The recent General Services Administration (GSA) Las Vegas conference scandal, involving clowns and a mind reader (I could not dream this stuff up if I tried), must seem like manna from heaven for the likes of John Stewart and Stephen Colbert. Admittedly, I derive great entertainment from the seemingly endless gaffes by our federal government. At the same time, as a federal medicine employee, I grieve for the good people who are the brunt of these jokes.

While I do not condone the decisions that led to taxpayer dollars being spent on clowns, I am no stranger to the bureaucratic “group-think” that can lead to a decision that seems barren of common sense. The military is certainly not immune to these gaffes. There have been times in my career when I have become so baffled by policies that I wonder how the first bullet in a conflict ever gets downrange with so much bureaucratic inertia weighing down the system. The answer to that question is, of course, people — our leaders in particular. Perhaps what has attracted me to federal medicine for so long is that I have witnessed leaders making things work in our system, not because of the regulations but often in spite of them.

Calvin E. Stowe (1802-1886) was an American biblical scholar at Bowdoin College in Maine, who is quoted as saying, “Common sense is the knack of seeing things as they are and doing things as they ought to be done.” From my perspective, this quote sums up much of what it takes to be a good leader. If someone had been there to whisper Stowe’s quote into a heeding ear, perhaps GSA leaders could have avoided their unfortunate clown decision. Alas, this is not what transpired, and the press has had a field day with mind-reading clown jokes, all at GSA (and taxpayer) expense.

As is often the case when the seemingly endless capacity for human foolishness finds a weakness in our regulatory bureaucracy, new regulations burst forth from the federal regulatory cornucopia. This is not necessarily a bad thing. A bit more financial regulation on the subprime mortgage system in 2006 might have prevented the considerable pain of the bursting housing bubble that ensued. The trick, of course, is finding the right balance between common-sense regulations designed to prevent clowns from overrunning the next GSA meeting, while not creating so much regulation that the GSA meeting is eliminated altogether. I do not think the average taxpayer would be offended by the GSA’s need to have training meetings; however, I do think the need for clown entertainment at such a meeting does not meet the ordinary taxpayer’s common-sense test.

Why am I going on about this? As expected, following the GSA debacle (and other issues with Secret Service prostitutes and $16 Department of Justice muffins), fresh new regulations regarding conferences and nonfederal entity relationships in the military appeared, seemingly overnight. Just in case there was any confusion in federal leaders’ minds that clowns, prostitutes and $16 dollar muffins are a bad idea at meetings, the new rules effectively eliminate that bewilderment. Unfortunately, in the process of banishing that absurdity, we have nearly regulated military medicine out of the business of holding federally-sponsored medical meetings.

This issue was brought home to me as the (recently resigned) president of the Uniformed Services Society of Anesthesiologists (USSA) (www.ussa-asa.org). For the past decade, this tri-service military and civilian retiree group of anesthesiologists has gathered at the American Society of Anesthesiologists’ annual national meeting.

The group has focused on enhancing the anesthetic care provided by military anesthesiologists at home and on the battlefield. Significant improvements in the practice of battlefield medicine can be traced specifically to this important annual event. The meeting provides younger officers a rare opportunity to learn from senior leaders, develop a sense of esprit de corps and learn about the opportunities a career in federal medicine can offer. More importantly, this organization houses the combined services anesthesiology knowledge and experience that has been forged during 11 years of continuous conflict. This is all accomplished through a program that offers required continuing medical education credits and, to reduce travel costs, is held in concert with the largest national anesthesiology meeting.

The taxpayer dollars invested in this conference have paid off handsomely in improvements in trauma anesthesia, better trained physicians and medical officers, and more efficient transfer of battlefield medicine lessons to the American system of medicine. All of this is accomplished, amazingly, in a clown-free environment.

The same regulatory brushstrokes applied to blot out GSA-like excesses also have tarred with the same brush meetings such as USSA. I have scrambled for the past few months to reinvent USSA, including to resign as president of the organization so a uniformed officer would not be involved with a nonfederal entity to conform to the new rules and their strict interpretation.

Many other senior military leaders have, or are going to have, experiences with similar issues in their own vital professional meetings. The loss of these professional organizations is not in the taxpayer’s best interests and does not meet the common-sense test. Fortunately, through the good judgment and effort of many leaders within the USSA leadership, we have made sweeping changes and concessions to allow this important organization to our national defense to continue this year.

My concern now is the future. The need to protect the taxpayer from federal excesses and abuses with unambiguous regulations is clear. The need to simultaneously protect vital federal medicine conferences from indiscriminate application of those regulations is no less sacrosanct. The challenge to our federal medicine leaders is to have the common sense to recognize the difference and create conditions and regulations which allow both of these correct behaviors to continue in parallel and without conflict.