The conservation of the army's fighting strength is clearly the primary goal. How one structures his combat medical care delivery system will depend in large measure upon the nature of the war, the quantitative and qualitative aspects of the casualty load and the medical personnel, logistical and physical plant capabilities. If the nature of the war allows, sophisticated medical facilities can be positioned very near the wounded soldier. As a general rule, as the medics increase their technical capabilities, they do so at the price of increased requirements for complex equipment, which in turn requires increased lift. These increased cube and gross weight medical airlift requirements compete with combat arms lift requirements.
Combat hospitals are already large, bulky, and difficult to move.
Highly sophisticated hospitals in the battle zone could encumber the combat commander, restrict his freedom of movement, and at times become a liability rather than an asset. A battlefield medical system must be a compromise between what is best for the soldier and what is best for the conduct of the battle. The basic objective is the realistic minimization of the loss of life and limb. The medical system of the German Army in Russia in 1941 was designed to evacuate the seriously wounded well to the rear and to care for the lightly wounded at the divisional level. This approach required only half as many medical personnel and achieved higher return to duty rates than did the U.S. Army's system in France in 1944, because the German system was intentionally designed for return to duty.