Maj. Gen. Bart Iddins is something like a galactic overlord of hospital administration. He’s a medical doctor with graduate degrees from Harvard and Air War College. He’s got two Bronze Stars and 31+ years of experience. He’s lived and worked all over the world, coordinated with foreign governments, healed multitudes of sick people, and logged time in sixteen aircraft as a flight surgeon.

And yet, astonishingly, he seems to understand little about how to actually lead people. Here’s an email relayed by his local toadie, a Group Commander who finds herself reporting directly to someone whose bio refers to him as “Chief Executive Officer” of the San Antonio military health bureaucracy.


Now, I realize it’s expected that John Q will happily join in any effort that bashes support functions, but that’s never really been the schtick here. I draw a distinction between individuals contributing negatively to the failing system in which they are trapped (e.g. Finance using manning shortages as cover for constant pisstaking) and alleged leaders creating that system or failing to address it, which is the greater of sins. Here we have a glaring example of the latter.

On the one hand, we can sympathize with what Overlord Iddins is trying to do here. He’s focusing on the patient experience and setting a high expectation. This sort of customer obsession is too rare in today’s Air Force, and should ordinarily be heralded.

But before we can drive a bargain this hard, we have to entitle ourselves to do so by properly resourcing our organizations. Iddins’ directive assumes the 59th Medical Operations Group is sufficiently staffed to achieve his standard. Sources tell JQP the group is woefully undermanned and struggling to achieve even minimal standards of care and responsiveness. Members of the unit desperately want to take care of patients. They want to answer phones. But they can’t capably do two or three jobs at a time to make up for gaps in their roster.

This raises two key questions. First, what does Iddins assume about his people? Does he assume they want to fail? Does he assume they’re letting phones ring off the hook for no good reason? What does he surmise they’re doing instead of answering the phones? Does he reason that they must not be prioritizing correctly? If the organization is comprised of derelicts, who is responsible for that?

Answering this first question hinges on the second: has Iddins done a “deep dive” to understand the problem he’s seeking to address? Or has he assumed the nature of the problem without studying it? It might well be that he has looked at it carefully. But sources at Wilford Hall believe Iddins is making bad assumptions based on his previous experience in the 59th, which dates back a decade to when manning was better and patient load was more manageable. He’s operating on false impression rather than informed consideration, and in doing so taking an inaccurate hip shot.

Whether Iddins has an accurate grip of the problem or not, it’s a bit much for a 2-star to start throwing the word “dereliction” around over an issue like this. This is like swatting a fly with a jackhammer, and it’s bound to make a bigger mess of things. Dereliction of Duty is a term of art corresponding to a violation of one of more punitive articles of the UCMJ. Proving it requires a criminal investigation. Do we really think unanswered phones at Wilford Hall rises to the level of criminality? Have we tried anything intermediate, or did we reach straight for the detonation trigger?

This critique wouldn’t be complete without mention of the illustrious Col. Lefebvre. What she’s done here is a disservice to both her own people and her 2-star boss. She owed him an honest response laying out the arguments in this article. She owed her people the deflection of unhealthy pressure rather than amplification of it. The Air Force pays its colonels big money, and they need to earn it by doing the difficult tasks rather than acting as passive conduits for fascist impulses.

Here’s my suggestion for the crowd: look up Iddins and Lefebvre in the global. At 2 PM this afternoon, besiege their phone lines. When they can’t answer, lodge a complaint in the comment section of this blog. We’ll wrap the responses into a message for Maj. Gen. Iddins, asking him if he considers himself guilty of dereliction.