Editor-in-Chief, Chester 'Trip' Buckenmaier III, MD, COL, MC, USA.

With this issue of Outlook 2012, U.S. Medicine brings 2011 to a close. This past year is notable for its anniversaries and milestones. We marked the 10^th anniversary of the 9/11 attacks, which literally changed the lives of countless Americans forever. Like many in federal medicine, I can recall details of my life on that day like few other days, such as graduation, my wedding or the birth of a child. It is difficult not to see my career through the lens of everything before, and then after that fateful date. For federal medicine, the gauntlet was thrown down that day as our military was soon involved in two wars, half a world away, fought by an all-volunteer force. With the passing of 2011, the United States will have been at war for over a decade, making these conflicts our longest second only to the Vietnam War. Despite these challenges, the federal system of medicine has responded admirably, achieving a historic less than 10% died-of-wounds rate. Along the way, federal medicine has redefined medical practice in trauma management, blood component therapy, traumatic brain injury, post-traumatic stress disorder, pain medicine, flight medicine, just a few areas of innovation. 

In this issue of Outlook 2012, leaders throughout the federal system of medicine provide an update on accomplishments and a peek at federal medicine’s prospects as the healthcare landscape in America changes, possibly dramatically, in the near future. Air Force Surgeon General Lt. Gen. Charles B. Green will comment on enhancements to aeromedical critical-care teams that have had a huge impact on the unprecedented survival rate of wounded in the present conflicts. Army Surgeon General Lt. Gen. Patricia Horoho will comment on the impact of Army Medical Home that will be patient-centered, team-based, and quality-focused, on the future of Army medicine. Navy Surgeon General Vice Adm. Matthew Nathan will provide information on six key areas of future Navy medicine focus; support of the war fighter, readiness, value, healthcare informatics, jointness and global engagement. These individual service perspectives will shape military medicine as the DoD begins a second decade at war. VA under Secretary for Health Dr. Robert Petzel will describe the changing demographics of the VHA that now treats 19-year-old veterans alongside veterans in their 80s or 90s and the need to accelerate toward a patient-centered healthcare delivery system to survive reductions in government healthcare spending. The Indian Health Service efforts to reform its systems and improve access to quality care will be addressed by the IHS Director, Dr. Yvette Roubideaux. Uniformed Services University of the Health Sciences President Dr. Charles Rice will outline the university’s efforts to sustain and expand its essential role in educating our future federal medicine leaders. These are just a few of the leaders who have provided their perspectives for federal medicine in Outlook 2012.  

Throughout the past decade, U.S. Medicine, has been your source for a clear, unbiased, and fair view of the state of federal medicine through these demanding times. Perhaps you have noticed the gradual new look and editorial changes that have occurred to the periodical, many in response to your comments. As I begin my third year as editor-in chief, I hope you will continue to make U.S. Medicine your primary source for the latest news and information concerning federal medicine. We thrive on your comments and suggestions. I look forward to serving with you in the coming year as we continue to lead the nation as we care for the finest patients anywhere. 

Yours in Service,

Chester Trip Buckenmaier III, MD
COL, MC, USA
Editor-in-Chief, U.S. Medicine

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