Uncategorized

What’s the biggest worry for military medicine in the next few years?

Posted on Updated on

Here’s a link to an article summarizing VADM Bono’s thoughts as she approaches retirement next week:

What’s the biggest worry for military medicine in the next few years?

Force Surgeon, Navy Reserve Forces Command – Norfolk, VA – O6

Posted on

An opportunity for an 0-6 to excel in a key Type Commander (TYCOM) job!

We need a Force Surgeon for COMNAVRESFOR – see this position description. For those outside of the Norfolk area, they would need to eligible to PCS. The ideal report date is late Fall 2019.

All applicants should send the Deputy Corps Chief, CAPT Christopher Quarles (contact info is in the global) an updated CV, BIO, and last 2 fitreps NLT 6 Sept 2019.

Selective Early Retirement Boards NAVADMIN

Posted on Updated on

Joel Schofer’s BLUF Summary

  • The default for this board is to keep physicians in the Navy. This default answer might change if you have a black mark on your record, like receiving NJP, getting a DUI, etc.
  • The following officers may be considered by the SER board:
    • Captains. Captains with 3 or more years time in grade when the SER board convenes.
    • Commanders. Commanders who have failed selection for promotion to the grade of Captain two or more times.
  • If you are in these categories and you don’t want to retire, you should probably make sure your officer record is up-to-date. You can read the Promo Prep to find out how to update your record.
  • The following officers are not eligible for consideration by the SER board:
    • Officers with approved voluntary retirement requests.
    • Officers with statutory retirements in FY-19 or FY-20.
    • Officers whose names are on a list of officers recommended for promotion.

The NAVADMIN is available here and pasted below:

UNCLASSIFIED//

ROUTINE

R 121425Z AUG 19

FM CNO WASHINGTON DC

TO NAVADMIN

INFO CNO WASHINGTON DC

BT
UNCLAS

NAVADMIN 189/19

PASS TO OFFICE CODES:
FM CNO WASHINGTON DC//N1//
INFO CNO WASHINGTON DC//N1//

MSGID/GENADMIN/CNO WASHINGTON DC/N1/AUG//

SUBJ/NOTICE OF CONVENING FY-20 ACTIVE-DUTY NAVY CAPTAIN AND COMMANDER 
SELECTIVE EARLY RETIREMENT BOARDS//

RMKS/1.  The Secretary of the Navy (SECNAV) approved the convening of fiscal 
year (FY) 2020 selective early retirement (SER) boards in order to consider 
captains and commanders in the line and staff corps on the active-duty list 
for early retirement.  The captain SER boards will convene on 20 September 
2019.  The commander SER boards will convene on 11 September 2019.

2.  As in FY-19, the SECNAV is convening the FY-20 SER boards in order to 
ensure the highest quality officer corps in the senior grades of captain and 
commander.  Our growing Navy requires the most consistently reliable top 
performers to lead and sustain a modern, ready and lethal force as the number 
of ships, squadrons and required manpower levels increase.  The Navy is 
committed to retaining and promoting the best leaders to meet the challenges 
of tomorrow, and to enforcing the highest performance standards for Navy 
leaders.  Our junior officers and enlisted Sailors deserve the best senior 
officers to emulate and lead them.  Each SER board will select only those 
officers whose early retirement, in the opinion of a majority of the board 
members, is in the best interest of the Navy.  When determining those 
officers who should be recommended for early retirement, the SER boards will 
consider a number of factors, including performance, the requirement for 
exemplary conduct, and adverse information.  The majority of eligible 
officers whose records will be considered by the SER boards are fully capable 
of performing the duties of their current grade.  Selecting zero officers in 
a competitive category is an acceptable outcome for the SER boards because no 
mandatory quotas are established.  The process of reviewing records and 
selecting officers for early retirement ensures the Navy will have a 
professional, healthy senior officer corps that is ready to meet the demands 
of the Navy the Nation needs.

3.  Captains and commanders whose records were considered by the FY-
19 SER boards may again be considered by the FY-20 SER boards.  In order to 
meet the Navys needs, the Secretary of Defense has authorized the SECNAV to 
waive the statutory limitation in section
638(c) of title 10, U.S. Code, which prohibits a captain or commander from 
being considered by a SER board more than once in a 5 year period.

4.  The following officers may be considered by the SER board:
    a.  Captains.  Captains with 3 or more years time in grade when the SER 
board convenes, and in the year groups and zone for their respective 
competitive category listed in paragraph 6.
    b.  Commanders.  Commanders who have failed selection for promotion to 
the grade of captain two or more times, and in the year groups and zone for 
their respective competitive category listed in paragraph 6.

5.  The following officers are not eligible for consideration by the SER 
board:
    a.  Officers with approved voluntary retirement requests.
    b.  Officers with statutory retirements in FY-19 or FY-20.
    c.  Officers whose names are on a list of officers recommended for 
promotion.

6.  The following list indicates the name, active-duty list (lineal) number 
and date of rank of the senior officer and junior officer eligible for early 
retirement in all competitive categories of the line and staff corps for the 
grades of captain and commander.  Each junior officer eligible, each senior 
officer eligible and all officers whose lineal number falls between the 
senior and junior officers eligible will be considered by the SER board, 
subject to the limitations in paragraph 5.
                               Captain
                                Line
                Unrestricted Line Officer (11XX/13XX)
                       Year Groups 1984-1996
Senior eligible - CAPT A. T. Cowden         010592-00   1 OCT 2005
Junior Eligible - CAPT B. S. Knowles        016246-50   1 SEP 2016
          Special Duty Officer (Human Resources) (120X)
                        Year Groups 1991-1996
Senior eligible - CAPT S. C. Satterwhite    012475-50   1 SEP 2012
Junior eligible  CAPT S. M. Milinkovich     016275-50   1 SEP 2016
    Special Duty Officer (Permanent Military Professor) (123X)
                       Year Groups 1988-1993
Senior eligible - CAPT J. M. Freymann       015362-50   1 SEP 2014
Junior eligible - CAPT E. R. Sanabia        016123-50   1 SEP 2016
                  Engineering Duty Officer (14XX)
                       Year Groups 1991-1996
Senior eligible - CAPT A. R. Walters        012333-50   1 APR 2012
Junior eligible - CAPT P. A. Lashomb        016266-50   1 SEP 2016
             Aerospace Engineering Duty Officer (151X)
                      Year Groups 1991-1996
Senior eligible - CAPT J. K. Lopez          012518-00   1 SEP 2012
Junior eligible - CAPT G. Gorton            016261-50   1 SEP 2016
            Special Duty Officer (Public Affairs) (165X)
                      Year Groups 1989-1995
Senior eligible - CAPT P. S. Kunze          011651-50   1 MAR 2010
Junior eligible - CAPT J. P. Salata         016213-00   1 SEP 2016
            Special Duty Officer (Foreign Area) (17XX)
                      Year Groups 1988-1996
Senior eligible - CAPT B. P. Wang           012531-50   1 OCT 2012
Junior eligible - CAPT R. M. Ursery         016277-00   1 SEP 2016
            Special Duty Officer (Oceanography) (180X)
                      Year Groups 1992-1995
Senior eligible - CAPT M. J. Roth           012658-50   1 SEP 2013
Junior eligible - CAPT W. A. Towle          016146-00   1 SEP 2016
          Special Duty Officer (Cryptologic Warfare) (181X)
                      Year Groups 1991-1995
Senior eligible - CAPT C. W. Bean III       012502-00   1 SEP 2012
Junior eligible - CAPT J. D. Davis          016254-50   1 SEP 2016
       Special Duty Officer (Information Professional) (182X)
                      Year Groups 1986-1996
Senior eligible - CAPT J. L. Cisneros       011725-00   1 JUN 2010
Junior eligible - CAPT N. E. Andrews        016265-50   1 SEP 2016
             Special Duty Officer (Intelligence) (183X)
                      Year Groups 1991-1995
Senior eligible - CAPT C. C. Bone           012458-50   1 SEP 2012
Junior eligible - CAPT C. M. Whittinghill   016176-50   1 SEP 2016
         Special Duty Officer (Cyberwarfare Engineer) (184X)
                         Year Group 1992
Senior eligible - CAPT B. L. Luke           012719-50   1 SEP 2013
Junior eligible - N/A
       Limited Duty Officer (Line) (61XX/62XX/63XX/64XX/68XX)
                      Year Groups 1993-1994
Senior eligible - CAPT M. A. Meskimen       015890-00   1 SEP 2015
Junior eligible - CAPT J. C. Grant          016163-50   1 SEP 2016
                           Staff Corps
                       Medical Corps (21XX)
                      Year Groups 1980-2006
Senior eligible - CAPT J. A. Acosta         010155-00   1 SEP 2002
Junior eligible - CAPT J. S. Yun            016271-00   1 SEP 2016
                        Dental Corps (22XX)
                      Year Groups 1984-1995
Senior eligible - CAPT J. S. Nordin         010881-00   1 JUN 2007
Junior eligible - CAPT H. L. Gnau           016259-00   1 SEP 2016
                   Medical Service Corps (23XX)
                      Year Groups 1987-1997
Senior eligible - CAPT R. P. Onan           011380-50   1 MAR 2009
Junior eligible - CAPT R. V. Folga          016276-50   1 SEP 2016
                Judge Advocate Generals Corps (25XX)
                      Year Groups 1987-1995
Senior eligible - CAPT J. R. Crisfield Jr   011446-50   1 JUN 2009
Junior eligible - CAPT D. Cimmino           016231-00   1 SEP 2016
                        Nurse Corps (29XX)
                      Year Groups 1988-1997
Senior eligible - CAPT C. R. Mcgee          011707-00   1 JUN 2010
Junior eligible - CAPT B. C. Whiteside      016270-00   1 SEP 2016
                       Supply Corps (310X)
                      Year Groups 1990-1995
Senior eligible - CAPT J. D. Soracco        012371-00   1 SEP 2012
Junior eligible - CAPT M. C. Rice           016241-00   1 SEP 2016
                      Chaplain Corps (41XX)
                      Year Groups 1986-1993
Senior eligible - CAPT W. M. Kennedy        011451-00   1 JUL 2009
Junior eligible - CAPT G. C. Cathcart       016035-00   1 SEP 2015
                   Civil Engineer Corps (51XX)
                      Year Groups 1991-1995
Senior eligible - CAPT P. A. Garin          012267-50   1 SEP 2011
Junior eligible - CAPT J. L. Greeson        016247-00   1 SEP 2016
               Limited Duty Officer (Staff) (65XX)
                      Year Group 1998
Senior eligible - CAPT H. J. Walton         016049-50   1 OCT 2015
Junior eligible - N/A
                          Commander
                            Line
               Unrestricted Line Officer (11XX/13XX)
                      Year Groups 1989-1998
Senior eligible - CDR A. W. Deley           020501-00   1 FEB 2004
Junior eligible - CDR K. W. Stonaker        023430-75   1 APR 2014
            Special Duty Officer (Human Resources) (120X)
                      Year Groups 1996-1998
Senior eligible - CDR D. W. Nikodym         022501-25   1 APR 2011
Junior eligible - CDR J. L. Duehring        023369-25   1 SEP 2013
     Special Duty Officer (Permanent Military Professor) (123X)
                      Year Groups 1993-1999
Senior eligible - CDR L. A. Gish            021592-75   1 FEB 2008
Junior eligible - CDR B. C. Earp            023639-75   1 SEP 2014
                  Engineering Duty Officer (14XX)
                      Year Groups 1993-1999
Senior eligible - CDR M. A. Porter          021680-00   1 JUN 2008
Junior eligible - CDR M. R. Perrett         023401-25   1 DEC 2013
      Aerospace Engineering Duty Officer (Engineering) (151X)
                      Year Groups 1994-1998
Senior eligible - CDR M. R. Conover         021932-00   1 APR 2009
Junior eligible - CDR C. L. Canniff         023426-25   1 MAR 2014
      Aerospace Engineering Duty Officer (Maintenance) (152X)
                      Year Groups 1996-1998
Senior eligible - CDR B. K. Genton          022768-25   1 SEP 2011
Junior eligible - CDR J. A. Hidalgo Jr      023402-50   1 JAN 2014
          Special Duty Officer (Public Affairs) (165X)
                      Year Groups 1993-1999
Senior eligible - CDR J. F. Sharpe          021737-00   1 AUG 2008
Junior eligible - CDR E. J. Reynolds        023452-75   1 JUN 2014
           Special Duty Officer (Foreign Area) (17XX)
                      Year Groups 1985-1998
Senior eligible - CDR M. J. Nyilis          020096-25   1 JUL 2000
Junior eligible - CDR G. M. Santiago        023409-00   1 FEB 2014
              Special Duty Officer (Oceanography) (180X)
                      Year Groups 1992-1998
Senior eligible - CDR A. Lomax              021340-75   1 JUN 2007
Junior eligible - CDR M. J. Loomis Jr       023172-50   1 MAR 2013
          Special Duty Officer (Cryptologic Warfare) (181X)
                      Year Groups 1993-1998
Senior eligible - CDR R. G. Froderman       021687-25   1 JUL 2008
Junior eligible - CDR C. P. Keating         023475-75   1 SEP 2014
        Special Duty Officer (Information Professional) (182X)
                      Year Groups 1982-1999
Senior eligible - CDR N. D. Villarin        020056-75   1 NOV 1998
Junior eligible - CDR E. N. Moyer           023569-00   1 SEP 2014
            Special Duty Officer (Intelligence) (183X)
                      Year Groups 1992-1998
Senior eligible - CDR F. Neto               021477-25   1 SEP 2007
Junior eligible - CDR B. M. Foss            023411-00   1 FEB 2014
                         Staff Corps
                       Medical Corps (21XX)
                      Year Groups 1983-2000
Senior eligible - CDR S. A. Magnes         020084-25   10 JAN 2000
Junior eligible - CDR J. C. Ventura        023305-75    1 SEP 2013
                        Dental Corps (22XX)
                      Year Groups 1982-1998
Senior eligible - CDR C. D. Jarrett         020183-25   1 MAY 2002
Junior eligible - CDR J. H. MacDowell       023403-75   1 JAN 2014
                   Medical Service Corps (23XX)
                      Year Groups 1988-1998
Senior eligible - CDR D. L. Mckay           021006-00   1 JAN 2006
Junior eligible - CDR R. C. Nairn           023520-75   1 SEP 2014
                Judge Advocate Generals Corps (25XX)
                      Year Groups 1991-1998
Senior eligible - CDR E. B. Obrien III      021481-25   1 SEP 2007
Junior eligible - CDR J. M. Levy            023584-25   1 SEP 2014
                        Nurse Corps (29XX)
                      Year Groups 1993-1999
Senior eligible - CDR D. M. Swisshelm       021806-50   1 SEP 2008
Junior eligible - CDR D. O. Reid            023557-75   1 SEP 2014
                        Supply Corps (310X)
                      Year Groups 1985-1998
Senior eligible - CDR J. A. Giles           021305-25   1 MAR 2007
Junior eligible - CDR D. D. Brown           023385-25   1 NOV 2013
                      Chaplain Corps (41XX)
                      Year Groups 1989-1998
Senior eligible - CDR K. L. Anderson Jr     021342-25   1 JUN 2007
Junior eligible - CDR R. C. Nordan          023969-00   1 FEB 2015
                    Civil Engineer Corps (51XX)
                      Year Groups 1995-1997
Senior eligible - CDR A. B. Crigler         022193-25   1 JAN 2010
Junior eligible - CDR S. J. Fichter         023378-00   1 OCT 2013

7.  Officers in a zone listed in paragraph 6 who are on active duty when the 
SER boards convene, but who do not meet the eligibility requirements in 
paragraph 4 or are not eligible under paragraph 5, will not be considered by 
the SER boards.

8.  SER eligible officers may request voluntary retirement.
Officers who have an approved voluntary retirement prior to the date of the 
SER boards will be excluded from consideration.

9.  By law, the number of captains or commanders selected for early 
retirement within each competitive category and grade may not exceed
30 percent of those eligible officers considered by a SER board.

10.  Only eligible officers may communicate with a SER board.
Correspondence must arrive no later than 10 calendar days before the 
convening date of the board and shall be addressed to:
    Navy Personnel Command (NPC) Customer Service Center
    President Active-Duty FY-20 (Grade) (Line or Staff Corps, as
applicable)
    Selective Early Retirement Board, Board #XXX, (Board number is a required 
field and may be found on the FY-20 selection board schedule located at 
https://www.mnp.navy.mil/group/advancement-and-
promotion/active-duty-officer
    5720 Integrity Drive, Millington, TN 38055-6300 To check on receipt of 
your package, go to the MyNavy Portal at
https://www.mnp.navy.mil/group/advancement-and-promotion/active-
duty-officer and click on the Information for Board Eligible Candidates link 
(to check on your letter to the board) or contact the MyNavy Career Center at 
(866)827-5672.  Written communication may invite to the attention of the 
board any matter concerning himself or herself that the officer considers 
important.  The written communication must be in accordance with MILPERSMAN 
1420- 010, Communication with Officer Promotion Selection Boards, and may 
include, as enclosures, correspondence from any individual concerning the 
eligible officer.  Correspondence not originated by the eligible officer, 
including endorsements to the officers letter and letters written on behalf 
of that officer, must contain a written acknowledgement by the eligible 
officer that he or she desires that such correspondence be presented to the 
board.
Correspondence without such acknowledgement is considered third- party 
correspondence and will be returned.  Classified correspondence will not be 
accepted.

11.  The cscselboard(at)navy.mil mailbox account is capable of receiving 
encrypted correspondence in line with Department of Defense policy.  If you 
are sending your board package from a non- NMCI network (BUMED.mil, 
EU.NAVY.mil, etc.), please visit https://dod411.gds.disa.mil to download the 
required mailbox certificate.  To download the *Cert* (please note, you MUST 
be using MS Outlook with a CAC reader, including ActivClient software and 
have Internet Explorer or Netscape 7.X), go to https://dod411.gds.disa.mil, 
type cscselboard(at)navy.mil in the *E- Mail address* field, then click 
*Search.*  Click the *BUPERS* link under *Last Name.*  Click on the link 
*Download Certificate(s) as
vCard.*  Click *Software Certificate for cscselboard(at)navy.mil.* Click the 
*Open* button for the *File Download* pop-up.  The certificate will then 
open.  Click *Save and Close.*  The certificate is then saved to the profile 
and can be used to send your encrypted e-mail.

12.  Officers selected for early retirement will be formally notified as soon 
as possible after the board report is approved.

13.  Mandatory retirement date of officers selected and approved for early 
retirement.
     a.  An officer selected and approved for early retirement must be 
retired, under any provision of law under which he or she is eligible to 
retire, on the date requested by the officer and approved by the Secretary, 
which date must no be later than the first day of the seventh calendar month 
beginning after the month in which the Secretary approves the board report.  
For the FY-20 SER boards, this mandatory retirement date is anticipated to be 
no later than 1 May 2020.
     b.  If an officer selected and approved for early retirement is not 
eligible for retirement under any provision of law, then the officer will be 
retained on active duty until qualified for retirement under section 8323 of 
title 10, U.S. Code and then retired under section 8323, unless sooner 
retired or discharged, no later than the first day of the month beginning 
after the month in which the officer becomes qualified for retirement under 
section 8323, or the first day of the seventh calendar month beginning after 
the month in which the SER board report is approved, whichever is later.

14.  This NAVADMIN is canceled for record purposes on 30 May 2020.

15.  Released by Vice Admiral John B. Nowell, Jr, N1//

BT
#0001
NNNN
UNCLASSIFIED//

Internal Medicine Specialty Leader Call for Applicants – O5/O6

Posted on

BUMED is pleased to announce a call for applicants for the Internal Medicine Specialty Leader position.  Interested candidates should submit a Letter of Intent, CV, Bio, OSR/PSR, last 3 FITREPs, and Command Letter of Endorsement to CDR Melissa Austin (e-mail address in the global) NLT 15 Sep 2019.

August Edition of Health Affairs Focused on Military Health System

Posted on

A special August edition of the journal Health Affairs, focused on military medicine and the MHS, is now available.

A listing of articles, with links to abstracts, is available at the journal’s table of contents:

https://www.healthaffairs.org/toc/hlthaff/38/8

Full articles are available to journal subscribers. An introductory article from editor of Health Affairs, available free to all readers, is below:

Date: Aug 5, 2019
Title: Military Health Systems
Source: Health Affairs
Author: Alan R. Weil

This month we examine the health systems that serve 1.4 million active duty
service members; provide care and coverage for another 8.1 million
reservists, retirees, and family members; and provide care for 9.0 million
veterans. As the Military Health System (MHS) goes through a major
restructuring, it also faces pressures and opportunities similar to those in
the civilian sector.

OVERVIEW
Terri Tanielian and Carrie Farmer describe the evolution of coverage for
military service members and their families from the 1880s to the current
TRICARE program. They note that almost 60 percent of those covered by
TRICARE are retirees or their dependents. The authors describe how TRICARE’s
evolution has mirrored that of private insurance, with the growth of managed
care, the adoption of patient-centered medical homes, and the recent
introduction of patient cost sharing.

Terry Adirim discusses the 2017 National Defense Authorization Act
requirement to consolidate the direct care system of “fifty-one inpatient
hospitals and medical centers and 672 ambulatory care, occupational health,
and dental clinics,” currently operated separately by the Army, Navy, and
Air Force, under a single authority. The hope is that a consolidated system
“can more effectively standardize care across the enterprise through the
implementation of standard clinical pathways, standard administrative
policies and procedures, and efficiencies realized by eliminating
redundancies in headquarters personnel and operations.”

An essential component of the MHS is its ability to deploy medical personnel
on a moment’s notice to remote, often austere settings. Paul Hutter and
coauthors describe the challenge of gaining and maintaining the skills
necessary to treat battlefield wounds when most training and medical
practice occurs in traditional clinical settings where patients with fairly
routine conditions are treated. The authors note that the current
consolidation of the MHS’s direct care system creates both opportunities and
challenges for achieving the goal of having a “ready medical force.”

QUALITY
In the United States there are significant racial disparities in the
prevalence of heart disease and the quality of coronary care. Muhammad
Chaudhary and coauthors analyze data from TRICARE and find “no difference in
[National Quality Forum]-endorsed quality-of-care metrics between African
American and white patients receiving coronary artery bypass grafting.” The
authors conclude that universal insurance and equal access can contribute to
reducing racial disparities in surgical care.

Peter Learn and coauthors describe the MHS’s participation in the American
College of Surgeons’ National Surgical Quality Improvement Program.
One-third of military hospitals participated in 2014, with all forty-six
qualifying hospitals participating in 2018. The authors find encouraging
trends of quality improvement in the earlier-adopting hospitals, adding to
the evidence that quality improvement collaboratives can have their desired
effect.

Craig Holden and coauthors examine unplanned readmission rates in military
health facilities. They find a significant reduction in seven-day
readmission rates for medical and surgical services in fiscal years 2011-18
, consistent with broad efforts in the health care system to reduce
readmissions.

CHILDREN
Children of parents who are injured while serving in the military are at
increased risk of various poor health outcomes. Elizabeth Hisle-Gorman and
coauthors examine data for children two years before and two years after
parental injuries and find that these children “received decreased
preventive health care and had increased health care visits for injury,
maltreatment, and mental health care and increased days on psychiatric
medications.” The authors also note “the lack of post-injury change in
visits for maltreatment, injury, and mental health care for children of
parents who sustained their injuries on the battlefield.”

Almost two million children receive coverage through TRICARE. Joseph
Zickafoose and coauthors compare the comprehensiveness of this coverage to
that of Medicaid and Affordable Care Act Marketplace plans in five large
states. Notable limitations of TRICARE relative to Medicaid are in the areas
of well-child visits for children older than age six and developmental
screening. Marketplace plans cover a set of services similar to those
covered by TRICARE, but often with significantly higher cost sharing.

Roopa Seshadri and coauthors analyze access and quality for children covered
by TRICARE. Overall, children on TRICARE are more likely to have complex
medical or mental health needs than children covered by other public or
private insurance programs. Children on TRICARE with special needs could
obtain referrals, but the authors conclude that “our findings suggest that
TRICARE-insured families might not have reliable access to care when their
children have special health care needs or behavioral health needs.”

ACKNOWLEDGMENTS
Health Affairs thanks Gail Wilensky of Project HOPE for serving as issue
adviser. We also thank the Uniformed Services University of the Health
Sciences and the New York State Health Foundation for financial support of
the issue.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00879