Author: Joel Schofer, MD, MBA, CPE
Study of Military Health System Shows Medical Liability Immunity Reduces Defensive Medicine, Costs by 5%
This is a pretty interesting blog post about a recent study of…well…US!
Medical Liability Immunity Reduces Defensive Medicine, Costs by 5%
Officer Promotions and the NDAA 19
Physicians are always interested in promotions, and the proposed NDAA 19 makes a number of changes to officer promotions. If you want the scoop, first I’d read this article from Military Times:
Congress is Giving the Officer Promotion System a Massive Overhaul
In addition, here are the relevant changes I pulled out of an article from the DHA Early Bird a few days ago:
- Officers will continue to be considered for promotion as part of the same year group in which they were promoted to their current rank.
- Congress is required to annually authorize the number of officers allowed to serve in the ranks of O4 through O6 across all the services.
- It repeals a requirement that candidates for regular commissions not be older than 42, or at least have enough service years to complete 20 years by age 62.
- It enhances the services’ authority to award constructive service credit for special private sector training or experience to allow active or reserve officer appointments up to the rank of O6 in critically needed fields.
- Authorizing each service to award temporary promotions to the ranks O3 through O6 for specified positions. Only Navy has such authority today so this change would standardize it across all branches.
- Authorizing promotion boards to recommend that “officers of particular merit” be placed higher on promotion lists than peers.
- Allowing officers, when deemed in the best interest of the service, to have their names removed from consideration by a selection board for promotion to the next higher grade, and authorizing officers in certain military specialties to remain on active duty until reaching 40 years active service.
- Authorizing use of an alternative promotion processes for officers in certain secretary designated competitive categories, to include a term based continuation process when certain officers are not selected for promotion. This would selectively end the traditional up or out requirement for officer management.
The devil’s in the details, and the Military Times article states that the changes are not mandatory for the services, so we’ll have to see how it all plays out over the next few years.
Finance Fridays
Here are the articles for this week’s Finance Friday:
Critical Mistakes People are Making with the New Blended Retirement System
My Military Millions Portfolio
Navy Blocks Some GI Bill Transfers Starting Now
Sunday After Action Report (a collection of the best articles that we’ve read this week)
NDAA 2019 Update
On Monday the House and Senate came out of committee having reconciled their two versions of the 2019 National Defense Authorization Act (NDAA 19) into a combined bill that will be voted on. Oh, and if I got any of that wrong so be it. It’s been a while since my last social studies or civics class, but that is basically what happened.
What emerged and is now contained in the NDAA 19? Here are the highlights, which can be found in the FY19 NDAA Conference Summary (Note that I highlighted the parts that were relevant to my readership):
- A 2.6% pay raise, the highest in nine years.
- It makes the Career Intermission Program permanent.
- No medical treatment facilities are allowed to be closed or downgraded until they are all transitioned to the Defense Health Agency.
- Mandates retention of a Navy hospital ship capability.
Whether you knew it or not, prior to this committee work there were provisions that would have:
- Disestablished BUMED (and the equivalent Army and Air Force medical commands).
- Changed service obligations for training, requiring them to be served consecutively rather than concurrently.
These things were removed and are not in the unified version that emerged from committee. That’s probably a good thing since the last one probably would not have improved morale, accession, or retention (other than forced retention).
If you’re really interested, here are some other very long PDFs that tell you everything that was debated and the result:
Joint Explanatory Statement (651 pages long)
Conference Report to Accompany H.R. 5515 (2552 pages long)
Searching for “medicine” or “medical” will probably get you to the most relevant medical portions. There are also some significant changes to promotions that I have not had the time to deep dive on. You can find them by searching for “promotion.”
MOAA Post – Big Changes to Post 9/11 G.I. Bill: What You Need To Know
You can read the full post here:
Big Changes to Post 9/11 G.I. Bill: What You Need To Know
The quick summary is:
- Effective July 12, 2019, service members desiring to transfer their Post 9/11 GI Bill benefit to a spouse or children will need to do so no later than their 16th year of service.
- Effective immediately, any sailors and naval officers who can’t serve four additional years is ineligible to transfer the benefit. This affects Navy personnel ineligible due to their time in grade as well as those with an impending medical retirement.
- Regardless of where you are in your career, if you are considering transferring the benefit to one or more of your dependents, it’s best to do so now, before the new rule takes effect.
Finance Friday
Here are the personal finance articles from the past week:
After Action Report (a collection of our favorite personal finance articles from the previous week)
Extrinsic vs Intrinsic Motivation
Major Changes to the GI Bill and Tuition Assistance
The Cell Phone Price War for Military Customers
In addition to the articles from Military Millions above, this a great series of articles for physicians from Physician on FIRE:
Investing Basics for Physicians With Little Time or Experience, Part I
Investing Basics for Physicians With Little Time or Experience, Part II
Global Health Engagement Teleconference: The Building of an Enterprise – A Health Security Cooperation Framework to Support Regional Security and Stability
Here’s a Navy Medicine Global Health Engagement (GHE) event that you can attend in person at the Defense Health Agency (DHA) or dial in to:
In-person location: DHA Pavilion, Salon C
When: 7/17/2018, 12:00 to 1:00 EST
Remote Attendees: Please dial 800-988-9572, Pass Code: 3667141
Uniform Update and New Hairstyles for Women
WASHINGTON (NNS) — The Navy announced the expansion of hair styles for women along with several other uniform policy changes and updates in NAVADMIN 163/18, July 11.
Among the several hair style changes is the authorization for women to wear locks. The NAVADMIN provides specific and detailed regulation on how locks can be worn.
Women are also authorized to wear their hair in a single braid, French braid, or single ponytail in service, working and physical training uniforms. The ponytail may extend up to three inches below the bottom edge of the of the shirt, jacket or coat collar. The accessory holding the ponytail must not be visible when facing forward, and be consistent with the color of the hair. The hair cannot be worn below the bottom of the uniform collar where there are hazards such as rotating gear.
Women may now wear a hair bun that does not exceed or extend beyond the width of the back of the head.
Other uniform changes include the approval of the Navy Optional Physical Training Uniform (OPTU) that consists of a navy blue high performance shirt and five-inch running shorts. The uniform is expected to be available at Navy Exchange Uniform and Customer Care Centers starting October 2018.
Navy is also developing a standard navy blue Physical Training Uniform (PTU) that will be phased into the seabag issue at Recruit Training Command in the next 12-18 months.
The Black Relax-Fit Jacket (Eisenhower Jacket) has been designated a unisex item and Sailors can wear the men or women’s jacket sizing that best suits their uniform requirements.
To allow for greater visibility female Sailors have the option to wear identification badges on the right side above the pocket of their uniforms.
Wear testing of the improved female officer and chief Service uniform skirts and slacks will be complete this summer. Improvements include a straight line Service skirt, and redesigned khaki and white Service slacks with lower waist and reduced rise (waist to top of the inseam). These items are expected to be available at Navy Exchange Uniform and Customer Care Centers at the end of the year.
An improved Black Leather Safety Boot (I-Boot 4) for optional wear with all Navy working uniforms and coveralls will be for sale at designated fleet concentration locations beginning this October. The boots were selected based on Sailor feedback and the 2017 Navy Boot Study.
New uniform policies are the result of fleet feedback and the ongoing efforts to improve Navy uniforms, uniform policies and Sailor appearance.
The Navy Uniform mobile app will be updated in late July. The update will include all of Navy Uniform regulation illustrations, policies and NAVADMINs. The expanded uniform app’s goal is to provide one-stop uniform policy access and ability to submit uniform questions links to Navy Exchange on-line uniform sales via the app.
For complete on these uniform policy, details, guidance, and where to direct questions see NAVADMIN 163/18 at http://www.npc.navy.mil.
For more information, visit www.navy.mil, www.facebook.com/usnavy, or www.twitter.com/usnavy.
For more news from Chief of Naval Personnel, visit www.navy.mil/local/cnp/.
FY19 Medical Corps O5 Promotion Stats
| FY19 MEDICAL CORPS COMMANDER SELECTION BY SUBSPECIALTY | |||||||||
| SELECTION OPPORTUNITY 85 % | |||||||||
| # IZ | #SEL IZ | % SELECT IZ | # AZ | #SEL AZ | % SELECT AZ | # BZ | #SEL BZ | % SEL BZ | |
| FLT SRG | 2 | 0 | 0.00% | 4 | 0 | 0.00% | 11 | 0 | 0.00% |
| RAM | 3 | 1 | 33.33% | 9 | 1 | 11.11% | 5 | 0 | 0.00% |
| ANESTH | 12 | 6 | 50.00% | 9 | 5 | 55.56% | 23 | 1 | 4.35% |
| SURG | 20 | 11 | 55.00% | 15 | 7 | 46.67% | 34 | 0 | 0.00% |
| NEURO SURG | 6 | 1 | 16.67% | 1 | 1 | 100.00% | 5 | 0 | 0.00% |
| OB GYN | 8 | 4 | 50.00% | 10 | 6 | 60.00% | 11 | 0 | 0.00% |
| GMO | 2 | 0 | 0.00% | 2 | 0 | 0.00% | 9 | 0 | 0.00% |
| OPHTH | 3 | 1 | 33.33% | 1 | 1 | 100.00% | 2 | 0 | 0.00% |
| ORTHO | 13 | 8 | 61.54% | 5 | 2 | 40.00% | 26 | 0 | 0.00% |
| OTO | 6 | 5 | 83.33% | 4 | 3 | 75.00% | 6 | 0 | 0.00% |
| URO | 2 | 2 | 100.00% | 1 | 0 | 0.00% | 8 | 0 | 0.00% |
| PREV MED | 2 | 2 | 100.00% | 7 | 2 | 28.57% | 2 | 0 | 0.00% |
| OCC MED | 3 | 1 | 33.33% | 4 | 1 | 25.00% | 6 | 0 | 0.00% |
| PHYS MED | 2 | 0 | 0.00% | 0 | 0 | N/A | 1 | 0 | 0.00% |
| PATH | 3 | 2 | 66.67% | 6 | 2 | 33.33% | 4 | 0 | 0.00% |
| DERM | 5 | 2 | 40.00% | 1 | 1 | 100.00% | 11 | 0 | 0.00% |
| EMERG | 10 | 3 | 30.00% | 9 | 6 | 66.67% | 30 | 0 | 0.00% |
| FAM PRAC | 18 | 5 | 27.78% | 16 | 7 | 43.75% | 51 | 0 | 0.00% |
| INT MED | 17 | 12 | 70.59% | 18 | 5 | 27.78% | 36 | 0 | 0.00% |
| NEURO | 0 | 0 | N/A | 0 | 0 | N/A | 6 | 0 | 0.00% |
| UMO | 1 | 1 | 100.00% | 3 | 1 | 33.33% | 5 | 0 | 0.00% |
| PEDS | 10 | 7 | 70.00% | 6 | 2 | 33.33% | 16 | 0 | 0.00% |
| NUC MED | 0 | 0 | N/A | 0 | 0 | N/A | 0 | 0 | #DIV/0! |
| PSYCH | 9 | 7 | 77.78% | 4 | 1 | 25.00% | 19 | 0 | 0.00% |
| DIAG RAD | 15 | 8 | 53.33% | 12 | 1 | 8.33% | 21 | 0 | 0.00% |
| RAD ONC | 1 | 1 | 100.00% | 2 | 1 | 50.00% | 3 | 0 | 0.00% |
| TOTAL | 173 | 90 | 52.02% | 149 | 56 | 37.58% | 351 | 1 | 0.28% |
| FY19 MC CDR SELECTIONS BY ZONE | |||||||||
| # OF PEOPLE | # SELECTED | % SELECTED | |||||||
| ABOVE ZONE | 149 | 56 | 37.58% | ||||||
| IN ZONE | 173 | 90 | 52.02% | ||||||
| BELOW ZONE | 351 | 1 | 0.28% | ||||||