Memo Giving Authority, Direction, and Control of MTFs to DHA
The memo transferring authority, direction, and control (ADC) of the military treatment facilities (MTFs) to the Defense Health Agency (DHA) has finally been signed and is viewable here:
Continuing Implementation of the Reform of the Military Health System
Save the Date – Medical Corps Ball (San Diego, 7 MAR) and Symposium (Portsmouth VA, 3 APR)
This fiscal year we are going to move the Medical Corps Ball out of the DC area. It is tentatively scheduled to be held in San Diego on 7 MAR 2020. Further details are being finalized and will be disseminated once they are firmed up.
We are also going to join our MSC colleagues and start a one day Medical Corps Symposium, currently scheduled to occur at NMC Portsmouth on 3 APR 2020. There will be CME available to attendees, and this is a chance to get up to speed on Medical Corps issues such as graduate medical education (GME), professional development, and where we’re headed as an enterprise and a Corps. Here is a save the date graphic they created:
Medical Corps Symposium Save the Date
There is no central funding for either of these events, so you have to find your way there if you are not local. Because of this, the plan is to rotate these to various sites every year.
Day 1 Messages from the New SG, RADM Gillingham
Esteemed Shipmates,
I am honored and privileged to serve as your 39th Surgeon General of the Navy. Attached you will see an outline of my priorities, and the course that we will sail together. Take a moment to review and discuss this information with your Shipmates, reflecting on how YOUR actions contribute to maritime superiority. As a high reliability organization, your active engagement and feedback will be critically important to our continued success. More detailed guidance will be forthcoming. As always, thank you for everything you do for our warfighters and their families.
I look forward to seeing you in the fleet!
SG Sends
Here also is a video from the SG:
Defense Strategies Institute Operational Medicine Symposium -22-23 JAN 2020 – San Diego
Here’s a link to the conference website for those interested in operational medicine (which should be everyone reading this):
Reader Question – Does the TSP G Fund Count as a Bond or Cash in my Asset Allocation?
A reader wrote in and asked the following question:
Hi there. I thoroughly enjoy your website! When determining what my current asset allocation is, should I consider the TSP’s G Fund as “cash” or as a bond fund? I have a Vanguard account, and their website shows you these great “pie charts” reflecting one’s asset allocation. But what’s the best way to think of the G Fund in this context? Thanks a lot!
The Answer – It’s a Bond Fund
I can see why people might consider the G Fund a cash equivalent in their asset allocation, but I think it is best considered a bond because it is not liquid and is paying intermediate-term interest rates. Plus, Personal Capital agrees with me.
What is a cash equivalent? Here’s what Investopedia says:
Cash equivalents are one of the three main asset classes, along with stocks and bonds. These securities have a low-risk, low-return profile and include U.S. government Treasury bills, bank certificates of deposit, bankers’ acceptances, corporate commercial paper and other money market instruments.
The G Fund invests in “a nonmarketable short-term U.S. Treasury security that is specially issued to the TSP.” That makes it sound like a Treasury bill, which is listed as a cash equivalent above, but remember that the G Fund offers you a free lunch. It is a short term security but the interest rate it pays is:
based on the weighted average yield of all outstanding Treasury notes and bonds with 4 or more years to maturity. As a result, participants who invest in the G Fund are rewarded with a long-term rate on what is essentially a short-term security. Generally, long-term interest rates are higher than short-term rates.
In other words, it is really a hybrid between a short and long-term Treasury.
The other aspect of the G Fund that makes it a bond and not a cash equivalent is that it is not liquid. In other words, because it is in a retirement account you can’t sell it and use the proceeds to buy a car, deal with an emergency, or whatever else you need it for. Cash equivalents like CDs, money market accounts/funds, checking/savings accounts, or cold hard cash are all accessible and could be used for these purposes. Unless you are retirement age and withdrawing from your TSP account, the only way to get to the G Fund would be to take out a TSP loan, which I would not recommend.
Just to double check myself, I went to my favorite tool to automatically track my asset allocation, Personal Capital, to see what they considered my G Fund holdings. Personal Capital is also considering the G Fund a U.S. Bond holding.
Chair, Emergency Department, NMC Portsmouth – O4-O6
The Department Head/Academic Chair position is available in the Emergency Department at NMC Portsmouth. The details are in this document:
Finance Friday Articles
Here are this week’s best articles:
Rules For Asset Allocation Implementation
Staying Home – A Discussion of Foreign Stock Market Allocation
Here are the rest of the articles:
5 Reasons I’m Not Joining the Drop Out of Medicine Club
Crowds are Crazy Like a Fox When it Comes to Investing
Everything You Need to Know About Recessions
Free credit monitoring now available for troops. Here’s where to get it.
Herding Isn’t Just for Lemmings
How I Built a Short-Term Rental Business with Dr. David Draghinas
Prenups, Trusts, and Beneficiary Designations – Friday Q&A Series
Principles to Consider When Doing Home Renovations
The Alphabet Soup of “Financial Advisors”
The Importance of Revocable Living Trusts
The Lucrative Side Hustles of a 7-Figure Urologist
The Pros and Cons of a Doctor Going Part-Time
Top 5 Reasons to Retire With Less Than 25 Years of Expenses
Sun Herald – Cuts coming to Keesler hospital? It’s first up as Congress looks to trim military health jobs.
Here’s a link to this article in the Sun Herald, which gives some updates on the status of Section 703 of NDAA 17:
Cuts coming to Keesler hospital? It’s first up as Congress looks to trim military health jobs.
October Message from the Assistant Secretary of Defense for Health Affairs
MHS Team:
As the Defense Health Agency formally assumes responsibility for management
of MTFs across the United States, I commend your continued commitment and
hard work across all levels of the MHS to ensure our warfighters maintain
the military medical combat support capabilities we provide, our patients
see no disruption of quality or access to the healthcare delivery services
they depend on, and our collective efforts to deliver on an implementation
plan to make this transition a success. You are part of an historic
transformation in military medicine – thank you for your service to the
nation during this pivotal period of change. While we have accomplished much
to date, much work remains, and I know you will continue to deliver at the
same high level as this work continues.
In addition to business reform, the MHS continues to build critical
partnerships to advance readiness and operational support. Recently, I
joined Acting Commissioner Dr. Ned Sharpless and his staff at the Food and
Drug Administration for the FDA-DoD semi-annual meeting to discuss our
continued, close partnership to ensure delivery of critical battlefield
medicine to our service members downrange. Over the past two years of
enhanced collaboration between the DoD and FDA, we’ve achieved a number of
successes to advance warfighter readiness and improve overall battlefield
trauma response. We’ve established Emergency Use Authorization for
freeze-dried plasma in initial hemorrhage control efforts as part of
battlefield trauma care, approved drugs for battlefield pain control and
infectious disease threats, and increased the Department’s access to
platelets for injured warfighters in theater. These successes are already
yielding dividends in building a better prepared, better protected, and
better cared for force, equipping the U.S. warfighter with the best possible
military medical support. A special thanks to Dr. Terry Rauch and the DoD
team for your hard work on this critical partnership – including LTC
Colacicco-Mayhugh, RADM (Ret) Carmen Maher, Ms. Kathy Berst, Mr. Nathan
Pawlicki, COL Jennifer Kishimori, Mr. Jeremiah Kelly, Ms. Emily
Badraslioglu, and Ms. Jennifer Dabisch.
Our partnership efforts within the MHS continue to develop as well. I had
the opportunity to join the National Intrepid Center of Excellence (NICoE),
the 10 Intrepid Spirit Centers (ISC), and the Center for the Intrepid (CFI)
to discuss progress and areas of focus as the MHS continues to develop the
best care and treatment for the more than 172,000 patient encounters – seen
this year alone – related to traumatic brain injury and associated health
conditions. With new improvements for treatment and care, including NICoE’s
TBI Portal – which, in collaboration with the Defense Health Agency and the
ISCs, consolidates TBI patient data to better inform clinical decision
making and treatment – the MHS is building a collaborative network of TBI
research, education, and care to enhance warfighter readiness. Special
thanks to NICoE Director CAPT Walter Greenhalgh, NCR Director Brig. Gen.
Anita Fligge, Intrepid Fallen Heroes Fund Honorary Chairman Mr. Arnold
Fisher, Walter Reed National Military Medical Center Director COL Andrew
Barr, and our talented colleagues across the University and the Defense and
Veterans Brain Injury Center for advancing the MHS’s partnership and best
practices that are putting military medicine at the global forefront to
prevent and respond to TBI.
On a final note, we bid farewell to Vice Adm. Forrest Faison as the 38th
surgeon general of the Navy, as he retires after 39 years of service to the
Nation. On behalf of the entire MHS, thank you for your passionate
commitment to the military medical enterprise and to the soldiers, sailors,
airmen, Marines, Coast Guard members and the families who the MHS supports
and cares for.
Tom
Throwback Thursday Classic Post – You Made CDR! Now What?
If you are one of the lucky people who made CDR, I have some things for you to consider:
- The next 2-3 years of fitreps may mean very little to your overall career. First, you are soon going to be in the most competitive group in the Medical Corps, Commanders scratching and clawing to make Captain. If you are at a medium to large command, no matter what you do as a junior Commander, you are likely to get a P (promotable) on your fitreps. That is just how it works for most commands.
- This first bullet means that now is the PERFECT time to do something “alternative” (off the usual career path for a physician) or take a position that you know will get you 1/1 fitreps or be part of a very small competitive group. Go to the War College. Take a senior operational job where you’ll get a 1/1 fitrep. Become a Detailer. Apply for fellowship because the NOB fitreps won’t hurt you as a junior Commander or Commander Select. Now is the time to do these type of things. You don’t want to wait until you are a few years below zone for Captain. When you reach this stage you’ll need competitive EP fitreps.
- After you are selected for your next rank is also a great time to move/PCS. Have you ever been OCONUS? If not, now would be a great time to go. You can PCS somewhere for 2-3 years and then PCS to the command where you are going to set up shop and try to make Captain. At OCONUS commands there is more turnover of staff, so major leadership jobs like MEC President, Department Head, and director positions open up more frequently, setting you up to get a senior position when you return to CONUS.
- You may think I’m crazy, but it is time to start thinking about how you are going to make Captain. As I mentioned in the first bullet, getting a job that will make you a Captain is tough and competitive. Now is the time to do the things that will make you an excellent candidate for one of those jobs. Want to be a residency director? Maybe you should get a degree in adult or medical education. Want to be a director? Maybe you should get a management degree like a Masters in Medical Management or an MBA. Want to be a senior operational leader? Now is the time to do Joint Professional Military Education I and/or II.
- Here is a list of the jobs that I think will make you a Captain. Read the list…figure out which of these jobs you are going to use to make Captain…and get busy preparing yourself to get them:
- Residency Director
- Department Head in a large MTF
- Director
- Chief Medical Officer
- Officer-in-Charge
- Major committee chair
- Medical Executive Committee President
- BUMED staff
- Specialty Leader
- Deployment requiring an O-5
- Detailer
- Senior operational leader
- Division/Group/Wing Surgeon
- CATF Surgeon
- Amphib or CVN Senior Medical Officer
Optimally you’ll have the time when you are an O5 to do multiple jobs on the preceding list. For example, as an O5 I had been a Detailer, a Specialty Leader, Department Head, Associate Director, and CO of a deployed unit. My next step was to become a director at a major MTF, and while I was a senior LCDR and CDR I obtained a Naval Postgraduate School MBA as well as achieved certification as a Certified Physician Executive to try and make myself a competitive candidate for a director position. Ultimately, I became the Director for Healthcare Business at NMC Portsmouth.
Congratulations on making Commander…take a deep breath…and start thinking about some of the things I mentioned in this post. Before you know it you’ll be in zone for Captain.
Joel Schofer's Career Planning Blog 