Page 46 - JSOM Spring 2025

Beyond Command

Exploring the Dynamics of the Military Medical Officer
and Non-Commissioned Officer Relationship in Military Medicine

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Kiia Crawford, MC, USN *; Makinna Farrell, MC USN ; Ariana Daukss Barilla, USA ;
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Amy F. Hildreth, MD, MHPE ; Rebekah Cole, PhD, Med 5

ABSTRACT
Background: Military medical officers (MMOs) and non- their leadership and military skills, followed by years of spe-
commissioned officers (NCOs) serve critical roles within mil- cialized medical education to prepare them for their roles as
itary healthcare teams, and a successful working relationship physicians. 1,4
between them is essential for mission success. The purpose of
this study is to explore our participant NCOs’ insights into how Enlisted medical personnel, including Navy Hospital Corps-
MMOs and NCOs can foster positive working relationships. men, Air Force Aerospace Medical Technicians, Army Combat
Methods: Utilizing a qualitative existential- phenomenological Medics, and others, are essential as medical support within
design, the research team interviewed eight medical NCOs the United States Armed Forces. Often placed in duty stations
twice through a focus group and individual interviews. Each or outposts where enlisted medical personnel outnumber the
interaction was transcribed and coded. Phenomenological MMOs, these enlisted specialists are considered an extension
analysis methods were applied to identify emergent themes. of the physician, providing immediate medical care as appro-
Results: Three interdependent themes were identified: (1) open priate. Experienced enlisted members with leadership respon-
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communication, (2) trust in training, and (3) mutual mentor- sibilities, holding ranks from E-4 and above, have the title of
ship. The MMO should establish and maintain open lines of Non-commissioned Officer (NCO). NCOs derive their au-
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communication. The MMO should understand NCO roles thority from their rank and experience, and the orders of the
and abilities, and work to build trust through respect for their commissioned officers appointed over them. This combina-
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skills and contributions. Reciprocal learning is essential for tion of direct and delegated authority allows them to lead and
professional development between MMOs and NCOs. Con- develop subordinates, and exercise effective followership in
clusion: Potential methods to integrate training into existing mission accomplishment. Medical NCOs are the backbone of
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medical school curricula include interprofessional mentorship the Military Healthcare System (MHS), epitomizing excellence
training and high-fidelity military medical simulations with and competence in their respective specialties. This dual role
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opportunities for structured feedback. of leadership and expertise places medical NCOs in a unique
position with significant influence, as they not only ensure the
Keywords: military medical officer; non-commissioned officer; operational readiness of their units but, along with the MMO,
role; healthcare, team; communication; trust; mentorship; carry the critical responsibility of safeguarding the lives and
efficiency; effectiveness; medic; corpsman; enlisted; reciprocity health of their fellow service members. 6,7
Team Collaboration in Medicine
In military settings, patient care depends heavily on collabo-
Background
rative efforts. MMOs typically work within military interpro-
The primary role of the Military Medical Officer (MMO) is fessional healthcare teams (MIHTs) that include, but are not
to serve as a commissioned officer in the United States Armed limited to, physician assistants, nurses, and medical NCOs.
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Forces. MMOs joining the U.S. Armed Forces during their Despite their specialized functions and varying scopes of prac-
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time in medical school, (via the Uniformed Services University tice, each role is responsible for providing essential medical
[USU], Health Professions Scholarship Program [HPSP], or care and support. Our study focuses more narrowly on the
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Health Services Collegiate Program [HSCP]), will be commis- specific dynamics between medical NCOs and MMOs within
sioned by direct Presidential appointment, as their academic MIHTs, aiming to identify the key pillars that uphold their
program dictates. This role entails a profound trust be- working relationship. By examining how this partnership
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stowed by the American public, devotion to the performance functions and thrives, we seek to determine the best practices
of their duties, and a call to service through leadership. As for reinforcing its resilience and effectiveness.
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military physicians, MMOs begin their journey by taking the
Oath of Office, pledging allegiance to the United States, and Several research studies have investigated the operational dy-
the Hippocratic Oath, committing to ethical patient care. namics and success factors of MIHTs within military health-
1,3
They undergo rigorous officer training programs to develop care settings. A scoping literature review conducted by Varpio
*Correspondence to kiia.crawford@usuhs.edu
1 ENS Kiia Crawford, ENS Makinna Farrell, and 2LT Ariana Daukss Barilla are affiliated with the School of Medicine, Uniformed Services Uni-
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versity, Bethesda, MD. Dr. Amy F. Hildreth is affiliated with the Department of Military and Emergency Medicine, Uniformed Services University,
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Bethesda, MD. Dr. Rebekah Cole is affiliated with the Department of Military and Emergency Medicine and Department of Health Professions
Education, Uniformed Services University, Bethesda, MD.
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