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NAVNORTH FRAGO Summary Graphics
Here are the graphics that summarize the COVID-related restrictions due to the NAVNORTH FRACO recently released:
SG’s Message – Words That Define Us
Esteemed colleagues:
At this time last year we were happily awaiting the Fourth of July holiday, relishing the opportunity for outdoor recreation, barbecues, and relaxing with our friends and family. Little did we know, a year later, we would be facing the prospect of a fifth month of restrictions in our daily life including social distancing, the need to wear facial coverings, and the loss of our cherished freedom of movement.
We begin this summer very different as we continue to face an adversary that shows no signs of backing down. Recent trends, in fact, demonstrate a concerning increase in cases affecting all of our Navy and Marine Corps team, to include Navy Medicine personnel. How will we respond to this ongoing challenge? For me, four words that describe Navy medicine’s foundational characteristics provide the answer: resolve, persistence, toughness, and resilience.
Resolve: to decide firmly on a course of action. As the Navy’s medical force, our war fighters and their families look to us to provide the expertise to protect them. They also look to us as role models for how to behave and act in this challenging environment. We must demonstrate the resolve to practice what we preach and become the standard-bearers for how to overcome this adversary.
Persistence: firm or obstinate continuance in a course of action in spite of difficulty or opposition. Time and again, Navy Medical personnel have demonstrated the ability to fight through adversity to complete their mission. We are no strangers to sustained, superior performance. Now more than ever, staying the course, even in the face of what may seem like overwhelming odds and insurmountable challenges, is critically important.
Toughness: the ability to deal with hardship or to cope in difficult situations. Toughness is a core Navy attribute. We relish the opportunity to show others that we have what it takes, no matter the circumstance. When the going gets tough, Navy Medicine gets going. As our Navy motto attributes – Semper Fortis.
Resilience: the capacity to recover quickly from difficulties. A key characteristic of high reliability organizations is that they take a hit and come back stronger. SARS-CoV-2 has hit us hard, but much like the USS Constitution, we are built of sterner stuff. As a learning organization, we know knowledge is power and each encounter with our adversary has made us stronger. Every day the insights gained by our scientists, public health experts, and medical teams have made us more powerful. We use this power for the benefit of those that we have the privilege of protecting. We thrive on the opportunity to grow and adapt.
Resolve, persistence, toughness, and resilience…these words define our incredible team and the characteristics that will see us through this challenge. As our Nation finds itself in the midst of this generational struggle, know that you are the living embodiment of these words, and it is you who gives Navy Medicine its power to prevail. Thank you for all you do and please know what a privilege it is to serve alongside you.
With my continued respect and admiration,
SG
Bruce L. Gillingham, MD, CPE, FAOA
RADM, MC, USN
Surgeon General, U.S. Navy
Chief, Bureau of Medicine and Surgery
Special Pays Update – Senate Proposal to Increase Pays and BUMED Pays Update
FY21 NDAA – SASC Bill Released
Please note the good news below, including a PROPOSED increase in special pays, in the legislative summary from the BUMED Legislative Liaison. While it is just a proposal at this point, at least it is a sign that they read the GAO report that concluded that military physicians are grossly underpaid and that they appreciate the extra efforts everyone has been giving due to COVID:
The SASC has released their version of the FY21 NDAA. Please note the bill still needs to be voted on by the Senate, which will include amendments being proposed. I have attached two modified documents: One includes sections 602 and 612 (described below), the other includes all of Title VII – Health Care Provisions. The full bill can be found here.
Below is a brief summary of notable legislative provisions included in the Bill:
Sec. 602. Hazardous duty pay for members of the Armed Forces performing duty in response to the Coronavirus Disease 2019.
Sec. 612. Increase in special and incentive pays for officers in health professions. This provision increases the amounts of the accession bonus, retention bonus, incentive pay, and board certification pay.
Sec. 703. Waiver of fees charged to certain civilians for emergency medical treatment provided at military medical treatment facilities. A military MTF may waive a fee charged to a civilian who in not a covered beneficiary under certain conditions. Please note there is related report language (to be conducted by GAO) in Sec. 751 entitled Assessment of receipt by civilians of emergency medical treatment at military medical treatment facilities.
Sec. 721. Modifications to transfer of Army Medical Research and Development Command and public health commands to Defense Health Agency. While this section is largely focused on Army and preserving the infrastructure and personnel of MRMC/MRDC, it does include language very similar to the house language with respect to delaying the transition of R&D and PH to DHA. The HASC is delaying until 2025, SASC is 2024.
Sec. 748. Audit of medical conditions of tenants in privatized military housing. GAO audit of the medical conditions of eligible individuals and the association between adverse exposures of such individuals in unsafe or unhealthy housing units and the health of such individuals.
With both the HASC and SASC bills moving to the floor of their respective chambers, we will keep you updated if we find anything of significant interest to Navy Medicine from amendments that are adopted. Once the House and Senate pass their versions of the bill, we will produce a Navy Medicine Leadership Side-by-Side including both versions of the Bill.
One of my Army colleagues sent me this summary of the proposed changes to the maximum pay caps:
- HPO Accession Bonus (AB) from $30,000/yr. to $100,000/yr.
- Critically Short Wartime Specialty Accession Bonus (CSWSAB) from $100,000/yr. to $200,000/yr.
- Retention Bonus (RB) from $75,000/yr. to $150,000/yr.
- 4. Incentive Pay (IP) for physicians and dentists from $100,000/yr. to $200,000/yr. and ancillary specialties from $15,000/yr. to $50,000/yr.
- Board Certification Pay (BCP) from $6,000/yr. to $15,000/yr.
Special Pays Update from BUMED
Here is a cut/paste of a message e-mailed to the Special Pay POCs that spells out the various Incentive Pays (IPs). As usual, anyone with questions should address them with their command admin/HRD, or to the BUMED Special Pays email address:
usn.ncr.bumedfchva.mbx.specialpays-bumed@mail.mil
Subject: IMPORTANT-INCENTIVE PAY DATES UPCOMING THIS SUMMER (UNCLASSIFIED)
Ladies and Gentlemen, please make sure this email is disseminated as much as possible. As you can see by all the names and email addresses, there are a large number of contacts for the special pays office, and this is only the ones we are aware of, and we communicate with on a regular basis. There are even more than this we work with, but do not necessarily have up to date POCs identified, such as Fleet Support Teams etc.
This email is to remind everyone of the dates for submitting for Incentive Pay, which particularly for Medical Corps is vital in the summer months. This information is also in the Pay Guidance for each Corps, and the Special Pays Information Power Point under reference on the BUMED Special Pays webpage.
For those MC completing residency 30 June, the GMO IP should have already been submitted to BUMED Special Pays. If not then get it done ASAP. For all commands when a MC or DC officer completes a residency 30 June, they cannot submit for the specialty IP until 60 days out from the effective date, which means if they completed the residency at another command they cannot submit for the specialty IP until they are at your command. Make sure individuals checking in are advised on when, and how to submit, for the IP at your command. DO NOT assume they know, or someone else in the command will tell them. Send out emails, advisories, or anything that will get out to your command telling them they need to submit. We are continuing to receive too many retroactive requests, and many do not have justification to support why an officer has not been paid for over a year.
Medical Corps –
New interns reporting to AD from Medical school via USUHS or HPSP etc. Eligibility for IP is 3 months after completing medical school, and on AD, so if an officer completes Med School 3 May 2020, is eligible for Internship IP effective 3 August 2020, provided on AD on that date.
Residency IP – If completing Internship eligible for IP 3 months after completing internship, but must be licensed. If not licensed at 3 months, then not eligible for IP until become licensed, and eligibility date is date licensed. If entering residency after GMO/UMO/Flight Surgery tour, then eligibility date is residency start date, and must submit.
GMO IP – If completing internship, same as residency IP, 3 months after completing internship, and licensed. If completing residency, eligible for GMO IP day after completing residency if residency completed while on AD.
Specialty IP – 3 months after completing residency/fellowship.
Dental Corps –
General Dentist IP – 3 months after completing dental school, and must be licensed. If not licensed at 3 months, then eligibility date is date licensed.
Specialty IP – Same as MC specialty IP, 3 months after completing residency.
MSC/NC –
Specialty IP is same as MC specialty IP 3 months after completing qualifying training program.
June Message from the Assistant Secretary of Defense for Health
MHS Team:
As the Department and the Nation begin to transition to reopening in
alignment with White House guidelines, the Military Health System continues
to focus on our mission to prepare, protect, and care for our service
members and beneficiaries. I am increasingly impressed with your endeavors
serving on the front lines, despite the unprecedented challenges our Nation
is currently facing. While many of you have had to manage changes to your
daily lives due to COVID-19, you continued to rise above those hurdles to
ensure our military, their families, and our retirees continue to get the
best quality healthcare we can provide.
Some updates on current MHS issues:
Vaccine and Therapeutics Acceleration Plan. Health Affairs is partnering
with the Joint Program Executive Office for Chemical, Biological,
Radiological and Nuclear Defense (JPEO-CBRND) in implementing a strategy to
accelerate development of COVID-19 vaccines and antibody therapeutics. This
joint effort, funded by the CARES Act, capitalizes on our enormous capacity
to develop, manufacture, and distribute medical countermeasures to the
force. Antibody therapeutics could play a vital role in supporting our
operational missions with prophylaxis measures and post-exposure treatment
options.
COVID-19 Convalescent Plasma. The Department has launched an effort to
obtain 10,000 units of COVID-19 Convalescent Plasma (CCP) in support of
force readiness. It is critical to collect as much plasma as possible, both
for potential treatment purposes now as well as for use in research efforts
and potential use as a future therapeutic. To qualify to be a donor, DoD
personnel and their families, as well as non-DoD civilians with access to
collection facilities on installations, must have fully recovered from
COVID-19 to support this effort. To date, we have already obtained 4,367
units through a combination of procurement and individual donations at Armed
Services Blood Program donor centers across the continental United States,
Hawaii, Guam, and Germany. More on this campaign can be found here:
https://www.militaryblood.dod.mil/Donors/COVID-19andBloodDonation.aspx.
A special call out to Navy Medicine who, in support of the DoD CCP campaign,
sent a team to Guam and rapidly collected CCP from volunteers aboard the USS
Theodore Roosevelt. Over the course of three days, the blood donor center at
U.S. Naval Hospital Guam collected more than 200 life-saving plasma units.
This was the first of many donations as crew from the USS Kidd also
contributed plasma.
Navy Medicine is also directly involved in COVID-19 research efforts. For
the past two months, the USS Theodore Roosevelt was the focus of a public
health outbreak investigation conducted by the Navy and Marine Corps Public
Health Center in partnership with the CDC. Volunteer crew members completed
a short survey and provided two specimens for laboratory testing (voluntary
blood and nasal swab samples). This was the first CDC-published report on
this specific demographic of young adults. One of the key findings was that
loss of taste or smell was the main symptom most associated with COVID-19
infection. This joint effort furthers our understanding of this disease and
will inform future testing and mitigation strategies to ensure the readiness
of our Nation’s military force.
Force Health Protection Guidance Supplement 11. On June 11, 2020, the
Department issued new Force Health Protection guidance outlining the
military’s surveillance strategy for the COVID-19 pandemic response,
including health surveillance activities, screening, asymptomatic testing,
and sentinel surveillance testing. The Department’s surveillance and
screening strategy is designed to break the chain of disease transmission to
reduce risk to the force and to DoD missions. The full guidance can be found
here:
https://media.defense.gov/2020/Jun/12/2002315485/-1/-1/1/DOD-Guidance-for-CO
VID-19-Surveillance-and-Screening-with-Testing.pdf.
COVID-19 Registry. The DHA has established a COVID-19 Registry to provide a
centralized data collection platform of COVID-19 patients. This registry,
which already includes data from 6,510 patients, will support COVID-19
clinical performance improvement and track the epidemiology of the disease.
The data will help research and medical teams, both in the DoD and the
civilian sector, provide more accurate insight into future advancements in
vaccines and treatments. The registry also will track the outcomes of
patients who receive COVID-19 Convalescent Plasma compared to those who do
not – all of which will greatly enhance efforts toward therapeutic treatment
development. The expediency of the design, implementation, and execution of
this monumental task would not have been possible without the dedication and
hard work of Col Stacy Shackelford, Chief, DHA Joint Trauma Center (JTS),
and Mr. Phil Sartin, Data Acquisition Branch Chief for JTS.
As communities begin to slowly open back up, please stay vigilant. The COVID
fight is not over. Many of you are working tirelessly in MTFs, labs, or in
supporting roles to help achieve our health system’s goals and meet the
evolving needs of the Department. Your efforts are critical to ensuring we
accomplish our mission. Please practice self-care, take time for your
families, and check in on each other. As a medical enterprise, we must
remain strong and healthy to ensure we keep our military in the fight.
Thank you for your service and selfless commitment to our troops, their
families, and to our Nation during these challenging times.
Tom
Finance Friday Articles
Here are my favorites this week:
Beyond the pandemic: What to expect from stocks, bonds
Don’t Leave a Mess When You Die
Top 8 questions on investing in the current climate
Top 10 Things Bogleheads Get Wrong
Here are the rest of this week’s articles:
6 Greatest Sins of Insurance Agents
6 Ways to Invest in Apartment Buildings
10 Milestones to Financial Independence Worth Celebrating
10 Reasons Why Residents Shouldn’t Buy A House
Changing My Mind About Personal Finance Due to the Pandemic
How to Fund a Million Dollar Roth IRA for Your Child with Government Money
How to Start Investing in Private Real Estate Deals
How Would Investors React If We Finally Get Some Inflation?
Mortgage Debt Versus Student Loan Debt: Which is Better to Have?
Residency Interviews: Spend Less and Interview More
Military.com – House Lawmakers Want to Pause Military Health System Overhaul
Here’s a little bit longer article that discusses the same thing as yesterday’s article:
House Lawmakers Want to Pause Military Health System Overhaul
Financial Blogs I Recommend
For those looking to get financial education online, here are the blogs and other online resources I’d recommend:
A Wealth of Common Sense – This is a blog written by one of the Animal Spirits podcasters I recommended you listen to. He provides excellent contemporary analysis of the financial markets.
Humble Dollar – Jonathan Clements was a personal finance writer at The Wall Street Journal for 20 years and is a well-respected source for financial advice. He has a number of books and a blog called Humble Dollar that includes a free comprehensive money guide that is a continuously updated guide to all aspects of personal finance.
Mr. Money Mustache – There is an entire early retirement culture on line, of which many physicians are unaware. If you have an interest in early retirement, you’ll love this website and the story of Pete (Mr. Money Mustache), a software engineer who retired in his thirties. It is filled with investing information, as well as practical advice on how to save money in everyday life. The site has an anti-consumerism, pro-Earth bent and Mr. Money Mustache is a strong proponent of using a bicycle instead of driving a car, even in the dead of winter. He will show you that retiring early and controlling your spending doesn’t have to lead to unhappiness. In fact, he’ll probably convince you that the less you own the happier you’ll be.
Oblivious Investor – This is a tax-focused investing blog by an accountant who also writes a series of very short, informative books on all finance topics.
Vanguard Blog – Regular readers know I’m a huge fan of Vanguard and do all of my non-military retirement investing there. You should too! Many know that Vanguard was founded by John Bogle, and those who follow his investing principles are self-named “Bogleheads.” They have a Bogleheads Wiki that you can read in addition to the Vanguard blog.
White Coat Investor Empire – Fellow Emergency Physician James Dahle, MD has created a digital and print media empire. You can’t go wrong if you make this your solitary source of financial information. There is a blog, internet forum, Facebook group, sub-Reddit, podcast, and book, so no matter how you prefer to ingest information you can find what you are looking for on this site. In addition, he has partnered with three other physician financial blogs, Physician on FIRE (which stands for Financial Independence, Retire Early), Passive Income M.D., and The Physician Philosopher. All three of these are excellent sources as well.
Message from the SG – Brilliant on the Basics
Esteemed Navy Medicine Shipmates,
Michael Jordan once said, “Get the fundamentals down and the level of everything you do will rise.” The fundamentals are the basics. They are not always the most exciting thing to learn or do, but they are usually the most important. People, teams, and organizations who achieve greatness, do so by mastering the fundamentals – and then sticking to them. You have probably heard me say – we all need to be brilliant on the basics.
There is currently no vaccine to prevent us from contracting this disease; however, when it comes to our collective battle against COVID-19, we need to continue to practice and encourage others to follow the fundamentals of force health protection to prevent illness and avoid exposure to this virus. Continue to cover your mouth and nose with a cloth face cover when around others, wash your hands often and avoid touching your face, clean and disinfect frequently touched surfaces, monitor your health for symptoms, and enforce restriction of moment.
As medical professionals, we must continue to educate and advise our Sailors, Marines, and family members to stay the course. To help turn fundamentals into habits requires repetitive action. I’m reminded of a basic teaching formula: you hear, you forget; you see, you remember; you do, you understand. And when you truly understand, that is when the basics become part of our DNA. Think muscle memory!
This week marked the 122nd anniversary of the Hospital Corps. As we continue to adapt and confront the challenges posed by this pandemic, the men and women of our Hospital Corps remain a powerful presence on all fronts in the fight against COVID-19. Whether serving as IDCs on surface ships, subs, or diving units; as preventive medicine and laboratory technicians, as general duty Corpsmen at MTFs, or the 8404s embedded with Marine units, our ability to project Medical Power continues to rest on the shoulders of these brave and dedicated Corpsmen.
The recent exploits of Corpsmen during the pandemic have only added luster to the distinguished history of the Corps:
- The quick thinking of the USS KIDD’s IDC and his two fellow “docs” in medevac’ing a suspected case of COVID and implementing newly developed mitigation procedures helped reduce the impact of the disease aboard the warship.
- Five HMs attached to the Naval Hospital Jacksonville’s Rapid Response Team helped ensure the success of an unprecedented mission, conducting testing of the USS KIDD’s crew while helping to provide vital medical support 24/7 in a COVID exposure environment.
- Corpsmen serving with forward deployed preventive medicine teams have remained an early, active, and ever-present force in novel coronavirus surveillance efforts at sea.
And whether contact tracing, onsite testing, administering to patients, or helping to enforce DoD and CDC COVID-19 guidance, our Corpsmen remain at the vanguard of ensuring warfighter readiness across the Department of the Navy.
This month also offers a palpable reminder that Summer is in full-swing and many may be eager to travel or enjoy recreational activities since restrictions have loosened up across the country. Before executing any plans, please take a moment to review NAVADMIN 168/20 regarding our current leave, liberty, and TDY restrictions; as well as the Naval Safety Center, 101 Critical Days of Summer found here.
Please continue to use good judgement, follow existing guidelines, remain vigilant, and most importantly stay safe.
It is important that we all take time to step away from our jobs to decompress, and all of us are eagerly anticipating returning to a sense of normalcy. However, as we try to rediscover what has been lost, let us not forget everything that we have learned along the way. If I had one wish, it would be that you could see the organization from my perspective, as the brilliance you have all demonstrated on the basics have been the building blocks of all that Navy Medicine has accomplished. I am truly humbled to be part of this amazing team.
With my continued respect and admiration,
SG
Bruce L. Gillingham, MD, CPE, FAOA
RADM, MC, USN
Surgeon General, U.S. Navy
Chief, Bureau of Medicine and Surgery
Debt, College, and Discretionary Spending
Here are the slides I used to record this episode of the podcast:
Debt, College, and Discretionary Spending
Here’s the screencast:
Joel Schofer's Career Planning Blog 