Author: Joel Schofer, MD, MBA, CPE
Specialty Leader vs Detailer – What’s the Difference?
Many Medical Corps officers don’t understand the difference between their Specialty Leader and their Detailer. After you read this post, this won’t be a problem.
DIFFERENCE #1 – WHO THEY WORK FOR
A Specialty Leader works for Navy Medicine (BUMED), the Surgeon General, and the Medical Corps Chief while a Detailer works for Navy Personnel Command (NPC or PERS). NPC/PERS is a line command, while BUMED is obviously medical. This difference is probably not of significance to the average Naval physician, but it can make a difference at times because these two commands (and people) will look at things from a different perspective.
For example, lets say you are one of two subspecialists at NH Camp Lejeune and you have a fairly light clinical load. You decide you want to leave early to get to your next command, Naval Medical Center Portsmouth (NMCP), because they are actually down one provider in your specialty due to the illness of another member of your community. Your Specialty Leader will probably endorse this early move because it makes sense. You are underemployed at Lejeune and there is a need at NMCP.
Your Detailer, however, will look at it differently. First, you haven’t served your full tour, so moving you early will require a waiver that may be denied by PERS. This largely has to do with money and PCS rules and has nothing to do with your specialty or the needs of the Navy. I’m not saying that Detailers don’t care about the needs of the Navy because they do, but they are constrained by the rules of PERS while a Specialty Leader is not.
DIFFERENCE #2 – WHAT THEY DO
A Specialty Leader serves as a liaison between you, BUMED, and your specialty as a whole. He or she also coordinates deployments, although the control they have over this was lessened by the return to platform-based deployments (deployments determined by what billet you are in or what unit/platform you are assigned to rather than whose turn it is to deploy). They also serve as a consultant both to you and your Detailer when it comes to career management and PCS moves.
A Detailer is your advocate to help you advance in your career, prepare for promotion boards by improving your officer service record, and negotiate orders for your next PCS. They will often speak with both you and your Specialty Leader while trying to balance your needs with the needs of the Navy. They also are the final approval authority for extension requests and actually write your PCS orders.
DIFFERENCE #3 – WHAT THEY DON’T DO
Specialty Leaders do not write orders. Many physicians think that the Specialty Leader is the one who decides what orders they get and where they PCS, but the reality is that Specialty Leaders can’t write orders. Only Detailers can, therefore it is the Detailer who makes the final decision in nearly all cases. If there is a good Specialty Leader-Detailer relationship, most of the time both are in agreement and there is no controversy, but about 5% of the time there is at least some level of disagreement that has to be worked out.
Detailers can write your orders to a command, but they do not influence who gets command-level leadership positions. For example, you may want to go to Jacksonville to be the Department Head of your specialty’s department. A Detailer can write you orders to Jacksonville, but which physician the command picks to be Department Head is up to them, not the Detailer (or the Specialty Leader).
Specialty Leaders will often talk to commands, but Detailers usually do not. The Detailer is SUPPOSED to talk to three people – you, the Specialty Leaders, and the Placement Officers. The Placement Officers are officers at PERS who represent the commands. You can think of them as the detailers for commands. They make sure that commands aren’t taking gapped billets, that the providers sent to the command meet the requirements of the billet they are entering, and weigh in on other issues like extension requests.
I say that a Detailer is SUPPOSED to talk to three people and USUALLY does not talk to commands, but the reality is that commands frequently call the Detailer instead of talking to their Placement Officers. This often happens because the Director at a command knows the Detailer but doesn’t know the Placement Officer. In addition, the Detailer is usually a physician (3 of 4 Medical Corps Detailers are physicians, the 4th is a MSC officer) and the Placement Officer is always a MSC officer. Physicians like talking to other physicians.
Finally, Specialty Leaders do not alter your officer service record. In fact, unless you send it to them, they can’t even see it or your FITREPs. Detailers, on the other hand, can see just about everything and can update/change some things, mostly additional qualification designators or AQDs.
WHY SHOULD I CARE ABOUT ANY OF THIS?
Because you must actively manage your career to get what you want. This means you should talk with both your Specialty Leader and Detailer 9-18 months ahead of your projected rotation date (PRD). You should discuss your short and long-term goals, whether you want to PCS or extend, whether you are planning a Naval career or want to resign or retire, your family situation, and your medical situation if applicable.
Most importantly, though, is to be honest with both your Detailer and Specialty Leader. Most Specialty Leaders get along well with the Detailer, so if there is any disagreement between the three of you make sure that you keep things professional and respectful at all times. It’s a small Navy and, to be honest, it will be readily apparent if you are playing one off against the other.
O6 Billet Available – Navy Reserve Forces Command Force Surgeon
This is a call for nominations for the position of FORCE SURGEON COMNAVRESFOR (US), which is an excellent opportunity in the Norfolk area!
You must be a CAPT at time of fill in Summer 2016. You also need to be at your projected rotation date (PRD) in Summer 2016, but PERS will consider people who are CONUS with at least 2 years on station. (A command endorsement of your early rotation with a potential gap will be required.)
Contact your Detailer if you are interested. The application deadline is 20 NOV 2015.
Who’s On Your List?
In my opinion, every Naval physician needs to have a list of people. On this list are the people who you absolutely, positively will not mess with. When you talk to them, you show them the utmost respect. When they ask you for something, you give it to them better and faster than you ever give anyone anything. These are the people who have determined your career path to this point and are likely to continue to steer if for the near future.
Who’s on your list? If you don’t know, you should think about this as soon as you can. You might think it is silly, but I’d actually make a list. Just to show you I’m serious, I’ll share my list:
- Current Emergency Medicine (EM) Specialty Leader
- Prior Deputy Commander of NMC Portsmouth
- Prior EM Specialty Leader
- Current Director of Medical Services at NMC San Diego
- Prior EM Specialty Leader and Deputy Medical Corps Chief
Why are they on my list? They are Emergency Physicians like me, and they are the most senior and potentially influential people in my career. They are the people who are senior to me, well thought of in my specialty, and get phone calls or in person inquiries when I apply for a leadership position. For example, one of the people on this list thought of me when the Detailer job became available and endorsed me for it.
Who’s not on my list? There are no admirals on my list. As a CDR, it is rare that I’m on the radar of an admiral. Some of them know who I am, and some of them could have a major impact on my career path, but it is unlikely that they’ll take a huge interest in my career until I’m a CAPT and qualify for major leadership positions working directly for them. If an admiral wants to know about Joel Schofer, they’ll probably call one of the CAPTs on my list and ask them about me.
Who should be on your list? The people you should consider putting on your list include:
- Your Specialty Leader and prior Specialty Leader
- Your Detailer
- Influential people in your specialty who are 1-2 ranks senior to you
- Whoever is currently in the job(s) you want
Undoubtedly there are other people you should consider, but this list is a good start.
Once you create the list, here are the things you need to keep in mind. Always treat these people with the utmost of respect. You should always treat everyone with respect, but these people get special attention. Never get into an argument with them. I’m not saying you have be a “yes man” (or woman) and agree with everything that they say, but any disagreement needs to be collegial and respectful. You want to prevent them from getting mad at you, if at all possible. When they ask you for something or they give you a task, it immediately rises to the top of your to-do list. In addition, you never give them anything but your best, maximal effort.
The Navy is a large organization that can appear impersonal, but people run it. The people on your list are the ones who are going to determine your future and whether you get want you want or not. If I were you, this is one list I’d put some thought into and actually make.
Multiple National Capital Region Program Director Positions Open for 2016
The following National Capital Region program director positions will be opening in spring/summer 2016 in Bethesda:
1. Occupational Medicine Residency
2. Pathology Residency
3. Pediatric Infectious Diseases Fellowship
4. Pain Medicine Fellowship
5. Physical Medicine and Rehabilitation Residency
6. Body Imaging Fellowship
Contact your Detailer if you are interested in applying.
Updated Officer Record Management & Useful Links Page
There are two upgrades to the site:
- Navy Personnel Command has released an updated version of their Officer Record Management document, which can be found on the Joel Schofer’s Promo Prep page as well.
- I’ve created a Useful Links page. Probably the most useful site on the list is the PERS-4415 (Medical Assignments/Detailing) page. It is packed with useful information and you should check it out.
If there are other additions to the site that you’d like me to make, please use the Contact Me tab and let me know.
Senior Defense Health Agency Position Available
If you’re interested, contact your Detailer ASAP:
DHA, Chief of the Clinical Service Section
0-6 or 0-6 (SEL), Report in Mid-MARCH 2016
One of three section chiefs in the Immunization Healthcare Branch.
The role of Clinical Services Section is to anticipate, assess, and mitigate existing and emerging vaccine preventable disease by:
–Providing expert clinical consultation and case management 24 hours/day, 365 days a year
–Providing comprehensive healthcare clinical support and patient advocacy
–Supporting management of pandemic emergencies
–Delivering best quality immunization healthcare information, educational resources, and training services on-line and on-site
–Monitoring and evaluating the safety of vaccines
–Contributing to the body of knowledge in immunization healthcare through public health investigations, surveillance, and clinical studies
Responsible for leading and managing the 37 Civil Service employees in grades GS-11 to GP-15 assigned to the Clinical Operations Office and the Education and Training Office. My staff works in seven locations scattered
across the United States.
Preferred speciality in Aerospace Medicine/Occupational Medicine/Preventive Medicine.
The focus of what we do in the Immunization Healthcare Branch is population health, not direct patient care.
How to Manage Your PRD and Not Get Stuck with a Hotfill
(This is a re-post of one of my first blog posts. Since it was back in the beginning when the blog didn’t get much traffic, I wanted to repost it because I think it is one of the most important posts on the site:)
There are many important dates in your Navy career. One of the most important and neglected dates, though, is your projected rotation date or PRD. Your PRD is the month and year that your current orders will expire and you are scheduled to rotate to a new command. If you don’t manage your PRD and pay close attention to it, you can find yourself with few career options and in a situation you never thought you’d be in. With that in mind, here are my tips for managing your PRD.
First, know when it is because many physicians don’t know their PRD. If you are in this crowd, the easiest way to find your PRD is to login to BUPERS On-Line and look at block 14 of your Officer Data Card:
The other way to find your PRD is to contact your detailer because they can look it up in the detailing system. Many physicians don’t know their detailer, so here is a link to a page with “Contact Us” in the middle. That link will take you to your detailer’s contact info, but note that it is CAC protected:
http://www.npc.navy.mil/bupers-npc/officer/Detailing/rlstaffcorps/medical/Pages/default.aspx
Once you know your PRD, the easiest way to manage it is with whatever calendar you use (an app, web calendar like Google Calendar, Outlook, a date book, etc.). Place reminders in your calendar to correspond with these time frames:
13-18 MONTHS BEFORE YOUR PRD – This is when you should start thinking about your next career move. Although the normal time period to request an extension (find a template here) at your current command is 9-12 months before your PRD, many physicians request an extension during this time period if they are sure they want to extend. This is also a great time to talk to the operational detailer about operational billets you might have interest in or the senior detailer about what I’ll call “alternative billets” like those at DHA/BUMED, BUPERS, global health engagement billets, NAVMEDWEST, NAVMEDEAST, etc. If you act on your PRD in this timeframe, you’ll be well ahead of the game.
9-12 MONTHS BEFORE YOUR PRD – This is the traditional detailing window where you contact your detailer and specialty leader to negotiate your next career move. This is when physicians normally submit an extension request as well as explore potential billets for their next set of orders. The one caveat is that the availability of billets is often contingent on the results of the Graduate Medical Education Selection Board or GMESB. Since these results are not finalized until January, people with summer PRDs will find that they may have to wait beyond this time period to find out what billets are available and get orders.
6-8 MONTHS BEFORE YOUR PRD – This is when the list of billets that are actually available will solidify and most physicians will get orders. If you want to extend at your current command and you haven’t submitted an extension request yet, you should do that ASAP.
1-5 MONTHS BEFORE YOUR PRD – Many physicians will get into this period without orders. If it is because you were waiting on the results of the GMESB, you are probably fine. If you are in this period for another reason, you should get nervous. The truth is that unanticipated things always happen. Commanding Officers don’t endorse extension requests. Unanticipated openings cause a detailer and specialty leader to have a “hotfill” billet. When things like this happen, a detailer goes looking for officers close to their PRD to fill the need. If you are in this window without orders, you are low lying fruit for filling these needs. And just so you know, most of these “hotfills” are not in Rota or San Diego.
AT YOUR PRD OR BEYOND – Physicians let their PRDs pass all the time. Sometimes it is because they submit an extension request that never gets approved because it gets lost somewhere in the process. Other times they don’t know when their PRD is. Realistically, there is often no consequence if your PRD “expires,” although some commands will pick up on this fact and get your attention by threatening to take away your computer access. The biggest threat, though, is the aforementioned “hotfills” that inevitably show up. If your PRD is expired, you are going to rise to the top of the list when the detailer goes looking for people to fill that need. Have fun wherever that “hotfill” is.
THE BOTTOM LINE – Know when your PRD is and manage it according to the above timeline. This will give you the maximum chance of getting what you want and reduce the chance that you are selected for a “hotfill” you don’t want.
3rd Step to Financial Freedom – Debt Management
“Annual income, twenty pounds; annual expenditure, nineteen pounds; result, happiness. Annual income, twenty pounds; annual expenditure, twenty-one pounds; result, misery.” – Wilkins Micawber in David Copperfield
Debt has a bad reputation. It is prevalent, no one wants it, and everyone who has it wants to get rid of it. Everyone wants to be debt free.
There is, however, another way to look at debt. Debt is a financial tool to meet your personal and financial goals. For example, according to the Association of American Medical Colleges the median level of medical student debt was $180,000 in 2014. While we’d all agree that this level of debt is high, when necessary it has allowed most of us to meet our personal goal of becoming a physician.
Dealing with Debt Wisely
Banks and financial institutions see physicians as low-risk and are willing to loan us a lot of money, which can be good or bad. You can probably get a loan to buy a $100,000 luxury car, and while this might be fun, it is probably not wise. The same thing goes for a jumbo mortgage.
Every time you are considering a loan, you should ask yourself if what you are about to purchase is worth it. Will that fancy car or extra large house truly bring you happiness? Or does it just bring a ton of overhead, increased expenses, and four extra rooms you’ll need to buy furniture for.
The book The Millionaire Next Door by Stanley and Danko was a longitudinal study of millionaires. This study showed that most millionaires don’t drive expensive cars. In fact, most drive “normal” cars or buy them used. In addition, most don’t live in large houses in expensive neighborhoods. Their study showed that physicians are notorious for buying these items to live up to society’s expectations. Doctors are supposed to drive luxury cars and live in expensive neighborhoods, right? This is also why they found that physicians under accumulate wealth and have much a lower net worth than their income would predict.
Do yourself a favor and buy a smaller house, drive a less expensive car, and avoid a boat. You don’t want to own the boat, you want to be best friends with the owner of the boat. Skip the vacation home. You can probably rent an equivalent home for much less than it would cost to buy it, and in 2013 the Nobel Prize in Economics was given to Robert J. Shiller, who showed that housing prices barely outpace inflation over the long haul, making real estate a less attractive investment.
While the ultimate goal is to get to the point where you can pay cash for cars and other major purchases, you will likely take out loans for some period of time when a major need arises. Here are some financial rules of thumb to keep you from getting in debt beyond what you can handle:
- Monthly debt payments (excluding your mortgage) should be <20% of your monthly income.
- Your housing costs should be <30% of your income.
No matter what debt you accumulate, make sure you always make your payments on time. The #1 factor that goes into calculating your credit score is your ability to make timely payments on your debt, and your credit score will determine the interest rate you are charged on nearly every loan you ever take. One late $50 payment could cost you thousands of dollars on a mortgage, for example.
Credit Cards
“Keeping a balance on your credit card is about the worst financial move you can make.” – Burton G. Malkiel, Chair of Economics, Princeton University, Author of A Random Walk Down Wall Street
The quote above says it all. If you are going to use a credit card for the convenience, always pay off the entire balance every month because the interest rates they charge can be very high. If you can’t control your credit card debt, cut them up, cancel them, or only have one that you use in special circumstances. If you have to keep credit card debt, make sure you ask your credit card company to lower the rate or transfer the debt to a low rate card. Check credit.com, cardtrak.com, or lowcards.com for a list of low rate cards.
Good Debt?
In addition to helping you achieve financial goals that are important to you, debt can be used to limit the amount of your own investments that must be in cash equivalents. Having easy access to credit can provide a nice backstop in case of a sudden need for cash.
If you have equity in your home, a home equity line of credit can serve this purpose. Their interest rates are usually low and the interest is often tax deductible, further lowering the cost of borrowing. Home equity lines of credit (and other lines of credit as well) should be set up in advance, not after you or your spouse/partner loses their job and you are a credit risk. Beware of fees your lender may charge and see if you can find one that will waive them for a slightly higher interest rate. A slightly higher interest rate isn’t that big of a deal as you hope to never use this line of credit anyway.
Student Loans
Despite the HPSP program and USUHS, many readers will have significant student loans. Since I never had student loans, I will admit that this is a weak area in my financial knowledge. By far the best source for information on student loans, paying them off, getting them forgiven, and refinancing them is The White Coat Investor. I would STRONGLY ENCOURAGE anyone, especially those with student loans, to check out this resource. It is unparalleled and the most useful financial site for physicians on the web.
Probably the most important step that residents can take to pay off their student loans is to avoid jumping straight into the “doctor lifestyle” as soon as they graduate residency. If you continue to live like a resident until your student loans are paid off, it shouldn’t take more than a few years to get rid of them, after which you can splurge a little and enjoy your income free of student loans. This is easy to type and hard to do, but just a few years of “roughing it” can wipe out your student loans.
Paying Off Debt
When you pay off debt, you are earning an after-tax return equivalent to the interest rate you are being charged. For example, if you pay off credit card debt with an 18% interest rate, this is the equivalent of earning a guaranteed 18% return on your investment tax-free. With the long-term rate of return for the stock market averaging just under 10%, you can see that paying off high-rate debt is often a better move than investing in the stock market. In other words, it makes no sense to pay the minimum on high-interest debt like credit cards while investing in the stock market. Pay off your high interest debt first.
The one exception to this is if you get an employer match on your retirement account contributions. If you get a 50% match, that is an immediate 50% return on your investment, so contribute to your retirement account up to the maximum that your employer matches, then pay off high interest debt. Unfortunately, military physicians don’t get any match right now.
If you have multiple loans, pay off the one with the highest interest rate first. In addition, see if you can stretch out the payments for your low interest loans over a longer period of time, lowering your monthly payments and freeing up cash to pay off your higher interest debts faster. For example, if you have credit card debt with a 14% interest rate, a car loan with an 8% rate, and a mortgage with a 5% rate, pay off the credit card first, then the car loan, and then the mortgage.
Keep in mind that it often doesn’t make sense to pay off debt when the interest rate is lower than the after-tax rate you could earn on an investment. If you want a number, I would pay off high-interest debt (rates greater than 6-8%) such as credit cards, car loans, and private educational loans. If the rate is less than 6%, as with most mortgages nowadays, it probably makes more sense to invest the money in mutual funds and pay off the debt as slowly as possible.
Another move to consider is to take out a home equity loan to pay off high interest debt. You get a lump sum with a fixed interest rate that is often lower than your current debt and pay it off over 5-15 years. In most cases the interest you pay is tax deductible. Keep in mind that you could lose your house if you default on this type of loan, and beware of any up front fees that you need to factor into your calculations.
Conclusion
Don’t wait until a crisis hits (divorce, job loss, disability, or a lawsuit) to get your debt in order. If you have major problems with debt and need help, seek a fee-only financial planner with experience with high-income individuals who can help you restructure and manage your debt.
Senior O6 Positions in DC Area Available
Here are 2 senior (O6 or O6 select) positions available. If you are interested, contact your Detailer:
- Deputy M2 – M2 Deputy Position Description
- Chief of the Clinical Service Section, Immunization Healthcare Branch, Defense Health Agency
One of three section chiefs in the Immunization Healthcare Branch.
The role of Clinical Services Section is to anticipate, assess, and mitigate existing and emerging vaccine preventable disease by:
–Providing expert clinical consultation and case management 24 hours/day, 365 days a year
–Providing comprehensive healthcare clinical support and patient advocacy
–Supporting management of pandemic emergencies
–Delivering best quality immunization healthcare information, educational resources, and training services on-line and on-site
–Monitoring and evaluating the safety of vaccines
–Contributing to the body of knowledge in immunization healthcare through public health investigations, surveillance, and clinical studies
Responsible for leading and managing the 37 Civil Service employees in grades GS-11 to GP-15 assigned to the Clinical Operations Office and the Education and Training Office. The staff works in seven locations scattered across the United States.
Preferred speciality in Aerospace Medicine/Occupational Medicine/Preventive Medicine. The focus of what we do in the Immunization Healthcare Branch is population health, not direct patient care.
FY16 Medical Corps Special Pay Guidance Released
Here is the FY16 Medical Corps Special Pay Guidance:
FY16 MC-DC Special Pay Implementation Guidance
Here is the website where you can get further information:
http://www.med.navy.mil/bumed/Special_Pay/Pages/default.aspx
And here is my video podcast explaining all the various special pays:
Joel Schofer's Career Planning Blog 