The President of the United States of America, authorized by Act of Congress, July 9, 1918, takes pleasure in presenting the Air Force Distinguished Service Medal to Major General Paul Kendall Carlton, Jr., United States Air Force, for exceptionally meritorious and distinguished service in a position of great responsibility to the Government of the United States. General Carlton distinguished himself as Commander, 59th Medical Wing, Lackland Air Force Base, Texas, and Lead Agent, TRICARE Region VI, San Antonio, Texas, from 26 September 1994 to 24 May 1999. During this period, his outstanding leadership, vision, integrity, courage and commitment to the Air Force mission and Military Health Systems pushed the Wing to the forefront of Air Force medicine. His improvement of ambulatory services, outreach initiatives, and response to military reductions had positive impact throughout the Air Force Medical Service. His liaison work creating a regional trauma consortium had a lasting effect throughout the Department of Defense. He skillfully guided implementation of TRICARE Senior Prime throughout the San Antonio and Texoma areas. He was a key leader in the genesis, development, and deployment of modular medical readiness capabilities culminating the in the implementation of the Critical Care Air Transport Teams and the Mobile Field Surgical Teams–each a key component of the Air force Global Engagement mission. He was the architect of the strategic planning process, which laid the foundation for implementing the medical center’s rightsizing, and readiness initiatives. The singularly distinctive accomplishments of General Carlton reflect the highest credit upon himself and the United States Air Force.

The President of the United States of America, authorized by Act of Congress, July 9, 1918, takes pleasure in presenting a Bronze Oak Leaf Cluster in lieu of a Second Award of the Air Force Distinguished Service Medal to Lieutenant General Paul Kendall Carlton, Jr., United States Air Force, for exceptionally meritorious and distinguished service in a position of great responsibility to the Government of the United States. General Carlton distinguished himself as Surgeon General, United States Air Force, from 1 December 1999 to 30 November 2002. During this period, General Carlton’s outstanding achievements and his dynamic leadership led to the re-definement of the Air Force Medical Service through a tripartite medical readiness mission, to shape the world medical environment through coalitions, respond to humanitarian and disaster situations, and be prepared to support the war fighting mission of the Air Force. General Carlton’s vision of medical response extended beyond the United States and the Air Force at large. To that end, General Carlton has been the driving force behind many initiatives. The creation of the International Health Specialist career field brings together cultural, language, and medical expertise, providing regional commanders with a unique diplomatic asset. In this capacity, medics assume a non-threatening role as the tip of the spear–the first engagers–for opening dialogue with other nations. The medical service must also have the ability to respond quickly to disaster situations, natural or man-made, anywhere in the world. With General Carlton’s vision and leadership, the medical service has developed the doctrine, concept of operations, and equipment to rapidly deploy as first responders and meet any contingency requirement. Using a targeted, building-block approach, personnel with backpacks or a small portable trailer can be launched within hours. The new construct of medical response faced its first big test during the 11 September 2001 attacks on New York and the Pentagon. A rapid response team was at the Pentagon within three hours providing patient care and supporting first responders. Within twenty-four hours of the attacks, over five hundred personnel with full inpatient capability were on the ground at McGuire Air force Base, New Jersey, standing ready to support New York. The singularly distinctive accomplishments of General Carlton culminate a long and distinguished career in the service of his country and reflect the highest credit upon himself and the United States Air Force.