parade and having to travel away from your work for care.

Of course, until we are brought up to strength like every other trade in the CF, we will not be able to fill all the positions required while still maintaining the operational tempo the CF demands of us.

 

[R22eRKodiak]

Although I will not argue here for or against the centralization of medics at higher levels than before, I must admit that I am concerned that the greater separation that medics have from front line units, the more will it be forgotten that although 99% of a medic's job is done under relatively stable conditions in garrison, 1% of the time (figuratively, of course), he will be required to follow along with combat troops and be able to perform fieldcraft with sufficient skill so as to not get the people he is attached to killed.

I do not say this to say that medical pers are willingly creating a separation from garison and field skills.  We already see the bitterness and competition that can sprout from two different battalions, despite being part of the same regiment.  The useless and sad competition between 1RCR and 3RCR springs to mind, but it is quite the same throughout the Army.  I am proud to say that the Vandoos are gradually learning to work together, but we still have much improvement to do as well.  So much more could be accomplished if we weren't all trying to be the biggest fish in a little pond and putting our efforts together to accomplishing the great things we are capable of.  Can't we just all get along? ;D  Anyway, I digress.  What I mean to say is that if so similar organizations can create rifts by simply trying to work a little differently, it will be very easy for 'non-embedded' (for lack of a better word) medical personnel to forget the other part of their job, simply because they will not be exposed to it.  It is human nature. 

This could be greatly improved if we ensure that sufficient numbers of medical personnel are invited and able to attend training events at different levels (sec and all the way up to BG and beyond).  I realize that there is a huge number of taskings sapping their numbers daily, but it should certainly be a focus.  Get the medics out from their centralized areas to work directly with the troops on a regular basis.  As I understand there is some form of provision for this.  However, the trend has been to concentrate all medical personnel at Coy and UMS levels and not detach them down to pl level, as this is not 'Canadian Doctrine'.

Unfortunately, it is time for us to open our eyes and see what the rest of the planet is doing.  We are not fighting WW II or the Soviet/Fantasian/Granovian army.  We can no longer afford to maintain the comfortable safety blanket wrapped around our heads and hope that all the badness will go away.  The Americans have learned that having medics at much lower levels increases survival rates of their soldiers.  Why do they know this?  Not because it has been wargamed, but rather because they get shot at every day.  I believe that these lessons are are slowly dawning on us as well.  We would not be talking about them here otherwise.

It is important for medical pers to have good field skills and exposure to frontline combat troops jobs, as it will be much less of a culture shock and a less dramatic transition for them when they are next asked to perform a 30 km combat patrol with snowshoes while attached to an infantry coy.  If they are not allowed to train up at the same time and with the same troops, then not only will they not enjoy themselves and not learn anything, they might actually become casualties themselves.  Worse yet, they may do something that will get the patrol compromised and get other people killed.  Fieldcraft skills are not something that are magically learned, but rather are gained through years of practice.  Although I do not expect a medic to be as capable at stalking an OP as a sniper is, I do need him/her to be savvy enough not to reveal the position of the patrol, to understand the importance of watching arcs and of never leaving anything behind when we leave the patrol base.  This is something that many young infanteers have a hard time learning.  It is that much harder when a medic has not done any such activity in 6 years before he is thrust into the breach.

When we can have such cooperation, the results are usually spectacular.  I have had the good fortune of working with fabulous medical personnel a few years ago.  I had the same medic attached to my coy for several exercises, some conducted in the US, winter exercises, etc.  He turned out to be one hard soldier and was more than willing to learn the infantryman skills required to defend himself and his patients in the field.  He volunteered to do individual and pairs live fires and turned out to be better than many of our finest soldiers.  As I said impressive.  Before anyone cries 'foul!' here, I would remind you that medical personnel in the field should be carrying weapons in the field for personal defense as well as protection of their casualties.  This is a provision of the Geneva Conventions.  However, I have never seen any other medic beside this one go around with a rifle.  Again, this is something that must be continuously practiced and improved. 

Cpl (Mcpl by now?) Comeau, wherever you are, you still have all my respect!

 

[Armymedic]

We (leaders of medical pers) have ack'ed that our medics are lacking fd skills and this is being addressed. One large problem is that this is being pushed by NCO (read Med Techs and PA's) but those in CFMG HQ  who make the tng decisions as to what to teach our baby medics are officers...A large disconnect that we are addressing.

Trust me when I say that being an infantry company medic is the BEST job in the army, just like being a ships medic is to the navy. We are doing our best to keep our med techs as close to the front line down and dirty as we can.

Aid to the Warrior

 

[Brad Sallows]

>1 lack of man power
>2 because of above reason medics are not always there when needed

When you lack enough of a critical resource, you concentrate and control it at the highest practical level.

1/pl plus 2 amb tms (either 2 or 3 pers each) is 7-9 medics/rifle coy.
3 coy + UMS (1 MO, 6 medics, 2 more amb tm) is 32-40/bn.
Give the armour (DFS) 2 tm/sqn + UMS = 23-31/regt.
Give the arty 1 tm/bty + UMS = 15-19/regt.
Give the svc bn UMS + 2 tm = 11-13/bn.

The brigade, then, for this idealized provision of support needs somewhere between 145-183 medical personnel integral to the non-medical units, 6 of whom are MOs.  Leaving aside the requirements of the next echelon (close support), how many medics are currently on strength in each fd amb?  Let me guess: there are not enough to go around, even after some frantic ATOF reshuffling (which would doubtless have medics relocating more frequently that many other trades).  Which manoeuvre or manoeuvre support platoons/troops do you want to trade in next to convert some PY to MOSID 7xx positions?

Note that for purposes of this particular sub-discussion it is completely irrelevant whether the medics are on the nominal [roll] of the supported units or the fd amb.

The pillaging was of course a plan on which the CLS signed off, and AFAIK the CF continues to have difficulty attracting medical professionals.  (Not all of the organizational restructure has been driven by issues at the bottom of the care hierarchy.)

My guess is that unless the CF figures out some way to bring in huge drafts of doctors, CF H Svcs Gp is going to have to come up with some innovative solutions involving relatively young NCMs with different professional qualifications.

 

[Lance Wiebe]

When did all of this change?

I know I've been out for a while, but the subject of the thread caught me by surprise.

At the Unit, we always had a Sgt Medic, plus four MCpl/Cpl medics.  Each Squadron had their own medic in the field, in garrison, they all worked together.  Each medic had their own amb (wheeled or tracked) plus their own dedicated driver.  Of course, sick parade was done in the Unit lines.

So, the reaon for "centralization" seems to be (I got this from this thread) a power grab from the Powers That Be, and not from a manpower shortage.  If this is the case, then something is drastically wrong.

 

[HItorMiss]

Wiebe:

Though nominally each Coy has I believe 2 medics attached to it, the key word in that statement is nominal, more often then naught they simply are over tasked, on course etc etc and not available to the Coy's for every little training event, and many big ones too.


Though I agree that medics need to be at the UMS level, I actually tried to leave the UMS situation out of my thought process I believe now that this miss lead some people as to my train of thought, I want the current staffing of the UMS to remain on strength and be a Bn medical asset an in house movable field expedient hospital someplace that bridges the gap between field doctoring and the rear ech hospital.

 

[HItorMiss]

Does an infantry company require medics in garrison?   Would there be sufficient depth in a company for the medics to conduct ttheirown skills training & pprofessionaldevelopment?

The UMS is the lowest level the medics should be kept at.   From there, they can be tasked to support sub-unit training or operations as required.   They would also have depth to conduct thitheirn training (thus ensensuring even better quality of medic available).

Sorry but I whole disagree there, I fully believe that Medics need to be with the troops, sure they will go away on courses and such but the lack of personal interaction leaves many soldiers withought faith in the medical personal and system used to keep them alive and healthy, Yes keep the UMS
as a centralized medical clearing house for lack of a better word, where in garrison soldiers go for sick parade, but having that one Medic who stays with the Coy pers everyday trains with them does PT with them refrefersem to the UMS does all training events with them that will the medic that the troops trust and I would say would be the better more highly skilled Medic in the field to patch my Shot A** up when I as a Recce Ptrlmen take that round in the leg/arm/gut or whereever during a contact and also not be the lialiability said patrol

 

[vr]

A chicken in every pot...a medic on every recce patrol.  Here we go again, eh.

I do not personally know of any military force that carries out long range patrols (SAS,SF, Rangers) that use medical personnel on a routine basis.  They do train some of their troops to a very high trauma management standard a la TCCP and equipped accordingly.  What sort of high-speed medical kit is the Medic going to carry on a recce patrol that a TCCP qualified soldier can't use.  DF help me out.

Old adage:  You never have enough infantry, engineers, or medics.  Very true.  Trusting Brad Sallow's math as I always have you would need 143-183 medical personnel for the integral support of a bde group with equipment.  This is very close to the establishment of a Field Ambulance, probably much closer to the current numbers rather than doctrinal.  In essence we would have to double the size of each Bde group's medical establishment.  Including twice as many MO's/PA's!!!!  Unless the recruiting & training establishments wholly devote themselves to medics (not a bad thing) for the next few years or the CLS decides to re-role a cbt arms/svc bn as a medical unit this is not likely to be achieveable.  A medic in every platoon is doable for limited scope operations, ie Afghanistan but even that is proving difficult to sustain with current levels.  I believe that allocation of critical resources is a higher command function and medical personnel are a critical resource and central control is a necessity.  And like in any organization/corporation once you give them control over something you have to pry it from their cold dead fingers.

Since this debate has been/will be ongoing I believe that we need to separate the Reg & Reserve sides of it.  Since I have had limited exposure to RegF UMS's I will speak to what I know.  I would hope that other Reservists do the same.  Bringing all Reserve Medical personnel under the Medical Establishment is an absolute necessity for the viability (?survival) of the R end of the trade.

The Medic in a RegF UMS will have the opportunity to practice and develop their trade due to the size of the establishment they support and that they do it everyday.  They also work under the guidance of MOs/PAs with proper equipment available.  They support exercises and deployments of long duration often with medical scenarios/events written in.

The average Res Inf unit CPl Med A who spends their training nights updating the ADM Coy whiteboard or exercises as enemy force gets no chance to practice their trade.  What medical work they do is more often than not unsupervised by more experienced medical personnel.  Not only are mistakes made but mistakes become dogma.  Some units have taken to training night sick parades as a "make work" project.  This is silly: if you are too sick/injured to participate in a 3-hr trg night then you shouldn't be spreading your germs on public transit and are a hazard to yourself and others in traffic.  Furthermore unless they are directly working under an MO or PA they are not legally authorized to reccomend anything especially medications.

For reasons that have been posted in other forums and on other late and lamented boards it is necessary for Res Med A's to be part of the Medical establishment.  From what I have seen this has been done in an enlightened manner with the wishes of the med A's duly considered.  Besides in all my readings of QR&Os I have yet to find the phrase  "you have to like it".

 

[pbi]

While I know that my peers serving in the Field Force have their own serious misgivings about the directions taken by CFMS, my experience has been confined to the implementation of the changes as they related to the three Med Coys (and various unit med pers) that were organic to our Res Bde.

I have never, never, seen a more badly mismanaged force restructure issue in my life. Our Bde HQ was apparently the only one that spoke up, early on, about this clown act, earning us the undying enmity of certain power brokers in the CFMS world (esp the Res CFMS world....) Our attempts to make sense of the abysmally late, poorly thought out and utterly unrealistic staff work that emanated from that HQ consumed a disproportionate amount of my time as COS and that of our G1, as we attempted to ensure that our soldiers in the three Med Coys were not merely "abandoned" to this travesty. When we were finally able to get a staff team from the CFMS Res project to actually visit our HQ, it was immediately evident that they had little or no grasp on the reality of  running a Reserve unit, nor of the interrelation between a Res Med unit, its parent Bde or the other Res units around it.

I have seen nothing, nothing that has come out of this schmozzle that could not have been achieved by more intelligent recruiting efforts, better training, and a reasonable acceptance of civilian qualifications. None of this required the nonsense, wasted staff effort and hoop-jumping that this "plan" entailed.

So, as you can see, I am a bit less than objective when it comes to this issue. No more stovepipes. Cheers.

 

[Alex252]

I think this would be a good idea. Although I dont have experience with any of this ill give my 2 cents worth. If youve got 2 medics who are you going to choose? The one youve been training with and you trust or the one youve never known? I'd personally chose the 1st one. Also some of the medics having combat arms knowledge would be a good thing. A little off topic here but can medics still not carry a weapon?

 

[Fishbone Jones]

I think this would be a good idea. Although I dont have experience with any of this ill give my 2 cents worth. If youve got 2 medics who are you going to choose? The one youve been training with and you trust or the one youve never known? I'd personally chose the 1st one. Also some of the medics having combat arms knowledge would be a good thing. A little off topic here but can medics still not carry a weapon?

If I'm hurt, I don't care if I know the guy or not, I'll trust anyone willing to help me.

Medics carry weapons both for self and patient protection.