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Thyroid Storm
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It looks like the Air Force really is about to experience what they perceive as a "crippling" exodus of surgeons. They're now offering a 75k retention bonus for just signing on for one more year, or a 150k signing bonus for two more years. You have to have less 2 years left to qualify though. And it's only AF since the Army and Navy don't have as many surgeons about to retire.
 

IgD

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It looks like the Air Force really is about to experience what they perceive as a "crippling" exodus of surgeons. They're now offering a 75k retention bonus for just signing on for one more year, or a 150k signing bonus for two more years. You have to have less 2 years left to qualify though. And it's only AF since the Army and Navy don't have as many surgeons about to retire.
Do you have a reference for that??

It's so sad, they thought cutting everything would save money but it has had the opposite effect.
 
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Thyroid Storm
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Do you have a reference for that??

It's so sad, they thought cutting everything would save money but it has had the opposite effect.
I got the info via an email: Here's a cut and paste of the meat and potatoes. It's actually more money than I thought. If you sign on for 2 more years, the 150k is per year.

email said:
Subject: Air Force Critical Skills Retention Bonus (CSRB) for Air Force Surgeons


1. Purpose. To provide information about the Air Force CSRB for Surgeons and its impact on the Army.

2. Facts.

a. On 4 April 2008, the Deputy Under Secretary of Defense (P&R) approved an Air Force CSRB
authority for General and Subspecialty Surgeons in the amounts of up to $75,000 per year for a one year and $150,000 per year for a two year active duty service obligation (ADSO). The Air Force is now offering these contracts only to surgeons in the designated specialty areas with less than 24 months remaining of obligated service. By signing a CSRB contract, AF surgeons agree to serve for one/two years beyond the end date of their current ADSO. They will collect the payment now, but the one/two years of service beyond their current ADSO will be without MSP bonus pay, unless they sign a new MSP agreement that takes them 12 months or more beyond the ADSO end date for the CSRB.
 

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I got the info via an email: Here's a cut and paste of the meat and potatoes. It's actually more money than I thought. If you sign on for 2 more years, the 150k is per year.


Very interesting.

One one of the climate surveys we filled annually there was a question about how much money it would take to keep us in the military, and it was multiple choice with varying amounts, and the one that all of us marked:

"there is no amount of money that would keep me in."

Certainly seems to almost level the playing field with salaries, but with all the other crap surgeons have to put up with I wonder if it will even slow down the hemorrhage.
 

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It looks like the Air Force really is about to experience what they perceive as a "crippling" exodus of surgeons. They're now offering a 75k retention bonus for just signing on for one more year, or a 150k signing bonus for two more years. You have to have less 2 years left to qualify though. And it's only AF since the Army and Navy don't have as many surgeons about to retire.
If they were smart they'd throw the money at people who weren't close the end of their time. Much easier to make people feel wanted/ respected early than to talk them out of leaving after their bitter and have been thinking about leaving for a while.
 

mitchconnie

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I discussed this with our general surgery chief today, and this thing is not actually available just yet. It was apparently rapidly approved by the AF chain of command in Dec. because at the current rate of loss, the AF will be down to about 27 general surgeons within a few years. The thought was that the bonus would be offered in January and entice people to re-up for the spring, but it is stuck somewhere at the DoD level. Most people on the fence about leaving have now bailed.

If this does eventually get approved, it will be interesting to see how many takers there are. Previous retention bonuses were clearly not enough retain anyone and were just extra cash for careerists who were already planning on 20years. But $150K is at a level where some people might change their minds about leaving.

Not me of course, since staying in the AF is career suicide for a subspecialty surgeon.
 

Rudy

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who said there is no way the bonus would keep her in. These gadget bonuses really only reward the incompetent docs who don't have the skills to get good jobs on the outside. So you end up just paying the dead wood a lot more money. I think it would actually make more sense to raise the medical special pays across the board (since they haven't increased since the '80s) for all military docs, which would increase morale and potentially lead to happier docs along the way.

That being said, my decision to leave mil med as soon as absolutely possible is not a financial matter but a matter of principal. Rank should have no role in medical practice. Military medicine rewards incompetence; I see it every day and it is miserable work environment to be in. I am getting out as the first chance I get, regardless of pay
 

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who said there is no way the bonus would keep her in. These gadget bonuses really only reward the incompetent docs who don't have the skills to get good jobs on the outside. So you end up just paying the dead wood a lot more money. I think it would actually make more sense to raise the medical special pays across the board (since they haven't increased since the '80s) for all military docs, which would increase morale and potentially lead to happier docs along the way.

That being said, my decision to leave mil med as soon as absolutely possible is not a financial matter but a matter of principal. Rank should have no role in medical practice. Military medicine rewards incompetence; I see it every day and it is miserable work environment to be in. I am getting out as the first chance I get, regardless of pay
This is dead on right, and the sentiment most of my surgery colleagues had exactly. Also, I agree that if this bonus gets approved, they will be keeping alot of dead weight, with no recent surgeons duped by what basically comes to just under or equal the salary of a civilian general surgeon.
 

mitchconnie

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This acute shortage of general surgeons highlights the complete inability of the AF medical leadership to make any real changes or implement creative solutions. The problem was clearly foreseen at least five years ago and very little of substance has been done. Now all of a sudden it’s a crisis.

The need for major re-organization of assignments has been obvious for years. There would still be plenty of surgeons to do the mission if we would stop sending them to places where they are not needed and where their skills simply rot. There are many billets, both in-theater and in CONUS, where the surgeons really have minimal support and do little surgery. Not only is it a waste of a general surgeon, but it is also kills morale and causes people to exit at the first opportunity. But major changes in assignments are always blocked by either the SG or the local commanders who can’t accept the obvious fact that the AF has long since abandoned the concept of a full-service medical system.

It also highlights the folly of the AF in blocking an integrated tri-service medical corp. The so-called “crippling exodus” would not be an issue AT ALL if the general surgery assignments were tri-service and surgeons could be assigned efficiently based on local need.
 

The White Coat Investor

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I hope this is extended soon to the other specialties as this corrects one of the major problems with military medicine-the pay is pathetic.

I mean, I suppose that 9 out of every 10 military docs gets out as soon as his commitment is over. A pay raise across the board could decrease that to 7 or 8 out of 10, DOUBLING OR TRIPLING THE RETENTION RATE. This is highly significant.
 

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I hope this is extended soon to the other specialties as this corrects one of the major problems with military medicine-the pay is pathetic.

I mean, I suppose that 9 out of every 10 military docs gets out as soon as his commitment is over. A pay raise across the board could decrease that to 7 or 8 out of 10, DOUBLING OR TRIPLING THE RETENTION RATE. This is highly significant.
:lol: :clap:

I can see somebody putting that down as an OPR bullet
 

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Talked to an AD friend of mine today, and he told me that this was now a reality, but he's an ER physician, so I was wondering if anyone had heard otherwise?

Mitchconnie? is this real now?
 

mitchconnie

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I have been informed that final approval for this Critical Skills Retention Bonus (CSRB) has arrived.

Still, in my informal survey of about ten eligible surgeons, I find that it is not changing anyone's mind about leaving. Those surgeons that were already planning on staying in for 20 will take the CSRB and view it as a bucketload of free money falling out of the sky.

People who were planning to get out of the military will still leave. It just doesn't make sense to delay the move to civilian practice by two years, and get deployed two more times, in order to collect a bonus that just barely gets your salary close to what you would make as a civilian. Now, if there were a guarantee that the CSRB would continue indefinitely, and you would be making that kind of money for an entire career, I think there would be more takers. But CSRB is only geared to last for the next 2-3 years.

For non-career people, taking the CSRB only makes sense in isolated circumstances. For instance, people who may be thinking about staying in an extra two years because they have an active duty spouse who is not yet done with their committment; or surgeons who haven't found a good civilian practice yet and want an extra year or two to look around more.

Enthusiasm for the CSRB is also diminished due to persistent rumors about changing the deployment scheme for AF surgeons. Latest is moving to 6-month deployments for everyone (from 4) and potentially a 1:1 deployment/home ratio--i.e. 6 months in Iraq, 6 months home, 6 in Iraq, etc. This is a retention killer and much worse than the current 4 months deployed followed by a year at home.
 

The White Coat Investor

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I have been informed that final approval for this Critical Skills Retention Bonus (CSRB) has arrived.

Still, in my informal survey of about ten eligible surgeons, I find that it is not changing anyone's mind about leaving. Those surgeons that were already planning on staying in for 20 will take the CSRB and view it as a bucketload of free money falling out of the sky. .
My informal survey results were a bit better. Of three, one is taking it (staying anyway), one is very seriously considering taking it (as anti-military as most of us on this forum), and I haven't talked to the other. With this additional money the military is now paying MORE than the civilian sector for a lot less work and risk (although more deployments and b.s.). You'd be a fool not to at least consider it.
 

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My informal survey results were a bit better. Of three, one is taking it (staying anyway), one is very seriously considering taking it (as anti-military as most of us on this forum), and I haven't talked to the other. With this additional money the military is now paying MORE than the civilian sector for a lot less work and risk (although more deployments and b.s.). You'd be a fool not to at least consider it.

I would venture to say that its is not MORE. Everyday I get job notices that advertise 3-4K/year, and does not include deployment, being led by MORONS, nurses, and being treated like a third grader.

The three I know locally are laughing at it.
 

The White Coat Investor

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I would venture to say that its is not MORE. Everyday I get job notices that advertise 3-4K/year, and does not include deployment, being led by MORONS, nurses, and being treated like a third grader.

The three I know locally are laughing at it.
The data I've seen show an average salary for a general surgeon of $262,000.
http://www.physicianssearch.com/physician/salary2.html

That seems about right to me for an AVERAGE salary. The ones you see advertised are usually for A LOT of work in an undesirable location.

So if a typical O-4 with 9 years makes:
$5428*12= $65K fully taxable
BCP=$2.5K not FICA taxable
VSP $958*12=$11.5K not FICA taxable
ISP $29K not FICA taxable
ASP $15K not FICA taxable
MSP $10K not FICA taxable (I'm not sure on this one, I used '99 data)
BAH (used D.C., subtract $12K for San Antonio)$2586*12=$31K tax free
BAS =203*12= $2.5K
$150K new bonus not FICA taxable
Total:
$316.5K

Taking into account tax benefits
$65K fully taxable
$33.5K tax-exempt (33.5K/.67)=$50K
$204K not FICA taxable (204K/.92)=$222K

Total: $337K

Surely that is pretty good pay considering most military general surgeons aren't working very hard compared to their civilian colleagues (at least at the centers I'm familiar with.)

There are still lots of downsides, but this type of a pay increase eliminates the complaint that the military isn't paying the same as the civilian world.
 

Galo

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The data I've seen show an average salary for a general surgeon of $262,000.
http://www.physicianssearch.com/physician/salary2.html

That seems about right to me for an AVERAGE salary. The ones you see advertised are usually for A LOT of work in an undesirable location.

So if a typical O-4 with 9 years makes:
$5428*12= $65K fully taxable
BCP=$2.5K not FICA taxable
VSP $958*12=$11.5K not FICA taxable
ISP $29K not FICA taxable
ASP $15K not FICA taxable
MSP $10K not FICA taxable (I'm not sure on this one, I used '99 data)
BAH (used D.C., subtract $12K for San Antonio)$2586*12=$31K tax free
BAS =203*12= $2.5K
$150K new bonus not FICA taxable
Total:
$316.5K

Taking into account tax benefits
$65K fully taxable
$33.5K tax-exempt (33.5K/.67)=$50K
$204K not FICA taxable (204K/.92)=$222K

Total: $337K

Surely that is pretty good pay considering most military general surgeons aren't working very hard compared to their civilian colleagues (at least at the centers I'm familiar with.)

There are still lots of downsides, but this type of a pay increase eliminates the complaint that the military isn't paying the same as the civilian world.
You'd be surprised that alot of those high paying jobs are not in undesirable areas, unlike many AF bases.

Also, I'd rather be busy than sitting on my ass letting my skills rot. Also those are usually starting salaries, and as a practice grows, so does the salary.

Either way, the salary complaint has always been a minimal one when compared the the number of obstacles that it takes to practice medicine in the military. I hope there is a way to see how effective this money ruse is, but I think it will only scratch the surface, and allow a bunch of dead weight surgeons to stay on, while the talented hungry ones leave at the first chance no matter how much money they wave in their face. I can recall there would be no amount of money that would have made me stay, and many felt the exact same way.
 

mitchconnie

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Total: $337K

Surely that is pretty good pay considering most military general surgeons aren't working very hard compared to their civilian colleagues (at least at the centers I'm familiar with.)

There are still lots of downsides, but this type of a pay increase eliminates the complaint that the military isn't paying the same as the civilian world.
Agree that the money is good for the actual work hours you put in, but I still don't think it makes good career sense to stay for an extra two years just to collect the bonus. Two years spent in the AF is two years that you could have spent making partner in a private group (when the real money starts rolling in), two years publishing and making associate professor, or two years building a referral base for your own practice. Instead, it's two more years wasted, letting your skills atrophy and doing deployments.

If you can't find a good civilian job (very unlikely given current job market for general surgery) or are really on the fence about staying in for a career the bonus makes sense, but I'm not so sure about anyone else.
 

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Like I said...lots of downsides. We're not talking about increasing retention from 5% to 50%. We're talking about going from 5% to 10% or 15%.

Those who absolutely detest the lack of pathology, the deployments, and the B.S. won't stay even with the additional pay. But there are a few people out there that enjoy the short hours (and possibly even moonlight on the side) and don't mind the deployments so much that will now stay because the money tipped the equation for them. It'll be the same in every specialty. Most of us have a price. You might not stay for $150K, but I bet you'd stay for $1.5 Million. Most of us would stay for quite a bit less than that. As military pay becomes aligned with or greater than pay for comparable civilian work, many of the military's retention problems will cease and with improved retention, some of the other problems will go away too. I say kudos to whoever was responsible for getting the pay increased.
 

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Does anyone know if there will be bonuses that will apply to all other specialties as well and if so is there any way to find these figures? Thanks.
 

Galo

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Does anyone know if there will be bonuses that will apply to all other specialties as well and if so is there any way to find these figures? Thanks.
My guess is it will not happen till they are "critically undermanned". And even then it may take a while. I still think this is a single bandaid solution for a hemorrhage problem.
 

IgD

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Did you ever see the movie version of Hitchhiker's Guide? There is a space fight scene where Vogons decide that they are going to pursue the Heart of Gold. As I recall, they stop and fill out pursuit paperwork. They get the engines powered up and then an alarm sounds signifying tea time so they come to a full halt. Is this medical staffing process similar to that scene?
 

mitchconnie

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Like I said...lots of downsides. We're not talking about increasing retention from 5% to 50%. We're talking about going from 5% to 10% or 15%.

Those who absolutely detest the lack of pathology, the deployments, and the B.S. won't stay even with the additional pay. But there are a few people out there that enjoy the short hours (and possibly even moonlight on the side) and don't mind the deployments so much that will now stay because the money tipped the equation for them. It'll be the same in every specialty. Most of us have a price. You might not stay for $150K, but I bet you'd stay for $1.5 Million. Most of us would stay for quite a bit less than that. As military pay becomes aligned with or greater than pay for comparable civilian work, many of the military's retention problems will cease and with improved retention, some of the other problems will go away too. I say kudos to whoever was responsible for getting the pay increased.

I generally agree with this analysis, but I believe that they ARE trying to go from 5% to 50% retention, given this massive bonus which is totally unprecedented in military medicine and possibly the entire military. Given current projected shortfalls in surgery, going from 5 to 10% retention rate will not come anywhere close to solving the problem.
 

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:laugh:

Welcome to the military, son!

Did you ever see the movie version of Hitchhiker's Guide? There is a space fight scene where Vogons decide that they are going to pursue the Heart of Gold. As I recall, they stop and fill out pursuit paperwork. They get the engines powered up and then an alarm sounds signifying tea time so they come to a full halt. Is this medical staffing process similar to that scene?