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The U.S. Department of Defense has highlighted the importance of preparing health care leaders to succeed in joint, performance-based environments. The current wartime environment, rising health care costs, and an increased focus on joint operations have led to recommendations for Military Health System (MHS) transformation. Part of that transformation will involve improving the identification and development of potential MHS leaders. An examination of how candidates are identified for leadership positions, the training and education opportunities offered to them, and the competencies they are expected to achieve revealed both a range of approaches and several commonalities in the military, civilian, and government sectors. A conceptual framework guided a series of interviews with senior health care executives from a wide range of organizations and military health care leaders from the Army, Navy, and Air Force, as well as a case study of the leader development approaches used by the Veterans Health Administration. Several themes emerged in terms of how leaders are developed in each sector, including the importance of mentoring, career counseling, 360-degree feedback, self-development, and formal education and training programs. Lessons learned in the civilian and government sectors hold importance for transforming the way in which MHS identifies and develops health care officers with high leadership potential for senior executive positions.

Table of Contents

  • Chapter One


  • Chapter Two

    Conceptual Framework, Data, and Methods

  • Chapter Three

    How Military Health Care Leaders Are Currently Developed in the Services

  • Chapter Four

    Findings from Interviews with Military Health Care Leaders: A Cross-Case Analysis

  • Chapter Five

    Key Findings from Interviews with Leaders of Civilian Health Care Organizations

  • Chapter Six

    Case Study: The Veterans Health Administration's Approach to Leader Development

  • Chapter Seven

    Conclusions and Recommendations

  • Appendix A

    Methodology Underlying the Sets of Rankings Used to Select the Sample of Nonprofit Hospitals in Phase I

  • Appendix B

    Development of Line and Medical Officers

  • Appendix C

    Findings from Interviews with Army Health Professions Officers

  • Appendix D

    Findings from Interviews with Navy Health Professions Officers

  • Appendix E

    Findings from Interviews with Air Force Health Professions Officers

  • Appendix F

    Selected Examples of Leader Development Programs Implemented by Civilian Health Care Organizations

  • Appendix G

    Selected Senior Leader Development Programs Offered by the VA/VHA

The research reported here was sponsored by the Office of the Secretary of Defense (OSD). The research was conducted jointly by the Center for Military Health Policy Research, a RAND Health program, and the Forces and Resources Policy Center, a RAND National Defense Research Institute (NDRI) program. NDRI is a federally funded research and development center sponsored by OSD, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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