Whelp...

Discussion in 'Academy/Military News' started by USN16x, Jan 12, 2019.

  1. USN16x

    USN16x 5-Year Member

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  2. Devil Doc

    Devil Doc Teufel Doc

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    I doubt it gets to 1700 but with the number of civilians and contractors doing Corpsmen and Medic jobs in MTFs, it’s no wonder some bean counter determined the medical billets could be transferred to big Army, Navy, and AirForce. In the late 80s Navy Medicine played around with associate degree nurses filling warrant officer billets. It didn’t work out so an effort to make Independent Duty Corpsmen warrant officers emerged. The old time E-9 mafia didn’t want to trade starred anchors for a skinny bar so it was shot down. Physician Assistants were transitioning to the Medical Service Corps and the warrant billets were absorbed by Big Navy, thus leaving Navy Corpsmen with no path to warrant officer.

    Hospital Corpsman is the largest rating in the Navy with around 30,000 Sailors in the Hospital Corps, the only enlisted Corps in the USN. Losing 60o or so HMs will probably not be a big deal in the big picture.
     
  3. Jcleppe

    Jcleppe 5-Year Member

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    I think the numbers were 17,000 total and nearly 6000 from the Navy according to the article.
     
  4. USN16x

    USN16x 5-Year Member

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    I don’t understand how cutting staff will lead to better patient outcomes and more experience for providers. Speaking for the Army side of the house a lot of docs, nurses, and other healthcare workers are spooked. If this whole DHA take-over is in the name of “ increasing lethality and readiness” maybe we should work on coverting more MTF’s into level 1 trauma centers since there’s only one in the whole DoD...
     
  5. Devil Doc

    Devil Doc Teufel Doc

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    Yep, my 600 should have been 6000.
     
  6. raimius

    raimius 10-Year Member

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    Doesn't make much sense. It's already hard enough to schedule a visit.

    Well, I guess it does make dollars, just not sense or better care...
     
  7. MabryPsyD

    MabryPsyD Dr. G. 5-Year Member

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    I’m living the cuts right now. It’s not that they’re actively cutting medical personnel; once someone leaves the position, they’re not backfilling that person. It’s part of the DHA takeover.
     
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  8. conrack

    conrack Member

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    Its all about the money, I am a retired Army Reserve Nurse now working as a civilian contractor at Andrews AFB. DOD claims that there is long term savings by having civilians instead of active military mostly due to benefits and retirement pay; also with Tricare more patients are being sent to civilian hospitals because its cheaper in the long run.
     
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  9. DrMom

    DrMom 5-Year Member

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    Good Morning. It has to do with what should be done by someone in uniform that equates to military readiness versus what can be done by a civilian--and paid for/recruited/maintained through non-active duty resources.
    This is part of the reform of the Military Health System sparked by the NDAA 2017. Not to give myself away, but I would like to see the research that describes the impacts to the ready medical force as well as the overall cost and quality impact to healthcare received by service members, their dependents, and our retirees. The assumption that a civilian (GS or Contractor) is a one to one replacement for a uniformed person with the same skill set has not been well studied. Preliminary results recently published demonstrate a difference in practice behaviors and adherence to clinical practice guidelines--for example, with prescriptions of opioids for low back pain.
     
  10. Devil Doc

    Devil Doc Teufel Doc

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  11. UHBlackhawk

    UHBlackhawk Member

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    Man. I have to tread carefully.
    This entire thing is going to be a train wreck, yet very few (to include senior officers), have a clue that it is coming.
    Just as an example, with medical waivers, both of admittance to a SA and for commissioning, a civilian doctor with no military back ground will not have a clue about what is involved in military life.
     
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  12. USN16x

    USN16x 5-Year Member

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    There will be major growing pains for sure. We have town hall meetings every month with new updates. It’s a fun time to be in AMEDD (RIP)
     
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  13. MabryPsyD

    MabryPsyD Dr. G. 5-Year Member

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    Have you been briefed about the “reverse PROFIS” program? Get ready to be assigned to a CSH for life.
     
    Last edited: Mar 5, 2019
  14. Vaquero

    Vaquero Member

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    I've a grandson at the Air Force Academy, just finishing his doolie year, who thinks he wants to attend to medical school. While that's still several years in the future, present grades and performance in chemistry and physics indicate he could do so. After reading this thread and the article referenced by the op, do you all believe that the SAs will continue to send 15 - 20 individuals from each class to medical school and what does this portend for physicians serving in the military?

    Thank you all in advance for any advice and insights.
     
  15. MabryPsyD

    MabryPsyD Dr. G. 5-Year Member

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    With the Medical Commands being dissolved and the DHA take over, there are fewer hospital slots. We still don’t know what the domino effect will be once the dust settles.
     
  16. Devil Doc

    Devil Doc Teufel Doc

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    I linked an article from three retired surgeons general. The article is short, weak, and a poor attempt at voicing an opinion considering the three authors. Military medicine has gotten too reliant on civilian practitioners and ancillary personnel these past two decades. My wife and I receive care at Walter Reed and the number of civilians is equal to or greater than the uniformed personnel. I'm seen in the Internal Medicine clinic where about the only military physicians are the new ones doing their year before going operational. Their preceptors are mostly civilians. There are no Independent Duty Corpsmen doing military sick call. No junior HMs or medics doing check-ins, vitals, or EKGs. It's no surprise congress has picked medical billets to trim from the budget. The medical department has shown that they can get by with healthcare employees who were "bought" at a cheaper price.

    I was once the training program manager for Navy Medicine's operational NECs when that billet was at BUMED. It was a big job. I was a triple digit, MED-531, like the captains and commanders. One day a captain from the SG's office strolled by my office (the office Matthew Maury wrote his letter of resignation to Lincoln from) and said, "Senior Chief, we have been directed to cut the budget by cutting billets. All owners of personnel are required to submit point papers justifying the need for your billets." I was feeling frisky and a bit perturbed at the ridiculous request so I told him to just scrub all IDC billets from the Fleet. He said, "We can't do that. We only have medical officers on 20 percent (?) of the ships." I said, well there you go. No need for me to do a point paper. I never heard from him again.

    One other quick story, same place. Our Force Master Chief who is also the Director of the Hospital Corps and has equal standing as the Director of the Medical Corps, Nurse Corps, etc. apparently got the same memo about cutting billets. He wanted to cut training for cardiovascular techs, NEC 8408. His words were, "Any technician that can be bought to do their job on shore duty will be cut." This included psych techs, derm, and a couple other jobs that had no sea duty billet. The reason cardio tech was a big deal to me was I was in the process of developing training requirements for personnel in the different Marine Corps platforms. The only sea duty billets I found were in the three medical battalions. The BNs never saw them but they were part of the platform and would show up at some point if directed. Nevertheless, I wrote in training requirements for the 8408s and reported to the Force of my actions. He told me to scrub them because the eight or so phantom billets weren't enough to justify the cost. I then told him the MedBatts belonged to the Marines and we couldn't get rid of them. He had never been assigned to the Marines in his almost 30 years and looked at me like I had two heads.

    The personnel numbers game is tricky and at times contentious. It's up to billet owners to protect their territory and hold on to what they have. Dr. G above mentioned DHA taking over military medicine. It will be interesting on many fronts the effect this has on the delivery of healthcare.

    https://www.moaa.org/content/public...paign=TMNsend&utm_content=NC+AFHR+1+ERet+L+NC