Admiral Crusher?

[Guy Gardener]

How can a mere Commander be expected to be in command of Starfleet Medical?

Admiral Crusher?

Now ask yourself how/why was she demoted back to Commander when they returned her to the Enterprise in season 3?

 

[BillJ]

I guess the question becomes is, does the administrator of Starfleet Medical have to hold a flag rank? Have we ever had an episode show an administrator of Medical or even mention it? Could the position even be held by a civilian (in which rank would be meaningless)?

Who knows?

 

[Guy Gardener]

She has to be able to treat flag officers and lets not forget the paperwork side of the job that she's prbably in charge (input/veto powers?) of logistics too, deciding on medical postings and promotions both of which are completely interdependant on the political climate of where and when these Doctors are doing their jobs.

Also if she remained a Commander, Beverly wouldn't have the authority to promote her (extended) staff (every Doctor in the fleet) above the rank of lieutenant commander.

 

[BillJ]

She has to be able to treat flag officers and lets not forget the paperwork side of the job that she's prbably in charge (input/veto powers?) of logistics too, deciding on medical postings and promotions both of which are completely interdependant on the political climate of where and when these Doctors are doing their jobs.

Also if she remained a Commander, Beverly wouldn't have the authority to promote her (extended) staff (every Doctor in the fleet) above the rank of lieutenant commander.

I'm just confused as to why a doctor would need to rise above 'Commander'. Even captains of science and medical vessels were wearing command red in Modern Trek, indicating they were command officers. I wouldn't think their commands would be assigned by Medical as they are still Starfleet vessels, and according to 'All Good Things...' were still subject to the same chain-of-command as other Starfleet vessels.

Even a doctor at a Lieutenant rank would seem to have all the authority they need to carry out the duties of Chief Medical Officer. YMMV.

 

[PsychoPere]

TOS "Turnabout Intruder" mentioned a "Starfleet Surgeon General" position. While that position was never mentioned in any of the modern series, perhaps the administrator of Starfleet Medical reports to the Surgeon General, who might be a flag officer and responsible for promotions that the head of Medical couldn't issue.

I'm just confused as to why a doctor would need to rise above 'Commander'. [...] Even a doctor at a Lieutenant rank would seem to have all the authority they need to carry out the duties of Chief Medical Officer.

A CMO wouldn't need to be any higher than Commander (hell, Bashir was DS9's CMO as Lt JG). Based on Crusher's comments about the Bridge Officer Examination in "Thine Own Self," I imagine most CMOs (in the timeframe of the modern series, at any rate) probably aren't higher than Lt Commander, since they'd really only need to rise to Commander rank if they wanted to serve in a command position. An officer might not even be able to rise to Commander rank without taking the BOE, since that exam was how Troi earned her promotion from LtC to Commander.

 

[Guy Gardener]

And that's fine until you consider that some of these people are planning on spending half a century in starfleet or longer and it's just nasty to penalize them for specializing in medicine. They have to be forwarded some sense of accomplishment and achievement otherwise the bitterness turns into rot.

Considering that any ship will demand to have 80 to a thousand engineers or bully boy romperstompers, but no starship is going to be needing-to/want-to over stock their crew with superfluous medical personal... Can a Nurse rise to the rank of Admiral? Actually that makes sense since there are a hundred nurses in the fleet for every Doctor. Without representation at the top, they're basicaly a slave class, which is true of any unrepresented party.

Besides lets not get bogged down with the thought of starships, what about actual Hospital complexes or Starbases which actually have Thousands of doctors operating under a single roof? You can't have all of them as lieutenants because it blobs out any sense of hierarchy and then no one knows what to do and it all degenerates into sex elevators like in Greys Anatomy.

 

[PsychoPere]

The hierarchy wouldn't necessarily be undermined by having a hospital with many Lieutenant-ranked doctors staffing the facility. After all, the hierarchy would still have an organizational structure (department heads). There's no reason that a newly-promoted Lieutenant couldn't be assigned to a department headed by a more senior Lieutenant who has yet to earn a promotion to Lieutenant Commander.

I don't think it would necessarily "penalize" a doctor to not promote them past Lt Commander (without the Bridge Officer Exam) or Commander (after passing the BOE). Why would a doctor need to be Commander or above in order to be CMO or even Administrator of Starfleet Medical? The position the doctor holds determines the authority and responsibility the individual has, not just the rank. As an example, Miles O'Brien was Chief of Operation onboard Deep Space Nine, while holding the rank of Senior Chief Petty Officer. Do you think that every member of the engineering staff on DS9 was therefore also enlisted personnel, despite the vast majority of engineering personnel in the modern series being officers? In fact, in DS9 "Emissary," an Ensign refers to O'Brien as "sir," even though this is long after O'Brien was established as an NCO in TNG "Family."

Beverly Crusher was a Commander because she passed the BOE. She had full authority as a doctor and as CMO as Lt Commander, but wanted the additional responsibilities and career options that Commander rank would entail. There'd certainly be nothing to stop any other doctor from doing so as well. In fact, in the anti-time future of "All Good Things..." it would seem that she took advantage of those additional career options by transferring to the command track since she was Captain in rank and position of the U.S.S. Pasteur.

The only anomaly that I can currently think of would be Leonard McCoy, since he was an Admiral by the time the Enterprise-D was commissioned in 2364 and isn't exactly the type of person who'd be interested in command. The outfit he was wearing in "Encounter at Farpoint" appeared to be a uniform of some sort, though it was quite unlike the other modern Starfleet uniforms.

 

[Guy Gardener]

Beverly was the Captain of a medical vessel in all good things.

Consider.

If she has to do everything a captain does she doesn't have the time to any doctoring any more, that she might as well not even be a Doctor anymore and never even bothered ever being a doctor or going to medical school in the first place.

I'm assuming that there are high ranking doctors in the real worlds military since president Bartlet was being treated by an Admiral who was a doctor on the west wing. It's a society of communists, they don't get shit all extra in remuneration for working harder so they might as well accept titles and maybe larger quarters while adhering towards their philosophy to forward the human condition.

 

[Kaziarl]

I had a colonel fix my ingrown toenail. He was my family doctor and a neurosurgeon in the national guard here in oregon. So yes, there are high ranking military medical officers who aren't necessarily in command, but there are also Lt. level officers who are department heads. So it seems it can be flexible, and I would imagine the same for Starfleet.

 

[Guy Gardener]

I'm reminded of something from Babylon 5...

Bester: “Otherwise the military might start putting telepaths on the front lines. We’re not expendable. Mundanes are.”

Garibaldi: “That would be us.”

Bester: “Got it in one Mr. Garibaldi. Takes generations to breed a telepath. Mundanes breed like rabbits. Supply and demand.”

It takes but load more education to make a Doctor than it does to make a security guard.

Medical decisions about how to care for the Federation can't be made by soliders, especially since a great deal of what Starfleet does is about disaster relief and building up new entrants to the federation who are playing catch up in being "equal".

 

[Marten]

Can't Star Fleet Medical be civilian? In that case, she wouldn't need a rank, and got reinstated afterwards.

 

[Guy Gardener]

You're mistaking Federation Medical with Starfleet Medical.

Besides, Janeway created a drafting president that a civilian would be given a conscripted rank of officer and a provisional rank badge without spending a single hour in the academy to get their chops.

Starfleet doctors go where they are ordered to and can't argue with those orders without resigning or facing a court martial and possibly jail time in New Zealand.

New reason for a Doctor Admiral.

plague.

planetary triage.

You need a Doctor admiral to co-ordinate 10,000 Doctor lieutenants to stop the spread of a plague across a world and then maybe chase it to the next planet and then just keep the germs disease confined into solar system and then a sector...

Then of course there's just pure research. The frontier of scientific research doesn't have to be in deep space. Science factories. Just kennels of doctors preforming experiments on Jupiter's moons trying to cure this and that micromanaged by a superior Doctor officer who has to understand what his underlings are doing or he is a completely ineffective administrator.

besides.

Most of us have all known two High ranking (fictional) officers all our lives.

Col. Sherman Potter and Col. Henry Blake.

One is decidedly a soldier and the other decidedly not.

 

[Timo]

How can a mere Commander be expected to be in command of Starfleet Medical?

Depends on what Starfleet Medical is.

If it's this thing,

http://memory-alpha.org/wiki/File:Starfleet_Medical.jpg

then Commander would probably be a perfectly fitting rank. A Cmdr or LtCmdr would head the "hospitals" of large starships, so one could head this hospital as well, quite possibly in short tenures such as Crusher's one year - and bow to the head of Starfleet Medical Division, a flag-ranking officer, like all "hospital" chiefs do.

(hell, Bashir was DS9's CMO as Lt JG).

And that was a position he could pick for himself for being the second best in his class. The best in his class became a medical officer aboard the gigantic starship Lexington, and still held Lt(jg) rank as of "Explorers", making one wonder if she weren't a CMO at a shamefully low rank as well.

However, "Explorers" offers no hint let alone proof that Elizabeth Lense would have been the CMO of that behemoth ship; more probably, considering the menial tasks she talked about, she became a junior MO of some sort.

Timo Saloniemi

 

[PsychoPere]

Beverly was the Captain of a medical vessel in all good things.

Ah, but her uniform was red, indicating that she had transferred to the command track.

If she has to do everything a captain does she doesn't have the time to any doctoring any more, that she might as well not even be a Doctor anymore and never even bothered ever being a doctor or going to medical school in the first place.

She would certainly still be a doctor, she just wouldn't be a Starfleet medical officer at that point. Her medical knowledge would never go away (and considering in the "proper" TNG timeline, she was keeping current with command operations, I'm sure that she'd do the same with medical advances even if she wasn't an MO any longer) and would be available to her in the event of shipboard crisis, on the planets her ship visited if her ship's MO staff wasn't sufficient for the need, and for a post-Starfleet civilian career if she so wanted.

(hell, Bashir was DS9's CMO as Lt JG).

And that was a position he could pick for himself for being the second best in his class. The best in his class became a medical officer aboard the gigantic starship Lexington, and still held Lt(jg) rank as of "Explorers", making one wonder if she weren't a CMO at a shamefully low rank as well.

Fair point on Bashir being able to choose. It's also likely that such a remote, insignificant (at first) space station wouldn't have been considered to "need" a higher-ranked CMO. I haven't seen "Explorers" yet; I'm only in late season 2 of DS9 at the moment.

 

[Subcommander R.]

And that's fine until you consider that some of these people are planning on spending half a century in starfleet or longer and it's just nasty to penalize them for specializing in medicine. They have to be forwarded some sense of accomplishment and achievement otherwise the bitterness turns into rot.

For Doctors the sense of accomplishment comes from successful work and research, not from rank. Can you imagine a single CMO we've seen in Star Trek preferring shiny new rank insignia over healing the sick?

 

[lennier1]

I always assumed the medical and military career in Starfleet were partially separate from each other.

In TOS Bones already had many years of experience as a general practitioner, but still had to rise through the officer ranks.
TNG/DS9 showed this even more clearly, where Junior Lieutenants and even Ensigns served as resident psychologists and doctors for over a thousand people. Troi also served as a diplomatic aide of sorts, in situations where wrong advice could've lead to war. But Troi and Crusher still had to earn their qualifications like all military officers (e.g., the Bridge Qualification required for the rank of a full Commander).

 

[Tom Riley]

There's also the fact that regular doctors today still have hierarchy in hospitals without having ranks. It's because they go based on experience. Doctor's in more administrative positions in a hospital are only above regular doctors because that's what they were HIRED for. When it comes to heading Starfleet Medical, I would assume it would work in the same way. A doctor could be assigned to be in command of other doctors of the same rank because that is the position they were given. They were given a commanding role, so the others would report to them and the hierarchy would function regardless of the fact that they are all the same rank. Think Arsenal Of Freedom. LaForge is in command because Picard appointed him when he beamed down, and despite the fact that a higher ranking officer was around, LaForge retained command because that's the position Picard left him with. So why would it not work the same with Starfleet Medical? If a doctor with the rank of Commander was assigned to head Starfleet Medical, how would other Commander rank doctors be a problem? The one assigned to the commanding position would still be in charge.