The hazards of centralization: A comment on Tom’s blast yesterday at the Army paper on optimizing human performance

By Col. Scott Feil, USA (Ret.)

Best Defense guest columnist

I recall being a brigade commander and my next-door neighbor was the hospital commander. We were commiserating about the closure of troop medical clinics in the troop areas due to manpower and budget cuts in the medical branches. Typical downsizing response is to consolidate, so all morning sick call was done at the hospital. That burdened the hospital, meant the units had to run shuttle buses, and often took soldiers out of training for an entire day when all they needed was a "cold pack" and pat on the head (or kick in the butt).

We also recognized there were three groups of soldiers going to the hospitals — those who would need admission for serious injury or illness, those in the great middle (who needed the aforementioned cold pack, aspirin, prescription, etc., and could return immediately to training), and the goldbricks.

Solution: decentralize. We arranged to open the troop medical clinics for one hour each morning for unit sick call. Medics/PAs from the hospital unlocked the doors at 0500, admitted all, and then began triage. Goldbricks got sent back to unit immediately, the middle soldiers got their aspirin or Tylenol or other prescription, bandage, small suture, etc., and returned to training a little later. Those needing admission rode back to the hospital with the medics when the clinic closed for the day at 0600. 

The big benefit was that goldbricks got the message they couldn’t skate for a day sleeping in the broom closet at the hospital. I had more NCOs and soldiers at training, and the hospital staff dealt with soldiers needing hospital-level care, and not runny noses.

As for the language — it’s an eternal battle for the Army/services to communicate in clear, buzzword-free language. Unfortunately, they have bought into the concept that to be a "profession" the group/organization must have its own lexicon.