Author: Joel Schofer, MD, MBA, CPE
Summary of Specialty Leader Business Meeting
Here is a brief summary of last week’s Specialty Leader Business Meeting that is always held in conjunction with the Graduate Medical Education Selection Board:
- Current interim Chief Medical Officers (CMOs) need to formally apply to the next screening board in summer 2017. I would STRONGLY encourage other people to apply as well because it is a screened/appointed leadership position that allows you to remain clinically active and that I also think will lead to promotion to O6 if done successfully.
- Announcements for nominative positions often come out with very little time until the nominations are due. They all require your CV, BIO, Letter of Intent (LOI), Officer Summary Record (OSR), and Performance Summary Record (PSR). It is best if you have these ready to go due to the often short timeline. I will tell you that I update my CV and military biography monthly and have multiple LOI templates at the ready at all times, so I practice what I preach. Your OSR/PSR can downloaded from BUPERS On-Line anytime, so that requires no prep (assuming BOL is working).
- Current overall Medical Corps manning is 103.4%. This is of no real use to you but is simply an interesting fact/statistic. It does, perhaps, limit our promotion opportunity a lit bit, but…
- The Medical Corps promotion opportunities for FY18 are expected to be higher than they have been in recent years. You never know the actual percentage until the board has concluded, but this is certainly good news.
- As of now, there is no change in the conference approval process. Sorry.
- The Career Intermission Program (CIP) has been extended until 2019. This program allows you to take up to 3 years off from the Navy to do something else, hit the pause button on progression toward promotion, and then return afterward. You have a 2:1 additional commitment for any time off. In other words, if you take 2 years off you’ll owe 4 years when you return. Some people have tried to use the CIP to do fellowships on their own, but that is not the intent of the program and requests for CIP to do a fellowship will be closely scrutinized by BUMED before approval. Info on the program can be found here or you can contact your Detailer.
- There is no special pays update. They are still awaiting the NAVADMIN. The latest can always be found here:
http://www.med.navy.mil/bumed/Special_Pay/Pages/default.aspx
Deployments and Dwell Time
According to the policy that controls these things, dwell time is “the period of time a unit or individual is not on an operational deployment.” This policy also states that the target deployment-to-dwell ratio is 1:2 or greater. Here is an example to illustrate how this works:
- You deploy for 7 months.
- You minimum dwell time (or time at home until you get deployed again) is 14 months.
The policy spells out all sorts of ways you can request a waiver of this policy and certain other circumstances you may want to check out, but if you are in a specialty that deploys alot (like me) it is good to know that a 1:2 deployment-to-dwell ratio is the current target.
How to Get Specialty Consults/Assistance While Deployed
It is always good to know how to get help when you are deployed. During one of my deployments, I had a patient develop Mollaret’s meningitis, which I had never heard of, and using resources like those below I was able to get advice and provide the best care I could in a resource-limited environment. If you are going to deploy, make sure you are aware of these services that will allow you to get some help:
HEALTH EXPERTS ON-LINE PORTAL (HELP)
This system will allow you to get specialty consults and turn the consult into a patient movement request.
Background: Health Experts onLine Portal (HELP) is a web-based, HIPAA-compliant, secure, asynchronous, teleconsultation system started up by Naval Medical Center Portsmouth (NMCP) in June 2014. Naval Medical Center Portsmouth serves as the DoD’s tertiary medical care facility for Navy Medicine East Military Treatment Facilities (MTFs) in the eastern United States, Europe, Middle East, and their regionally associated Fleet and Marine assets. Many of these MTFs have limited or no access to local specialty consultation services. This vast region spans 11 time zones, making real-time synchronous teleconsultation impractical. This unique medical and geographic situation created the need for asynchronous teleconsultation capabilities. Health Experts onLine Portal was built upon the existing, tested, and proven Pacific Asynchronous TeleHealth (PATH) System in use at Tripler Army Medical Center since 2000.
System Description: HELP is a web-based, asynchronous (store-&-forward), HIPAA-compliant platform used for provider-to-provider teleconsultation, patient movement, and case management. The HELP website allows remote providers to submit patient demographics, clinical data, and supplementary multimedia as dictated by the clinical scenario. Consultations are screened by consult managers and forwarded to the appropriate subspecialist or Fleet Liaison for input. All case discussion is done on the web- based platform, with notification of new case activity via HIPAA-compliant e-mail.
Effectiveness/System Impact: HELP is based on the Pacific Asynchronous TeleHealth (PATH) system which first demonstrated improved healthcare access and quality with significant cost savings (Arch Ped Adol Med 2005 & Telemedicine and e-Health 2011). In February 2016, HELP demonstrated improved access and quality of care, while saving over $580,000 within its first year (SAGE Open Medicine 2016). Other associated benefits include HIPAA-compliance, proper documentation in the patient’s electronic health record, workload credit for specialty consultants, reduced testing, improved patient movement request coordination, and provision of continuing education to remote healthcare providers. In mid-2016, HELP brought providers and liason assets from Landstuhl Regional Medical Center and Walter Reed National Military Medical Center on board.
Patient Movement Functionality: Patient movement function was activated in February 2015 to allow outside MTFs and the Fleet improved visibility on their patients transferred to NMCP. It allows requests for information in a secure and HIPAA-compliant format, continuous situational awareness for consults, appointments, and patient arrival at NMCP. For more information on the patient movement functionality, please contact the NMCP Fleet Liaison office.
E-MAIL TELECONSULTATION SERVICE
This system is purely e-mail based, not HIPAA compliant, and cannot be turned into a patient movement request. That said, it is still available and will allow you to get a specialty consult so I wanted to make sure the information/service was available. The e-mail addresses and procedures to get a consult are all in this Powerpoint:
Navy Surgeon General Announces New Strategic Priorities
FALLS CHURCH, Va. (NNS) — The U.S. Navy’s top doctor announced new strategic priorities for Navy Medicine, Nov. 15.
Vice Adm. Forrest Faison, Navy surgeon general and chief, Bureau of Medicine and Surgery (BUMED), presented the new mission, vision, principles and priorities for Navy Medicine, with rapid change being the driving force.
“The world in which we operate is constantly changing,” said Faison. “Our success depends on how well we adapt to those changes and continue to honor the trust placed in our hands every day to care for America’s sons and daughters.”
The Navy Medicine mission is keeping the Navy and Marine Corps family ready, healthy and on the job.
“My vision for the Navy and Marine Corps family is to have the best readiness and health in the world and that we provide the best care our nation can offer, whenever and wherever needed,” Faison said.
Faison’s strategy introduces new principles to guide Navy Medicine personnel as they work to accomplish the new mission and vision.
“Each principle requires active engagement of everyone in Navy Medicine, from the most junior Corpsmen, to our most senior flag officers,” said Faison.
The strategy commits Navy Medicine to the following principles: honor the trust to care for America’s sons and daughters, honor the uniform we wear and honor the privilege of leadership.
“The tradition of caring, compassion, hope and resolve is a Navy Medicine hallmark that our team will continue to carry on,” said Faison. Readiness, health and partnerships are the new Navy Medicine priorities.
“These three pillars are the foundation to the changes to come within the enterprise,” Faison said.
Readiness: We save lives wherever our forces operate – at and from the sea. The skills and capabilities of our medical teams are vital to operation. Navy Medicine will ensure that its people are trained and prepared to save lives at sea, above the sea, below the sea and ashore.
Health: We will provide the best care our nation can offer to Sailors, Marines, and their families to keep them healthy, ready and on the job. Convenience, experience of care and technology drive the health care decisions of many patients today. Navy Medicine’s main focus is on providing patients with the best possible care and in ways acceptable to them.
Partnerships: We will expand and strengthen our partnerships to maximize readiness and health. Collaboration is critical in meeting the needs of the patient. Navy Medicine will strengthen its partnerships through incorporation of research, principles and practices of its operational colleagues.
“American families across the globe trust us with the health and well-being of their loved ones. This strategy is our guide as we chart the course ahead to better serve our Navy and Marine Corps team,” said Faison.
Navy Medicine is a global health care network of 63,000 personnel that provide health care support to the U.S. Navy, Marine Corps, their families and veterans in high operational tempo environments, at expeditionary medical facilities, medical treatment facilities, hospitals, clinics, hospital ships and research units around the world.
For more news from Navy Medicine, visit www.navy.mil/local/mednews/.
Deployment Gear Lists
The gear you need for a deployment will obviously depend on the type of deployment, but every time I deploy I take a look at the gear lists I have to see what I might need to bring that I’m forgetting. Some of the gear lists and deployment checklists I have are old and I don’t even know who created them, but I wanted to post them so people could use them if they so desired. Here they are:
CDR Temerlin’s Gear Organization
Recommended Blackhawk Stomp II Load
Thanks to Steve Temerlin and whoever else created these, and if you have any gear/deployment lists you’d like to share just use the Contact Me tab and you’ll then be able to send them to me over e-mail once I reply.
Types of Deployments
This post will help you learn all that you can about deployments. Personally, I’ve done three deployments, one as a GMO during the initial invasion of Iraq, and two after residency. In 2010 I deployed with the 15th Marine Expeditionary Unit or MEU and earlier this year I deployed to GTMO. In addition, as both a Detailer and Emergency Medicine Specialty Leader I’ve deployed a number of physicians, so I’m pretty familiar with all the details of the current deployment situation.
In the current operational environment, there are a few types of deployments. They include platform-based deployments, individual augmentee or IA deployments, global support agreement or GSA deployments, and what I’ll call parent unit deployments.
Let’s deal with the last one first because it is the easiest to explain. For what I’ll call a parent unit deployment, you deploy when your parent unit deploys. For example, if you are assigned to the Marine Corps with a MEU, when that MEU deploys so do you. You go with the unit you are primarily assigned to. The same could be said for a medical battalion, a Preventive Medicine Unit, and many other units.
A platform-based deployment happens to people who are stationed at military treatment facilities or MTFs. Some people who are primarily stationed at MTFs are assigned to what is called a “platform.” A platform is an operational unit of some kind. It could be the Mercy or Comfort, a Marine Corps unit, an Expeditionary Medical Facility, a fleet hospital, etc. In essence, it is an operational unit who “owns” you if they get activated or deployed. In other words, if your platform is a medical battalion and that medical battalion gets deployed, you would go with them because it is your platform. If they don’t get deployed, you may never have to do anything for or with your platform. On the other hand, if your platform regularly drills or does exercises, since it is your platform you may have to participate in these drills and get pulled away from your primary duties at your hospital or MTF.
How is it decided whether you get placed on a platform, and if so which one? The main determinant is most likely which billet you get orders into. Some billets at MTFs have secondary assignments to platforms. For example, the billet I am in at NMC Portsmouth is “mobilized to” or “MOB’ed to” an Expeditionary Medical Facility. That is my platform. To be honest, sometimes commands will rearrange platforms, so it is not always determined by the billet you are in. If you want to know if you are on a platform, you will have to go to your command’s Plans, Operations, Medical Intelligence or POMI officer. They are the ones who manage platforms and can tell you if you are on one.
Platform based deployments are the wave of the future in Navy Medicine, and you can expect an increased focus on platforms, platforms training, and deployments as a platform.
An individual augmentee or IA deployment is when a request in placed by an operational unit somewhere for an individual person, you are selected to fill that requirement, and you individually augment that unit. When they deploy, you deploy with them as an IA but stay attached administratively to your parent command. In other words, if you are at NMC Portsmouth but deploy as an IA, you stay attached to NMC Portsmouth the entire time you are deployed. This is the type of deployment most of us have experienced for the majority of our career, but the Navy is trying to get out of the “IA business” and is shifting, as already mentioned, to platforms.
The final type of deployment is a global support assignment or GSA. With this type, you detach from your current command, move or execute a permanent change of station or PCS to a processing center that becomes your new military command, and then you are given orders to deploy. For example, my last deployment was a GSA. I detached from BUPERS, my old command, PCS’ed to my new command, the processing center in Norfolk, and then was given deployment orders to go to my unit in GTMO. During this time my parent command was Expeditionary Combat Readiness Center or ECRC, the processing center, and they were primarily responsible for my fitreps and pay issues.
The unique part of a GSA deployment is that pretty much as soon as you report to the processing center you have to contact your Detailer and Specialty Leader to get orders to your next command. The GSA orders usually only last up to a year, and you’ll need orders so you can PCS to your next command when you get back from the deployment. This is the major downside that people complain about with a GSA…the fact that you get PCS orders and have to leave your old command, which people may not want to do. On the other hand, it can be a major benefit. If you are stationed somewhere you don’t want to be, volunteering for a GSA can get you out of there because you’ll PCS away. In addition, because you are volunteering or accepting a deployment, it may give you some leverage with the Detailer or Specialty Leader. For example, you could say, “I’ll deploy on this GSA, but only if you are willing to write me orders to Hawaii as follow-on orders.” That may not always work, but it is worth a try.
Those are the major types of deployments that currently exist, and here are some additional resources:
IA and GSA Frequently Asked Questions
NAVADMIN 332-10 – IA Manpower Management Business Rules
Call for Nominees for 2017 MHS Female Physician Leadership Course
BLUF: Seeking Navy Medicine nominations for the 2017 MHS Female Leadership Course
NOMINATION DUE DATE: 19 DEC 2016, 0730 EST (e-mail POC details contained in this document)
COURSE DATES: 27-29 MAR 2016 at Defense Health Headquarters (DHHQ) in Falls Church, VA
FUNDING SOURCE: Attendee’s assigned command (BUMED does not fund)
COMPLETE APPLICATION INCLUDES:
- MHS Female Physician Leadership Course Nomination Form
- Attestation Letter
- Nominee’s Personal Statement
- Nominee’s CV
- CO endorsement letter
Point of Contact: POC information is in this document
Navy Medicine,
On behalf of the Navy Medical Corps Chief’s Office and the Council for Female Physician Recruitment and Retention, we are AGAIN excited to offer this opportunity to your rising Navy Physician Female Leaders. The MHS Female Physician Leadership Course is offered to 100 service women across the Military Health System. Please share this information widely.
100 Attendees will be competitively selected from across the Military Health System and there will be 30 seats available to female Navy Medicine physicians. Attendees (and ranked alternates) will be selected by the Medical Corps Chief’s Office. Please review attached nomination form, course details, and attendee criteria. A complete nomination packet is due by the start of business (0730 EST) 19 DEC 2016.
The course is open to all LCDRs (including selects) and CDRs with < 2 years in grade. Residents, civilians, and Reservists are also eligible. Nominees may be self-nominated or nominated by any peer or colleague, however, all will require their Commanding Officer’s endorsement.
This is a leadership development course and simply having the potential for leadership is reason enough to consider nomination. Simply represent your nominee enthusiastically, and let the selection committee make the final decision. Please see nomination form for further guidance.
For nominees unable to attain a CO endorsement, an endorsement letter must be signed by the approval authority for travel/funding.
Director & Chair of Combat Casualty Research Program – O5/O6
Here is the announcement:
Director and Chair of Combat Casualty Research Program Announcement
Rank: O6, with consideration for a senior well-qualified O-5
Documents Required to Apply: CV, military biography, letter of intent, Officer Summary Record (OSR), Performance Summary Record (PSR)
Nomination Process: Contact your Specialty Leader by 21 NOV
Two USUHS Chair Positions Available – Military/Emergency Medicine and Prev Med/Biostatistics
The details are in these documents. Nominations are through Specialty Leaders, so contact your Specialty Leader ASAP if you are interested in either position:
Deputy AFRICOM Surgeon – Senior O6 Position
Not sure how many senior Captains are reading this blog but…
Position: Deputy Command Surgeon for Headquarters US Africa Command, Stuttgart, Germany
Description: Serves as the COCOM Deputy Command Surgeon, responsible for managing and supervising the daily activities of the Command Surgeon’s Office.
Rank: 0-6
Traits: Command experience preferred
Fill date: October 2017
Application contents: Nomination letter from the officer’s career manager highlighting his/her qualifications, a biography, career/officer record brief, five of the most recent evaluation reports, and photo
Application Due Date: 28 November
POC for CV/BIO: Your Detailer
Joel Schofer's Career Planning Blog 