Surgeon General’s Guidance & Value-Based Care

Posted on

The Navy Surgeon General just released his Commander’s Guidance for Navy Medicine:

Navy Medicine Commanders Guidance

As you will read, Readiness, Value, and Jointness have been replaced by Readiness, Health, and Partnerships.  In addition, there is a focus on value-based care.  A good article on value-based care from the Harvard Business Review can be found at this link.  I’ve pasted the executive summary below:

In health care, the days of business as usual are over. Around the world, every health care system is struggling with rising costs and uneven quality, despite the hard work of well- intentioned, well-trained clinicians. Health care leaders and policy makers have tried countless incremental fixes—attacking fraud, reducing errors, enforcing practice guidelines, making patients better “consumers,” implementing electronic medical records—but none have had much impact.

It’s time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. We must move away from a supply- driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need. We must shift the focus from the volume and profitability of services provided—physician visits, hospitalizations, procedures, and tests—to the patient outcomes achieved. And we must replace today’s fragmented system, in which every local provider offers a full range of services, with a system in which services for particular medical conditions are concentrated in health-delivery organizations and in the right locations to deliver high-value care.

The strategy for moving to a high-value health care delivery system comprises six interdependent components: organizing around patients’ medical conditions rather than physicians’ medical specialties, measuring costs and outcomes for each patient, developing bundled prices for the full care cycle, integrating care across separate facilities, expanding geographic reach, and building an enabling IT platform.

The transformation to value-based health care is well under way. Some organizations, such as the Cleveland Clinic and Germany’s Schön Klinik, have undertaken large-scale changes involving multiple components of the value agenda. The result has been striking improvements in outcomes and efficiency, and growth in market share.

Guest Post: Supplemental Disability Insurance for Active Duty Physicians

Posted on

(EDITOR’S NOTE: While we have great benefits in the military, one area where our benefits fall short is disability insurance.  If we were to be disabled on active duty, our disability pay would not reflect our physician bonuses and higher income.  For years I struggled to find supplemental disability insurance.  I used the American Medical Association plan because they’d give me up to $2500/month of additional coverage and it was all I could find.  That was until I contacted Andy Borgia at  He was able to get me the amount of coverage I needed when many, many other people couldn’t.  For some reason many disability insurers don’t want to cover active duty.  Below is a post from Andy about supplemental disability insurance.)

May is disability insurance awareness month and also the time of the year a number of physicians transition into new positions due to the completion of most training programs July 1st. As a result, it is an excellent time to examine protecting the most valuable asset any physician has, their ability to practice and earn an income. Whether you are a military physician with a number of years left to serve, soon to be exiting the military or currently in a residency/fellowship program, it would be prudent make certain you are adequately protected in the event you become disabled and unable to practice due to a sickness or accident. Statistics, which can be found all over the internet, including our site, indicate approximately 1 in 3 people will be disabled during their working career, which can be the cause of financial ruin. Disability insurance for physicians is universally recommended.

Being active duty military, you may think you are already adequately protected. This is far from accurate since military disability benefits only cover base pay and do not include incentive, special or bonus pay, allowances or private earned income. These extra forms of income usually provide the majority of a military physician’s pay and should and can be protected. If you are about to leave the military, the day after you are discharged, any military disability coverage will cease and you will be completely unprotected. Establishing an individual disability insurance policy can take up to 4 months, since medical records must be obtained so to be adequately protected requires advanced planning.

To make certain you and your family are protected, establish an individual disability insurance
policy. The individual policy contractual provisions should protect you in your chosen medical specialty for the entire benefit period, provide both total and partial disability benefits, allow for an increase in coverage upon completion of duty without additional medical requirements, and be noncancelable and guaranteed renewable (policy cannot be cancelled, premiums changed, coverage altered by the insurance company). Residents and fellows may be eligible for discounted polices if established prior to completion of training and should be taken advantage of.

Contact an experienced insurance agent that represents a number of companies and is familiar with contractual provisions and underwriting procedures, it does make a difference, to explore your
options. Please visit our website to obtain our Military Physician Disability Insurance Guide. This will provide an educational first step.

For a complementary personal disability insurance consultation please contact me directly (Andy G Borgia CLU,, 888-934-4637).

FY17 CAPT Board Statistics and Basic Promotion Board Math

Posted on

The FY17 Staff Corps O6 promotion board basic statistics are here.  I don’t have the specialty specific ones yet, but I’m sure they’ll be coming soon.

Let’s go over the basic stats for Medical Corps so that everyone understands them as they can be very confusing.

According to page 2 of the convening order, the promotion opportunity was 70%.  The number of people in zone was 91.  In order to find the total number of officers they could select for promotion, you take the promotion opportunity x the size of the zone:

(70% promotion opportunity) x (91 officer zone size) = 64 officers could be selected for promotion

As you see in the stats, they selected exactly 64:

  • Above Zone – selected 32 of 183 or 17.5%
  • In Zone – selected 31 of 91 or 34.1%
  • Below Zone – selected 1 of 150 or 0.7%

As you can see, even though the promotion opportunity was 70%, the chance you got selected in zone was only 34.1% because selects came from above and below zone.

CAPT Select List Released

Posted on

Congrats to all the new Captain Selects! (link here and list pasted below)

R 271500Z APR 16

ALNAV 026/16



RMKS/1.  I am pleased to announce the following Staff Corps Officers on the 
Active-Duty List for promotion to the permanent grade of Captain.

2.  This message is not authority to deliver appointments.  Authority to 
effect promotion will normally be issued by future NAVADMINs requiring 
NAVPERS 1421/7 preparation and forwarding of document to PERS-806.

3.  Frocking is not authorized for any Officer listed below until specific 
authorization is received per SECNAVINST 1420.2A.

4.  For proper alphabetical order read from left to right on each line. The 
numbers following each name to the right indicate the relative seniority 
among selectees within each competitive category. Members are directed to 
verify their select status via BUPERS Online.

                            Medical Corps
Akins Roger Scott            0031  Alsina Manuel F              0053
Altamar Hernan Orlando       0011  Ancona Michael R             0008
Antle Susan Farrar           0035  Berry Kyle R                 0047
Bunten Bradley L             0033  Bustamante Alexander I       0051
Callan James E               0056  Carr Russell B               0057
Dalitsch Walter W            0003  Demers Gerard                0032
Ellingson Christopher        0025  Espiritu Jennifer M          0026
Feldman Brian L              0061  Franzos Marc A               0043
Gallus Katerina Maria        0017  Gilhooly Jonathan E          0062
Gonzalez Hermann Franc       0015  Hagerman Rodney S            0038
Hanley Keith A               0001  Hanling Steven R             0023
Hussey Sean M                0034  Johnson David P              0058
Juliano Michael L            0052  Klugh Arnett                 0036
Lavery Eric A                0054  Lee Mike Hyun                0048
Lenart Mark J                0041  Lujan Eugenio                0050
Matwiyoff Gregory N          0027  Mclean Matthew David         0039
Moroney John W               0060  Nanos George P III           0028
Norris Craig Dewayne         0042  Omeara Kevin Michael         0046
Orsello Christopher A        0030  Penta Joseph F               0013
Powell Blaine Michael        0020  Quast Timothy M              0022
Rader Scott B                0037  Ramirez Alfredo R            0021
Randall Craig J              0045  Ricca Robert L               0064
Rice George M                0010  Robinson Michael A           0055
Rue John Paul Harris         0012  Sanchez Marlene L            0049
Sayles Timothy E             0014  Schiemel Andrew W            0007
Shiau Danny T                0016  Shippey Stuart H III         0006
Shusko Michael P             0063  Spalding Bryan M             0029
Spooner Michael T            0044  Stedjelarsen Eric T          0019
Steigleman Walter A          0040  Temple Richard W             0059
Thomas Karin E               0009  Tucker Anthony               0024
Wells Brian P                0004  Whittaker David Robert       0018
Wilson Charles E             0002  Wittenberger Michael D       0005
                           Dental Corps
Adcook Richard Scott         0014  Avillo Andrew James          0009
Craig David Merrill          0004  Donovan Sean Pat             0005
Evans Eric Scott             0013  Lee Chad Alan                0002
Mclaughlin John Daniel       0012  Monasky Ann Barbara          0008
Morales Enrique Manuel       0006  Myaingmisfeldt Rachel        0011
Stokes Steven Marc           0010  Walker Gary Jude             0003
Wilson John Hinton           0007  Young Benjamin Wayne J       0001
                        Medical Service Corps
Archila Andrew Mario         0008  Artino Anthony R Jr          0007
Bouma Matthew Frank          0014  Brenner David Bruce          0019
Brown Gabriel Toliver        0012  Bunch Roger Lynn             0025
Christian Alan Brent         0017  Darby Jason B                0020
Durand Paul Brandon          0005  Gellman Gregg William        0013
Greenstein Scott Lawre       0016  Gross Jessie Enrique         0004
Hardin Brandon Wayne         0021  Hindman Traci Jo             0009
Hodapp Kristin Rebecca       0031  Im Peter Oo                  0018
Lauby Todd J                 0002  Lepore Karla Mae             0030
Linderman James Russel       0011  Mckenzie Chad Eric           0022
Newell Steven Wayne          0003  Newton Keith Bernard         0024
Obenauer Peter Joseph        0015  Pimentel Guillermo           0023
Pinkham Wendy Hauler         0001  Rice Rose Ellen              0028
Ringer Cheryl Christin       0026  Shobe Katharine Krause       0029
Smith Tara Nicole            0010  Stancil Jeffrey Dwayne       0027
Stephens Douglas Eugen       0006
                    Judge Advocate General's Corps
Cooper Shane D               0008  Eskridge Laurin N            0007
Goldsmith Jennie L           0013  Gonzalez David Michael       0014
Hoelz Joseph Gehlen          0004  Leary Thomas Francis         0002
Lemoyne Irve Charles J       0005  Luken Michael John           0003
Mcleod Jonathan Mark         0001  Monahan Robert Paul Jr       0006
Nauman Joshua Paul           0012  NgBaumhackl Elysia Gah       0010
Vavra Randall James          0011
                           Nurse Corps
Bailey Johannes Michae       0028  Barnett Melissa Ann          0022
Braun Lisa Anne              0005  Buss Kevin Paul              0004
Carrillo Raul J              0018  Cunningham Craig Andre       0025
Deaton Laura Dawn            0027  Domotorffy Eva S             0019
Eckenrode John Edwin         0011  Farino Melissa Ann           0024
Fisak Jean Frances           0017  Hawker Jeremy John           0020
Hillery Julie Maria          0001  Hosea Lonnie Shelton         0016
King Heather Cuniff          0008  Kohler Michael Shawn         0002
Lemaire Clint Anthony        0023  Lewis Rachel Marsh           0030
Loesche Paul Andrew          0012  Lopez Eddie                  0015
Messmer Scott Jacob          0010  Meyerhuber Daniel Nels       0021
Parks Steven James           0014  Parrott Justice Mason        0006
Pickett Sara Sharmayne       0013  Scott Thecly H               0009
Smith Kathaleen Lynett       0007  Taylor Joseph Lee            0003
Vogelrogers Elizabeth        0029  Volk John Edward             0026
                             Supply Corps
Ayers Susan L                0021  Benedetto Michael V          0004
Blake Patrick Christop       0024  Booth William D              0018
Carnal David Dewitt          0028  Cash Eugene S                0002
Doyle David Edward           0019  Dozier Pamela Chanel         0008
Duenas John Sablan           0011  Dwy Charles                  0031
Feliz Jose L                 0007  Fitch Jason Bradley          0003
Garrigus Mark Reed           0015  Gathright Nicola M           0020
Gawaran Edmond J             0010  Heryford Michael Willi       0017
Holman Matthew D             0026  Hunter Julie M               0006
King Jerry Allen             0023  Lask Gregory Robert          0030
Mackenzie Douglas Stew       0005  Neville Thomas Joseph        0012
Scott Thomas A               0001  Treanor Julie Mary           0016
Troy Milton W III            0009  Turner Alsandro H            0029
Turner Dennis J              0013  Wanack Todd Alan             0022
Weber Leroy H                0014  Yanero Anthony Dominic       0027
York Michael                 0025
                            Chaplain Corps
Brown Michael David          0011  Donahue Kim Macdonald        0010
Hakanson John Michael        0006  Haley Brian Joseph Cam       0002
Johnson James Lowell         0008  Kalantzis John Angelo        0009
Mode Daniel Lawrence         0012  Moured Emile George          0007
Pittman James Howard         0004  Schluter Greg Thaddeus       0005
Stallard William Danie       0003  Stamm Brian James            0001
                          Civil Engineer Corps
Anderson John Rogers         0002  Cook Daniel W                0012
Cuadros Jorge Ricardo        0014  Dandrea Eileen Jean          0004
Deviney Jeffrey Corbin       0009  Geertsema Cameron Jae        0008
Hendricks Kent R             0011  Lengkeek Jeffrey Dale        0010
Price Nathanael B            0013  Siemer William Andrew        0001
Spears Kemit Wayne           0006  Stasick Steven James         0007
Via Christopher R            0003  Vogel Burr Michael           0005

5.  Released by Ray Mabus, Secretary of the Navy.//


New Feature: Career Consult & Record Review!

Posted on

There are a lot of people you can turn to when you need career advice.  There’s your Specialty Leader, your Detailer, and other senior mentors you’ve developed relationships with during your career.  If you want your record reviewed, you can either e-mail your Detailer or go to the Advanced Medical Department Officer’s Course (AMDOC) where a Detailer will review it one-on-one with you.  What do you do if you want an outside opinion or you can’t peel away to go to AMDOC?  Well…that’s where the new Career Consult & Record Review comes in!

If you just have some questions to ask, go to the new tab on the website, submit your questions, and hit send.  I’ll get back to you as soon as I can.

If you want your record reviewed, go to BUPERS On-Line and download the PDF copies of your Officer Summary Record and Performance Summary Record.  Once you have them, e-mail me with them attached (e-mail address on the tab or on the global) and I’ll review your record for you.  It’s that simple.

CDC-DoD Liaison Position Available

Posted on

1.  Job: DOD Liaison to the Centers for Disease Control
2.  Fill date: Summer 2016
3.  Rank: CDR and above (although if I was a LCDR I'd apply)
4.  Population health background required and must be eligible for orders.

The relevant documents that describe everything are here and here.

Anyone interested should contact their Detailer.