MAY 7, 2025 – Surgeons General from each of the three military services, the National Guard, and the Joint Staff surgeon addressed key issues affecting military health during a roundtable discussion at the 2025 Military Health System Conference in Cleveland, Ohio, on April 30.
The session, led Acting Principal Deputy Assistant Secretary of Defense for Health Affairs and Acting Director of Defense Health Agency Dr. David Smith, highlighted how each service is tackling the evolving demands of warfighting while working together to transform military medicine.
The forum brought together “the leaders who are in the forefront of military medicine, and are visionaries who have dedicated their careers to safeguarding the health, readiness, and resilience of our service members,” said Smith.
In a time of new emerging global threats, emerging medical challenges and technological advancements, Smith said, “Their collaboration and shared expertise has never been more important and critical,” referring to the surgeons.
Service-Specific Readiness Challenges and Initiatives
U.S. Army Lt. Gen. Mary Izaguirre, U.S. Army surgeon general, highlighted the U.S. Army’s focus on continuous transformation and partnerships, emphasizing the integration of medics into formations and the importance of local, organizational, and international collaborations. She stressed learning from past successes and from current partners like Ukraine.
U.S. Air Force Lt. Gen. John DeGoes, U.S. Air Force and U.S. Space Force surgeon general, discussed the changing role of medics, emphasizing the need for agile combat employment and redesigned training and equipment. He stressed the interconnectedness of healthcare delivery and readiness.
DeGoes said the future hinges on combat-ready medics who can operate in “complex, contested environments,” and noted the service has restructured how medics are embedded into operational squadrons.
U.S. Navy Rear Adm. Darin Via, U.S. Navy surgeon general, focused on total sailor readiness and the conflict between generating readiness at high-volume medical centers and meeting the needs of geographically dispersed units. He highlighted innovative partnerships with civilian trauma centers and the development of an enterprise approach to integrate fleet needs into health service governance.
Via emphasized building “total sailor readiness,” including mind, body and spirit. That includes leveraging partnerships with local trauma centers, where medics train in high-volume, high-acuity settings.
U.S. Marine Corps Rear Adm. Pamela Miller, medical officer of the Marine Corps, and deputy chief of Bureau of Medicine and Surgery, Reserve Policy and Integration, discussed the parallel transformation of health services alongside Force Design 2030, emphasizing prolonged casualty care, blood supply in dispersed environments, and joint force training. She stressed the importance of building trust with Marines through consistent, high-quality care.
“Our corpsmen are going to be at the pointy end of the spear,” Miller said. “We’re asking them to do more with less, and to be ready for something even our most senior leaders haven’t seen in decades.”
U.S. Army Maj. Gen. Lisa Hou, director, Office of the Joint Surgeon General, U.S. National Guard Bureau, outlined the unique challenges of the U.S. National Guard’s dual mission of warfighting and homeland defense, emphasizing the need for more time and resources for training, particularly in trauma care. She discussed partnerships with civilian hospitals and the state partnership program.
For the U.S. National Guard, which forms 20% of the joint force on 4% of the Department of Defense’s budget, the challenge is time and access, Hou said, She also noted that funding and licensing barriers may hold the service back.
U.S. Air Force Brig. Gen. John Andrus, U.S. Joint Staff surgeon, emphasized the need for joint qualification pathways for medics, integrated governance, normalization of processes, and enterprise management. He highlighted the importance of global integration and interoperability.
He said the MHS and services need to be continually enhancing. “If we are not undergoing change, we are not growing. We are not learning, we are not adapting, we are not becoming better, and that change is really important,” said Andrus.
Despite challenges with staffing, funding and access, all leaders agreed: Readiness requires integration—across services, with civilian partners, and with allies around the world.
Via concluded by asking those who wear the uniform to “find problems, fix problems, or elevate problems, and fail fast and run with scissors.”
Story by Robert Hammer
Office of the Assistant Secretary of Defense for Health Affairs/Military Health System