LEARNING OBJECTIVE: Identify the steps in the development of a joint medical operational plan.

As a Hospital Corpsman you should be able to assist in the development of a joint medical operational plan. This is a plan that outlines the use of medical assets in support of tactical operations. The tactical mission of the combat forces is the basis for all medical planning. Medical preparation and planning must be initiated early and must be specifically designed to support the tactical operation.

MEDICAL ESTIMATE
A medical estimate is an estimate of personnel and material needed to supply medical services in support of military operations. The steps that are taken in preparing the medical estimate include consideration of the command mission, consideration of the factors affecting the health services (workload, supplies, etc.), and evaluation of proposed courses of action (i.e., listing comparative advantages and disadvantages of each).

Medical Intelligence
The staff surgeon and dental surgeon must be thoroughly informed of all military operations before a proper medical estimate can be made. Some of the items that should be considered are enemy capabilities, friendly capabilities, and environment (terrain, climate, etc.). This information, taken together, becomes medical intelligence.

Patient Estimate
Based on the medical intelligence, a preliminary patient estimate can be made of the probable number of patients, types of patients, patient distribution, and the areas of greatest patient density. From these preliminary patient estimates, a calculation is made of the number and types of medical units and the amount and kinds of medical material which will be required. Similar estimates, based on the anticipated health situation, will be required for preventive medicine units.

Evaluation of Course of Action
The staff surgeon must determine the various courses of action that are available and the probable effect of each enemy capability on the success of each course of action, and weigh the advantages and disadvantages of each course of action. The staff surgeon will then decide which course of action promises to be the most successful in accomplishing the mission. A recommendation will be made to the commander for medical requirements, along with where, when, and how medical units should be employed.

PLANNING FACTORS
Basic planning for medical support in joint operations involves four major considerations:

Plans pertaining exclusively to each medical service

Plans of each medical service that require coordination with the other elements of the same armed service
Plans involving joint action among the services
Plans involving coordination with allied forces
Admission Rates
One of the prerequisites for sound medical planning is an accurate estimate of patients, calculated by applying admission rates to personnel strengths. Admission rates are numerical expressions of the relative frequency with which patients are admitted to hospitals from a specified population over a designated period of time. The particular admission rates used in medical planning represent average rates derived from similar experiences in similar military operations. The three primary categories of patients used in calculating admission rates in an area of military operation are wounded (battle) patients, nonbattle injury patients, and patients who are ill.

Evacuation
Patient evacuation policy is established by the Secretary of Defense, with the advice of the Joint Chiefs of Staff and the recommendation of the theater commander. The policy states, in number of days, the maximum period of noneffectiveness ( i . e . , hospitalization) that patients may be held within the command for treatment. Any patient who is not expected to return to duty within the number of days expressed in the theater evacuation policy is evacuated. Evacuation plans are greatly influenced by the amount and type of transportation available to medical service.

SUMMARY
In this chapter we discussed medical reports, logs, and records commonly used by the Navy Medical Department. We also covered maintenance and disposal of instructions and notices, preparation of correspondence, and filing procedures. Additionally, the chapter covered the Fleet Marine Force, development of a command medical readiness plan (to include the Mobile Medical Augmentation Readiness Team (MMART) and unit augmentation), and development of a joint medical operational plan.