FALLS CHURCH, Va. — Air Force Medicine has changed significantly since 1986, when Lt. Gen. Mark Ediger left his family medicine practice in Missouri to join the Air Force.

Ediger, the U.S. Air Force Surgeon General, retires June 1, after a 32-year career that took him around the world, through numerous postings and varied roles. Although Ediger rose to the highest position in Air Force Medicine, he says that was not his intended career path.

From rural to operational medicine

“It was never my plan to be a military doc,” said Ediger. “When I finished medical school, I was pretty sure I wanted my career to be in rural family medicine.”

After five years in family practice in Cass County, Missouri, Ediger was ready for a change. Seeking a greater diversity of medical experience, he joined the Air Force and remained on active duty ever since.

“Joining the Air Force was the right decision for me,” said Ediger. “In the Air Force, I have had many opportunities to take on different roles and jobs I never considered when I first joined.”

Ediger’s first assignment was in family medicine at Langley Air Force Base, Virginia. Soon after, he attended Flight Surgeon School at Brooks Air Force Base, Texas, and returned to Langley. Ediger says he found many parallels between family medicine and flight medicine.

“Practicing flight medicine was an extraordinary experience, because I used my skills as a family physician, but with a major new operational component,” said Ediger. “The challenges of aerospace medicine, like enhancing aircrew performance, managing their medical conditions to keep them flying, and providing medical support in remote environments, added a fascinating dimension.”

That interest in operational medicine was a passion that led to some of the most rewarding opportunities of Ediger’s career. While serving as the 16th Medical Group commander at Hurlburt Field, Florida, Ediger helped organize medical support for the initial response to the 9/11 attacks.

“I was part of the 16th Special Operation Wing [now the 1st SOW] when the attacks on 9/11 occurred,” said Ediger. “Our Wing’s Airmen were some of the first to go into Afghanistan to respond to the attacks. We had an extraordinary medical team that supported a large-scale special operations deployment in a very difficult environment.”

Ediger was also a part of delivering medical support to combat operations as a group commander during the initial months of Operation Iraqi Freedom. He also served as the command surgeon in Germany leading aeromedical evacuation and en route care at Ramstein Air Base for casualties from Afghanistan and Iraq.

“As I look back, those are assignments that I really value,” said Ediger. “Being part of the Air Force medical teams that responded to those challenges, and having the opportunity to care for Airmen who are out executing the mission, I found that especially rewarding.”

Evolving missions, evolving medical support

Ediger’s career spanned several eras in Air Force Medicine. He saw it evolve from a time when deployments were relatively rare, to the development of expeditionary medical capabilities after Desert Storm, to the non-stop deployments following 9/11.

“There have been remarkable changes since I joined the Air Force,” said Ediger. “We were still in the Cold War early in my career. Our deployment packages and equipment sets were large and difficult to set up. After Desert Storm, we evolved into an expeditionary Air Force, so our deployable medical capability changed with the creation of EMEDS [expeditionary medical support system] and mobile field surgical field teams.

“Now, after almost 20 years of continuous deployments, our medical force has unbelievable field experience and incredible new operational medical skills.”

In the 32 years that Ediger served, Air Force Medicine kept pace with change in the rest of Air Force. Space-based operations became increasingly important. Remotely piloted aircraft and strategic reconnaissance are much bigger components of the Air Force mission, and use of special operation forces grew tremendously. These changing mission sets drove the evolution of operational medical support.

“One of the biggest revolutions in Air Force Medicine during my career was the creation of the CCATT [critical care air transportation team] under Lt. Gen. Paul Carlton’s [U.S. Air Force Surgeon General from 1999 to 2002] leadership,” said Ediger. “Moving critical care patients by air improved outcomes and reduced the medical footprint of deployed medical teams in a combat theater.”

Ediger praised the improvement of battlefield medicine in austere environments. Air Force medics now deliver advanced care techniques in the field that save lives and limbs.

“When I joined the Air Force, we had a very limited scope of clinical procedures we thought could safely be done in a field hospital,” said Ediger. “Now, we can safely and effectively do vascular interventions to stop hemorrhage and salvage limbs, and do neuro-surgical interventions in the field. We do just amazing things in a deployed setting now.”

Work to do

When Ediger became Surgeon General, he outlined four priority areas: Full Spectrum Medical Readiness, Integrated Operational Support, Air Force Medical Home, and Trusted Care. Ediger feels the AFMS has made significant progress in each area, particularly in Full Spectrum Medical Readiness.

“We took a tremendous step forward in medical readiness by developing and applying a new model for keeping medical teams ready to deploy,” said Ediger. “We established specific standards for their clinical currency, and our commanders now manage to those standards.

“We are leveraging private-public partnerships like never before,” said Ediger. “We’ve seen steady growth in Air Force deployable personnel embedding in private sector health institutions to keep their skills current and ready for the deployed environment.”

The development of multidisciplinary medical teams that work directly with operational units outside the hospital or clinic is a significant accomplishment in the Integrated Operational Support realm. Ediger also highlighted improvements in meeting access standards and the adoption of a zero-harm culture as significant steps in Air Force Medical Home and Trusted Care.

“We’ve made great strides in each of the areas, but there’s still a lot of work to do,” said Ediger. “We have pilot programs in place for many of these initiatives, and we’re working to take them Air Force-wide.”

Looking to the future

Air Force Medicine is entering a time of significant change as all military treatment facilities are moving under the management of the Defense Health Agency. Ediger has been at the forefront preparing for that change, and is confident the AFMS will come out stronger and more capable of supporting combatant commanders.

“I believe we can meet the full intent of Congress and the DoD in a way that delivers effective operational support and readiness,” said Ediger. “We need to go about it very carefully and deliberately to ensure we are still achieving our operational support and readiness missions while we institute reform.”

Ediger calls on medical Airmen to reconnect to their core mission during challenging times.

“As we implement reform, always remember why we are in uniform as medical professionals,” said Ediger. “We are here to support service members who are performing increasingly demanding missions, keeping them healthy and performing every day.

“There are so many exciting opportunities available in Air Force Medicine. My career was so rewarding because I was willing to try new things and take on new responsibilities when I had the chance. Never lose sight of the fact that you are medics in the world’s greatest Air Force. That’s a special thing. Learn about and embrace the mission. Stay engaged with Airmen that we support, and step up where the mission needs our help.”