Story by Shireen Bedi, Air Force Medical Service
When Lt. Gen. Dorothy A. Hogg assumed the role of Air Force Surgeon General in 2018, she saw an opportunity to carve out a renewed readiness vision and foster a culture of innovation for the Air Force Medical Service.
After three years in the highest position in the AFMS, and more than 37 years of active duty service, Hogg retires June 4. Her tenure as Surgeon General was marked with the ongoing transformation of the Military Health System, the COVID-19 response, and the first Surgeon General responsible for the care of U.S. Space Force Guardians. Through it all, she has learned to embrace challenges as opportunities, to lean on her diverse leadership team when making tough decisions, to empower her medics, and strengthen their ability to support the mission.
Why did you join and why did you stay?
Whenever someone has retired in the past, Hogg would often ask why they joined the Air Force and why they stayed. When asked those same questions, her response was not unlike many of her fellow Airmen.
Hogg joined the Air Force when her husband, who was an active duty Airman, had to move for his first assignment. Having graduated with a bachelor of science in nursing just three years prior, she did not want her husband’s move to impact her nursing career – something many military families often have to deal with.
“I didn’t finish college just to have to start from square one every time we had to move,” said Hogg. “So, I figured I had nothing to lose by joining the military. I could get in, do my time, and leave if I didn’t like it. Or, I could get in and stay.”
When asked why she stayed, Hogg said it was the people and the mission that kept her in.
“One of my past Chiefs said, ‘In the first four years, I was in the Air Force. After that, the Air Force was in me,’’ said Hogg. “The people I have worked with are the best caliber of people I have ever had the opportunity to be around. And the mission is what makes it all worth it. We are in a lifesaving mission and in the national security mission. The opportunities I had would have never come my way had I been a civilian nurse. Every assignment, job, and place has been an absolute joy. Each experience taught me so much about myself and what it means to be an Air Force medic.”
Challenges as opportunities
Hogg took the helm at a time when the AFMS was undergoing, and is still undergoing, significant changes. In addition to the transition of military treatment facilities to the Defense Health Agency, the AFMS is also taking on critical transformations to increase its focus on medical readiness.
As the responsibility of delivering health care for all beneficiaries moves over to the DHA, Hogg directed a reexamination into the AFMS’s own structure with an eye towards transitioning to an operational focus.
During her tenure, the Air Force Medical Reform Model was rolled out at 66 MTFs. Under this model, the MTFs were restructured into two squadrons. The Operational Medical Readiness Squadron focuses on Airmen and Guardian health. The Healthcare Operations Squadron focuses on the health of all other beneficiaries. In 2019, the Air Force Medical Readiness Agency stood up to oversee medical readiness programs, expeditionary medical capabilities, and readiness-related mission support requirements.
“The reason we have medics in uniform is to go to war. We exist so that our warfighters live and come home safely,” said Hogg. “We not only keep our Airmen and Guardians mission-ready, we also ensure medics are ready to deliver care when deployed. Restructuring our medical squadrons and standing up the Air Force Medical Readiness Agency helped us put that readiness mission front and center of everything we do.”
According to Hogg, this ongoing transition and transformation did not come without its challenges, but the significant progress that has been made, and the work that has been put in, is something she is proud of.
“When the National Defense Authorization Act came out and identified the changes they wanted the Military Health System to go through, we were initially unsure how it was all going to work,” said Hogg. “Despite the many unanswered questions, our medics stepped up to the plate and ensured we could implement those changes effectively while addressing gaps and challenges along the way. Today, we have a better understanding of the changes taking place, which has brought on improved collaboration with DHA and our sister services to get us to that finish line.”
More recently, Hogg’s tenure as Surgeon General has also been significantly defined by the COVID-19 pandemic, which placed military medics on the frontlines like never before.
In early 2020, Hogg briefed Congress on evolving Air Force medical capabilities to meet new challenges. She testified at a time when the nation was just beginning to grapple with the potential severity of COVID-19.
Nearly 800 Air Force medics quickly deployed to overwhelmed civilian hospitals. They also collaborated with partners to rapidly develop and deploy the Negatively Pressurized Conex in July 2020 to safely transport infected patients while mitigating the spread of COVID-19 to aircrews. Since then, Airmen have successfully moved more than 370 COVID-19 patients. Air Force medics worked to ensure the Air Force and Space Force missions could continue safely by implementing vital protocols and guidelines to slow the spread while on the job.
“The COVID-19 battle was new for all of us,” said Hogg. “It was an enemy we couldn’t defeat with airpower. This was an enemy that required medical power. Without skipping a beat, our medics put their capabilities to the test, constantly evolving better and safer ways to do things as they learned more about COVID-19.”
Hogg attributed the success of Air Force medics to their ability to adjust and innovate when their patients, fellow service members, and the nation needed them.
“I empowered our medics to develop and deploy effective solutions at the local level to meet their needs. And they did just that,” said Hogg. “Having medics who are closest to the problem leads to the best solutions, solutions I would not have thought of, and many of which have been implemented across the Air Force.”
Through the indescribable tragedy and challenges brought on by the COVID-19 pandemic, Hogg saw her medics persevere and showed exactly why they train the way they do.
“Not only did our medics face this pandemic head on, wing leadership truly recognized what Air Force medicine brings to the fight,” said Hogg. “It’s more than just providing access to appointments. Our military medics do so much more. They’re aeromedical evacuation experts, they’re bioenvironmental engineering experts, they’re public health experts, they’re clinical care experts, they’re infectious disease experts, they’re respiratory care experts, they’re medical logistics experts, just to name a few, and we needed every single one of these medics to successfully defeat COVID-19.”
Personal growth and thinking without a box
Just as the AFMS has undergone significant changes, so has Hogg. As she reflects on her time in the AFMS, she is often reminded of the ways she was pushed to change, get out of her comfort zone and grow to become a better nurse, leader, and Airman.
“Change is hard and everyone responds to it differently, but change is the only constant we have,” said Hogg. “I am always reminded of a quote by [President] John F. Kennedy where he says, ‘Change is the law of life. And those who look only to the past or the present are certain to miss the future.’”
Hogg attributed much of her growth to her fellow medics, especially those who have challenged her way of thinking and supported her along the way. Hogg learned over time that no one can achieve and be successful alone, and that being a good leader requires a team.
“One is too small a number to achieve greatness. That is my leadership ethos,” said Hogg. “I have a diverse team with different experiences who identify gaps I might not be thinking about, which leads to better solutions. I value the feedback I get at every level. I don’t want my medics to agree with me just because of my rank. I want them to bring up issues and concerns so we can have those hard discussions. That way, when we make decisions, we are all singing off the same sheet of music.”
Hogg encourages medics to find opportunities to challenge their own way of thinking and strive to find innovative ways to face challenges.
“Throughout my time as Surgeon General, I have asked my medics to think without a box,” said Hogg. “I want them to feel empowered to challenge the status quo and take risks. We need to make sure we don’t get comfortable with doing something just because it has always been done that way. Life doesn’t stay that way, medicine doesn’t stay that way, and neither should how we do our jobs.”
Hogg’s leadership has been critical in moving the AFMS forward to become more operationally focused. She pushed for innovation and modernization of capabilities. She also championed her medics, empowering them to bring about necessary changes and further strengthen the AFMS. While Hogg looks forward to some much-deserved time off, she is also eager to see how Air Force medics continue to succeed in the years to come.
“The first thing I am going to do once I am done is enjoy some uninterrupted time with my mother, two daughters and five grandkids. They have had to share me for a very long time and we missed a lot of birthdays and holidays,” said Hogg. “I have a house on a lake, so I am going to enjoy taking a cup of tea down to the dock with a good book and enjoy the scenery.
“It was once said, ‘A sunset is nothing more and nothing less than the backside of a sunrise.’ As the sun sets on my tenure as your Surgeon General, it will rise again with your 24th Air Force Surgeon General in whom I have 100% confidence. I am overflowing with gratitude having worked with the world’s best medics who have made this job so enjoyable. I am proud of every Air Force medic and the work we have done together.”