Toward a 21st-Century Medical Offset Strategy

Authors

• George A. Barbee, Joint Medical Unit/Joint Special Operations Command, Fort Bragg, North Carolina
• Benjamin J. Ingram, NATO Allied Special Operations Forces Command, Supreme Headquarters Allied Powers Europe, Mons, Belgium

Abstract

This article argues that the joint force needs a medical offset strategy designed for large-scale combat operations and contested multidomain environments, where casualty volumes, evacuation constraints, dispersed operations, and attacks on medical support may overwhelm approaches that proved effective during the post-9/11 wars. The authors propose three complementary medical offset strategies: far-forward intervention, technology and innovation, and allies and partners. Far-forward intervention emphasizes early treatment, hemorrhage control, blood administration, austere care, and flexible casualty evacuation. The technology and innovation offset focuses on artificial intelligence–assisted patient movement, predictive and additive logistics, unmanned evacuation and sustainment systems, novel therapies, and improved medical data collection and interoperability. The allies and partners offset seeks to expand treatment and evacuation capacity through multinational medical interoperability, shared logistics, common standards, and stronger coordination with allied medical systems. The authors contend that combining these approaches can create medical overmatch, improve battlefield survivability, sustain combat power, and reduce operational and strategic risk in future conflict.