Page 131 - Journal of Special Operations Medicine - Summer 2016

from the
SEMAEMA
S

”The Ground Truth”
There are a few parallel processes in
As I return from the 2016 Special Op- addition to JCIDS, such as “Decision
erations Medical Association (SOMA) Gate,” which is a modified JCIDS
Scientific Assembly in Charlotte, SGM F. Bowling process used by the US Army Medical
North Carolina, I reflect upon how 18D, ATP Command Medical Research Materiel
far we have come since I graduated Command that aligns with US Food and
the Special Forces Medical Sergeant’s USSOCOM Drug Administration developmental
Course in 1994. Since that day, barely Senior Enlisted Medical Advisor phases. Another parallel JCIDS process
a full year since the Battle of the Black is SOFCIDS, which is the USSOCOM
Sea, we have implemented most, if not all, of the con- JCIDS process for gaps particular to SOF. The SOFCIDS
cepts created from an in-depth analysis of that battle. process is quite effective but can only be used for SOF-spe-
Tourniquets and hypotensive resuscitation are dogmatic cific gaps. For better or worse, there are few SOF-specific
doctrine. We have advanced beyond the concepts of Tac- gaps in medicine, so we must engage the Service medical
tical Combat Casualty Care and made advances in he- departments to address our gaps. Some of the things that
mostatic dressings, fresh whole-blood transfusions, the come out of the SPP and JCIDS are Doctrine, Organiza-
use of ketamine for pain relief, and have fielded freeze- tion, Training, Materiel, Leadership, Personnel, Facilities,
dried plasma, to name a few. The Advanced Tactical and Policy (DOTmLPF-P) Change Requests, Capability
Paramedic certification, begun in 2003, is now widely Based Assessments (CBAs), Initial Capability Documents,
recognized. and Capability Production Documents.

When I consider how all of these things have happened, The process for this is the SPP. Usually the SPP is tied to
one word comes to mind: “disjointed.” The feeling I some strategic vision like USSOCOM 2035 or USASOC
sense among many medical providers in Special Opera- 2020. Nearly every Major Command has a strategic vi-
tions Forces (SOF) is that much change is still needed, sion, even the Air National Guard (ANG), which has
including formalization of training and doctrine changes its Strategic Master Plan 2015–2035. This example is
to address the prolonged field-care gap, increase in not meant to slight the ANG; the Strategic Master Plan
blood support, better tactical and operational casualty 2015–2035 is quite good, in my humble opinion. It is
evacuation support, increased tailored surgical support meant to show that there is always some sort of Com-
for SOF, environmental monitoring, and the list goes on mander’s Guidance to which gaps can be “tied” to, espe-
and on. So how do you “change the world” to make cially at Major Commands. Within USSOCOM, the SPP
these things happen? consists of placing proposed gaps onto the Command-
er’s Integrated Priority List (IPL). These proposed gaps
There is a little-understood method called the Strategic are then voted upon within USSOCOM as to whether to
Planning Process (SPP), which is how you “change the place them on the IPL. The gaps are then reviewed deter-
world.” SPP is how commanders validate gaps and de- mine whether they are SOF-specific, in which case they
rive requirements. If you are not using SPP to determine might be addressed by USSOCOM, or whether they are
and validate gaps, you only have a good idea delivered not, in which case they are sent to the Joint Staff to be
on the wings of that hated fairy. SPP goes hand in hand addressed. The issue with this, again, is that there are
with the Joint Capabilities Integration and Development few gaps particular to SOF within the realm of medicine.
System (JCIDS). JCIDS is the formal US Department of
Defense procedure that defines acquisition requirements Thus, the USSOCOM medical enterprise has several
and evaluation criteria for future defense programs. challenges that must be addressed through disparate,

117