Downsizing

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MaxAnn

MaxAnn

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Navy Healthcare and apparently the other branches are downsizing; meaning billets are being cut. It's going to affect medical and dental; essentially the entire healthcare enterprise.

There's been a real push for dental services to be provided by civilian providers via the ADDP (active duty dental program).

Junior officers will be affected more than senior officers who've already hit terminal rank and could retire. It's hard for a junior officer to promote if there are less billets to promote to. Even said, every service member will feel these changes in some way or another.
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MaxAnn said:
Navy Healthcare and apparently the other branches are downsizing; meaning billets are being cut. It's going to affect medical and dental; essentially the entire healthcare enterprise.

There's been a real push for dental services to be provided by civilian providers via the ADDP (active duty dental program).

Junior officers will be affected more than senior officers who've already hit terminal rank and could retire. It's hard for a junior officer to promote if there are less billets to promote to. Even said, every service member will feel these changes in some way or another.
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Can confirm for the Army as well. They are now pushing for what's called a "Reverse PROFIS" meaning they want every dentist to be part of a dental support company instead of being part of the monolithic DENTAC or hell, even MEDCOM since they are trying to get rid of these two. Nobody knows exactly what it's going to mean in the near future but they are really trying the squeeze down the size. More importantly, that will mean all of the specialty programs that doesn't directly tie into deployability will eventually get cut or severely down sized. If I had to guess, 63A, B, and N will most likely stay around but I can't say for any of the other specialty. I wouldn't bet on Pedo, ortho, or public health programs sticking around for too long anymore.
 
There's been discussion on this on the facebook page for military dentistry as well.
Everything I am repeating is just rumor / second hand source. Some rumors is that it will start in 2020, specialties will be most affected, looking to downsize via attrition ( limit spots coming in, and people naturally exiting)
 
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Just like said above, I envision a future where most specialty work is farmed out to civilians. The lion’s share of dental work affecting readiness, i.e. exams and operative, is already handled by the O3 junior officers. The only real place you’ll see specialists is OCONUS, where they have no other option. If I were considering a career in the military I’d be sweating. Promotions will almost certainly become much tighter, which is a good thing for the quality of senior officers. Gone will be the days of promotion based almost exclusively on time in service. Imagine being at the 14 year mark and told you didn’t make the cut and they aren’t re-signing you.

Big Hoss
 
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i can speak on behalf of majority of still ad junior officers they dgaf about downsizing there will always be abundant o4 billets handed out freely to career o3s since retention rate is terrible (are we surprised?i feel for bad)
i feel bad for career specialists tho especially those who are close to retirement this new agenda is to save money by reducing expensive personnel and also by reducing number of potential pension recipients
nevertheless ad enlisted members in general are the ones affected the most since tricare pay is garbage which will ultimately further limit access to care
-lil norkii the supreme
 
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Some things are going to be affected, but it's not the cataclysm that some are making it out to be.

And the critical wartime specialties will likely see little to no change.
 
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There is too much unknown at this point. However, blanket cut is like sequestration with great consequences. ADDP dentists are known for over treating patients at the expense of government payments, and do not understand military readiness. Not all specialists in all branches are the same...some are deploy-able, some are not, and deployment lengths are different between branches. If the end goal is to save money, then the government better hold contractors accountable with their cost overruns and mismanagement of projects.
 
vellnueve said:
Some things are going to be affected, but it's not the cataclysm that some are making it out to be.

And the critical wartime specialties will likely see little to no change.
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Maybe and maybe not. I’d just hate to be the guy planning on a career and have it terminated prematurely because of downsizing. Definitely something to think about if you’re still very early on.

Big Hoss
Incoming CO 1st CivDiv
E2B1A880-E85D-46BD-BB52-B61BDDAFF94B.jpeg
 
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Luna724 said:
Can confirm for the Army as well. They are now pushing for what's called a "Reverse PROFIS" meaning they want every dentist to be part of a dental support company instead of being part of the monolithic DENTAC or hell, even MEDCOM since they are trying to get rid of these two. Nobody knows exactly what it's going to mean in the near future but they are really trying the squeeze down the size. More importantly, that will mean all of the specialty programs that doesn't directly tie into deployability will eventually get cut or severely down sized. If I had to guess, 63A, B, and N will most likely stay around but I can't say for any of the other specialty. I wouldn't bet on Pedo, ortho, or public health programs sticking around for too long anymore.
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Hasn't ortho and peds already been outsourced to civilian programs? Or do you mean dental officers won't be granted a leave of absence form to complete their residencies in civilian programs?
 
lb ruski said:
Hasn't ortho and peds already been outsourced to civilian programs? Or do you mean dental officers won't be granted a leave of absence form to complete their residencies in civilian programs?
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There will be a reduction in the number of providers, which will then have an effect on specialty training pipelines. Fewer people will be selected to pursue specialty training, as more of the actual dentistry is sent out to civilian providers. I heard from a Navy periodontist that something like 25% of perio billets are being eliminated. Lots of endo spots are also going.

Big Hoss
 
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How will this affect those currently in school under HPSP? Or will there not be any affect until after graduation and begin payback?
 
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DynamicDental said:
How will this affect those currently in school under HPSP? Or will there not be any affect until after graduation and begin payback?
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I don’t think the cuts start until 2020. You likely won’t be affected, unless you decide to make the military a career. Then you might have some worries. HPSP slots might decrease down the road, and with tuition ever rising it will be more competitive.

Big Hoss
 
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Ditto to all the things said above. I am 2 months in at my first command and heard that they are cutting down a significant amount of providers in our clinic.
 
From what I’ve been able to gather, the billets that are going away are specialty spots and shoreside non-operational spots. Obviously, they can’t cut operational billets. So with fewer cushy non-operational billets, will providers see more frequent deployments? I suppose so.

Big Hoss
 
Big Time Hoosier said:
I don’t think the cuts start until 2020. You likely won’t be affected, unless you decide to make the military a career. Then you might have some worries. HPSP slots might decrease down the road, and with tuition ever rising it will be more competitive.

Big Hoss
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So from what I'm gathering, the job security just won't be there anymore for military health? I was looking to go the 20... I suppose I should start researching about the TSP?
 
Big Time Hoosier said:
From what I’ve been able to gather, the billets that are going away are specialty spots and shoreside non-operational spots. Obviously, they can’t cut operational billets. So with fewer cushy non-operational billets, will providers see more frequent deployments? I suppose so.

Big Hoss
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The specialties most likely to be significantly affected are the ones that don't deploy. While fewer GPs means more deployments, in practice I don't think you'll see a significant change.
 
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BobbyBeavis said:
So from what I'm gathering, the job security just won't be there anymore for military health? I was looking to go the 20... I suppose I should start researching about the TSP?
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No one knows how these changes will all shake out. Definitely should give you pause. Like I said, I’d hate to be someone planning on that 20+ years and then have that cut short. In that case, you probably would have been better off getting out at the first opportunity.

It’s all about cost savings. Historically, the longer you stay in, the more “admin” you get stuck doing. More admin time means you’re doing less actual dentistry. It makes no sense to have these trained O4, O5, and O6 clinicians filling administrative roles when such roles could be better filled by trained O1 and O2 healthcare administrators. It’s ridiculous when you meet an O5 endodontist who only spends maybe 20% of his time chairside. The military is paying that person O5 base pay, a dentist bonus, and a specialist bonus. That’s a lot of money for very little dentistry actually being done. An O1 or O2 medical services officer who’s actually trained to run healthcare operations would do a better job administratively AND cost a fraction of what that endodontist costs the military.

Big Hoss

Edit: Just to remphasize the dead weight in military dentistry, there’s an O4 general dentist in my clinic that saw a grand total of 25 patients in the month of November. Considering this provider’s total compensation, how much did each patient encounter cost the Navy?!
 
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does anyone know how the transition of healthcare being under the DHA will affect military dentists?
 
So, would it be safe to say that your chances of being accepting straight out of dental school for a residency are going to decrease significantly? I'd only assume if they take away seats they give what few they have to the people who have been serving for a bit?
 
VolDental said:
So, would it be safe to say that your chances of being accepting straight out of dental school for a residency are going to decrease significantly? I'd only assume if they take away seats they give what few they have to the people who have been serving for a bit?
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I doubt it'll make any difference
 
VolDental said:
So, would it be safe to say that your chances of being accepting straight out of dental school for a residency are going to decrease significantly? I'd only assume if they take away seats they give what few they have to the people who have been serving for a bit?
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Aside from oral surgery, it’s already very difficult to be selected right out of school. Plan on serving 3-4 years to have a realistic chance.

Big Hoss
 
It is possible in the Air Force to be selected for Oral Surgery, Perio, Prosth, and Comprehensive Dentistry straight out of school.
Practically impossible for other specialties
 
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vellnueve said:
The specialties most likely to be significantly affected are the ones that don't deploy. While fewer GPs means more deployments, in practice I don't think you'll see a significant change.
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Which specialties in the Navy don't have to deploy?
 
InformMe123 said:
does anyone know how the transition of healthcare being under the DHA will affect military dentists?
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downsizing is dha's proposal at least for navy shore duty billets
heard through the grapevine surgeon general "promised more funding" for operational billets in order to maintain if not increase it numbers to ensure operational readiness
but we all know how military works
nothing is true until we get a written order

Big Time Hoosier said:
No one knows how these changes will all shake out. Definitely should give you pause. Like I said, I’d hate to be someone planning on that 20+ years and then have that cut short. In that case, you probably would have been better off getting out at the first opportunity.

It’s all about cost savings. Historically, the longer you stay in, the more “admin” you get stuck doing. More admin time means you’re doing less actual dentistry. It makes no sense to have these trained O4, O5, and O6 clinicians filling administrative roles when such roles could be better filled by trained O1 and O2 healthcare administrators. It’s ridiculous when you meet an O5 endodontist who only spends maybe 20% of his time chairside. The military is paying that person O5 base pay, a dentist bonus, and a specialist bonus. That’s a lot of money for very little dentistry actually being done. An O1 or O2 medical services officer who’s actually trained to run healthcare operations would do a better job administratively AND cost a fraction of what that endodontist costs the military.

Big Hoss

Edit: Just to remphasize the dead weight in military dentistry, there’s an O4 general dentist in my clinic that saw a grand total of 25 patients in the month of November. Considering this provider’s total compensation, how much did each patient encounter cost the Navy?!
Click to expand...

that o4 sounds like a pos tax money wasting garbage
i bet he preaches production to his subordinates on a daily basis
 
Destiny11 said:
Is that true for the Army and Air Force as well?
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Most likely. The more specialized you are, the less useful you are if there’s just one or a handful of dentists, like aboard a ship or forward operating base. This is what most people think of as being deployed. (Surgery is a different animal because of the need to manage severe trauma and whatnot.) That said, as a specialist you absolutely may be stationed overseas. As a military orthodontist or pediatric dentist, for example, you will spend the majority of your time overseas.

Big Hoss
 
Big Time Hoosier said:
No one knows how these changes will all shake out. Definitely should give you pause. Like I said, I’d hate to be someone planning on that 20+ years and then have that cut short. In that case, you probably would have been better off getting out at the first opportunity.

It’s all about cost savings. Historically, the longer you stay in, the more “admin” you get stuck doing. More admin time means you’re doing less actual dentistry. It makes no sense to have these trained O4, O5, and O6 clinicians filling administrative roles when such roles could be better filled by trained O1 and O2 healthcare administrators. It’s ridiculous when you meet an O5 endodontist who only spends maybe 20% of his time chairside. The military is paying that person O5 base pay, a dentist bonus, and a specialist bonus. That’s a lot of money for very little dentistry actually being done. An O1 or O2 medical services officer who’s actually trained to run healthcare operations would do a better job administratively AND cost a fraction of what that endodontist costs the military.

Big Hoss

Edit: Just to remphasize the dead weight in military dentistry, there’s an O4 general dentist in my clinic that saw a grand total of 25 patients in the month of November. Considering this provider’s total compensation, how much did each patient encounter cost the Navy?!
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This is spot on. The amount of dead weight in the military is astonishing. And you forgot to mention that Endodontist’s benefits, family’s benefits, pension, etc. Just one of the many reasons military healthcare is a sinking ship. Surprised it has taken this long honestly.
 
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I'm Currently active duty Navy and in the first ambulatory clinic to transition under DHA in the world. The facility is a combined medical/dental. The warfighter side is taking billets from the medical/dental side. We are waiting to hear the specifics from DHA on how they will be structuring the facilities but we will be under their full control Oct 1st this year, earlier if possible. From first hand knowledge I can confirm 106 Navy dental billets are being eliminated, which is roughly 10% of Navy Dentistry. The current plan to do this is through attrition and less specialty training spots but that can always change. Similar to an above post, specialty billets will see a bigger reduction over time, 25% of endo, pros, etc. All providers will be assigned to a deployable platform, no matter where you are. If your platform deploys, so do you. The rollout will be in the US over the next two years, then overseas, then the Marines at year 3. These changes will hit all the DoD over the next few years, going to be an interesting ride.
 
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Big Time Hoosier said:
No one knows how these changes will all shake out. Definitely should give you pause. Like I said, I’d hate to be someone planning on that 20+ years and then have that cut short. In that case, you probably would have been better off getting out at the first opportunity.

It’s all about cost savings. Historically, the longer you stay in, the more “admin” you get stuck doing. More admin time means you’re doing less actual dentistry. It makes no sense to have these trained O4, O5, and O6 clinicians filling administrative roles when such roles could be better filled by trained O1 and O2 healthcare administrators. It’s ridiculous when you meet an O5 endodontist who only spends maybe 20% of his time chairside. The military is paying that person O5 base pay, a dentist bonus, and a specialist bonus. That’s a lot of money for very little dentistry actually being done. An O1 or O2 medical services officer who’s actually trained to run healthcare operations would do a better job administratively AND cost a fraction of what that endodontist costs the military.

Big Hoss

Edit: Just to remphasize the dead weight in military dentistry, there’s an O4 general dentist in my clinic that saw a grand total of 25 patients in the month of November. Considering this provider’s total compensation, how much did each patient encounter cost the Navy?!
Click to expand...

I could not agree more. Some of the crapiest practitioners stay in the military because private practice would be too much real work for them. And yes some (actually most) of the leaders in DENTAC are there because promotion was automatic. What's even worse is when a poor leader can use something like family stabilization to game the system and stay at highly requested bases and then game the system with "disabilities and physical ailments" that suddenly need to get documented right before they retire, to maximize disability pay. All the while, they have not actually passed a full PT test in 5-10 years and they need to wear girdles for a week before height and tape in order pass (it's fairly obvious they couldn't otherwise pass). It's all fairly despicable. The best in army dentistry almost all universally leave, mostly out of frustration and contempt for the system that is holding them back. In the MEDCOM, the unit leaders are a O2-O3 level. In the DENTAC, the leaders have to be minimum O4 and are often O6 (very top heavy DENTAC these days). Draw your own conclusions about this ridiculous logic.
 
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Tooth Ferry said:
March 10:
Medical corps in crosshairs of military bean counters
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No surprise the old guard is defending the status quo. "What do you mean I can't hide behind a desk any longer? Do you really expect me to see patients?! Seriously?! On top of this crap, you mean to tell me I can't just homestead in sunny San Diego? You really expect me to deploy or get sent overseas? I didn't sign on to this!"

Big Hoss
 
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Big Time Hoosier said:
No surprise the old guard is defending the status quo. "What do you mean I can't hide behind a desk any longer? Do you really expect me to see patients?! Seriously?! On top of this crap, you mean to tell me I can't just homestead in sunny San Diego? You really expect me to deploy or get sent overseas? I didn't sign on to this!"

Big Hoss
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Another interesting observation is that military dentistry does not even seem to be merit based at all. It's predicated on seniority and who can embellish their fitreps and kiss the most booty, it's a game I do not care to play and is one reason why I don't want to stay in after my contract is up. I scratch my head a lot when I hear Senior dental officers trying to rationalize their inefficient/illogical approach to many things:droid:.
 
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FYI all,
Currently at ADA lobby day in DC.

Rear Admiral Ricks, Assistant Surgeon General and Chief Dentist of the Public Health Service, is here speaking and referenced the downsizing.

He noted that the USAF and USN are going to lose 100 dentists in the next 2 years and USA will be losing 300 dental officers.
 
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Tooth Ferry said:
FYI all,
Currently at ADA lobby day in DC.

Rear Admiral Ricks, Assistant Surgeon General and Chief Dentist of the Public Health Service, is here speaking and referenced the downsizing.

He noted that the USAF and USN are going to lose 100 dentists in the next 2 years and USA will be losing 300 dental officers.
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Wow. Considering that the Army only has about 1050 active dental officers, of which about 25% of them are currently in some kind of training, we only have about 800 dentists in the whole Army seeing patients (theoretically). Of those, a lot of them are in leadership/mentorship roles so we don't have a whole lot of dentists purely focused on seeing patients. If they are going to reduce up to 300 dental officers, I wonder how many dentists will be really left to take care of the Soldiers clinically.
 
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Luna724 said:
Of those, a lot of them are in leadership/mentorship roles so we don't have a whole lot of dentists purely focused on seeing patients.
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Enter the Defense Health Agency. I foresee civilian DHA employees tackling most of the “leadership” and administrative roles. Military healthcare providers will do just that, provide healthcare. You don’t need an MD/DO or DDS/DMD to be a paper pusher.

Even as a military dentist myself, I’m all for the cuts. There is a way too much deadweight in military medicine, like I’ve said. Maybe they should ask me for recommendations on who to cut. ;)

Big Hoss
 
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Will these cuts affect HPSP recipients prior to next year? I recently had my medical waiver approved and am supposed to commission (USAF) in a few weeks. Until all is said and done, I am a little nervous about something interfering.
 
So it looks like HPSP got even more competitive for me. Will be applying for D school next summer and was really hoping for an Army HPSP slot (Go Army!).

Guess it’s time for me to buckle up
 
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Luna724 said:
Wow. Considering that the Army only has about 1050 active dental officers, of which about 25% of them are currently in some kind of training, we only have about 800 dentists in the whole Army seeing patients (theoretically). Of those, a lot of them are in leadership/mentorship roles so we don't have a whole lot of dentists purely focused on seeing patients. If they are going to reduce up to 300 dental officers, I wonder how many dentists will be really left to take care of the Soldiers clinically.
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Welcome to socialized medicine. You will have a doctor but not get care.
 
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