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File: 970207_aadct_005.txt
Page: 005
Total Pages: 14


                                           MEDICAL LESSONS LEARNED
                                                DESERT SHIELD/STORM

        CATEGORY: TRAINING
    
        ISSUE ITEM #:
    
        SUBJECT: TRAINING-Total Force Integration
    
        BACKGROUND: There were instances of rank structure problems both
        from a clinical standpoint of reserve providers of care
        outranking active duty counterparts, and from an administrative
        standpoint of the best qualified individual not being in charge
        because active duty held all the command positions.  
    
       DISCUSSION: The clinical rank structure inversion is a product of
       the limited command opportunities within the reserves and the
       population we recruit from. Older, more established physicians
       and nurses are attracted to the reserves and come in at higher
       rank. The position of the reserves is that these individuals are
       to be recalled to provide clinical services and are not expected
       to be in command or leadership roles. This position is not always
       understood by both the individual and active duty personnel. The
       reverse situation also occured in instances where reserve
       commanders were not allowed to command the troops they normally
       train with and command.
    
       ACTION RECOMMENDED: Reserve providers need continually reminders
       that their role in a call-up is clinical. Active duty personnel
       need to be sensitized to the fact that these reservists are
       experienced senior officers and should be treated with respect
       due their rank regardless of their lack of administrative roles.
       In regard to command positions, it should be recognized that for
       certain missions, the reserves probably have the most experienced
       and best qualified commanders.There should be a more flexible
       policy that would allow the best qualified officers to be in
       charge whether they are active or reserve. Mobilized units should
       be commanded by their own senior staff whenever possible.
    
       SUGGESTED OPR(s), OCR(s): SGH

       COL KOENIGSBERG
       [(b)(2)]
    

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