HPSP offered to PA students

[onthego]

---

Members do not see this ad.

I have read from other forums PA forums and NWPA-S that the Navy and Air Force are currently offering HPSP scholarships to PA students. I guess the military got tired of doctors crying about the military's unfairness. How do you docs in misery feel about this?

 

[73BARMYPgsp]

This one will get fun REAL quick.

 

[FutureNavyFP]

Is this what a troll is?

 

[elderjack21]

Just what the military needs...

 

[IgD]

The idea of augmenting a strong physician backbone with PAs, nurse practitioners and social workers is a good one. On the other hand, recently I ran into an O6 nurse who appeared to be enthusiastic about replacing physicians with nurse practitioners. I got the impression he was happy and could possibly be facilitating the departure of physicians to accelerate this process.

"Politically based medicine" 🙂

Man I've been in a cynical mood lately...

 

[Perrotfish]

On the other hand, recently I ran into an O6 nurse who appeared to be enthusiastic about replacing physicians with nurse practitioners. I got the impression he was happy and could possibly be facilitating the departure of physicians to accelerate this process

Is this a bad thing? My impression is that quite a few docs on this board would be sanguine about letting PAs take over some of the GMO positions. In the past, on this forum at least, quite a lot of people seemed to like the idea of PAs being the highest level of care provider assigned to the batallion level, with supervising doctors on the regimental level, rather than forcing a doc into every batallion.

 

[onthego]

Is this a bad thing? My impression is that quite a few docs on this board would be sanguine about letting PAs take over some of the GMO positions. In the past, on this forum at least, quite a lot of people seemed to like the idea of PAs being the highest level of care provider assigned to the batallion level, with supervising doctors on the regimental level, rather than forcing a doc into every batallion.

I like the idea

 

[The White Coat Investor]

Were you hoping for some kind of anti-PA diatribe here? Most of us think highly of the PAs we work with. A PA could (and does) do 1 of my 2 jobs and could have handled 98% of what I saw while deployed.

The fastest provider in my group is a PA (civilian.)

 

[MaximusD]

Don't see how PAs would hurt. PAs would help the understaffing situation as USAFdoc described. PAs would also take up GMO spots...

Only downside is there will be less incentive for the military to create more accessions to student physicians... and would it be possible for it to decrease available HPSP spots for MD/DO students?

 

[Perrotfish]

Only downside is there will be less incentive for the military to create more accessions to student physicians... and would it be possible for it to decrease available HPSP spots for MD/DO students?

Well the Navy could decrease the available spots by 40% and still not be making target, so I don't think there's a lot to worry about there.

 

[IgD]

My firm belief is that every battalion needs a board certified FP physician. Marines are like professional athletes. They deserve and require the kind of medical care that a professional athlete receives throughout every phase of the deployment cycle.

 

[Perrotfish]

My firm belief is that every battalion needs a board certified FP physician. Marines are like professional athletes. They deserve and require the kind of medical care that a professional athlete receives throughout every phase of the deployment cycle.

I'm sorry I just don't see why this means the FP needs to be at the Batallion level. HS football players need access to this kid of care, but that doesn't mean every HS football team needs it's own dedicated doctor. Is the volume of complaints (specifically complaints that a PA can't handle) really high enough to necessitate one FP per batallion?

Of course I have no experience here, but I've always heard that the main problem that Marine attached GMOs had with their job was that there just wasn't all that much to do.

 

[IgD]

Of course I have no experience here...

Well said🙂

 

[NavyFP]

I have a read from other forums PA forums and NWPA-S that the Navy and Air Force are currently offering HPSP scholarships to PA students. I guess the military got tired of doctors crying about the military's unfairness. How do you docs in misery feel about this?

Not sure why this should be a problem. Navy needs PAs too. They are still looking for a whole lot more docs.

 

[The White Coat Investor]

My firm belief is that every battalion needs a board certified FP physician. Marines are like professional athletes. They deserve and require the kind of medical care that a professional athlete receives throughout every phase of the deployment cycle.

That's an interesting concept. Maybe we should start assigning athletic trainers to battalions too. They could tape up every morning so they don't sprain their ankle while kicking in doors.

 

[gastrodoc]

At least in the Army each deployed brigade has a PT and at least 1 PT tech for the wraps and rehab.

I suspect the PA's you get from a civilian school would have a tougher time integrating with the trigger pullers. All the PA's I've met are former enlisted, usually a medic, frequently an SF medic. They know the system well and are planning on staying to retirement.

Having said that, anyone who wants to take a rotation in the sandbox is welcome to join up.

 

[IgD]

That's an interesting concept. Maybe we should start assigning athletic trainers to battalions too. They could tape up every morning so they don't sprain their ankle while kicking in doors.

Every battalion: FP physician, FP nurse practitioner, corpsmen, physical therapy tech, psych tech... Will be bored during peace time but mission critical at war time.

What do you think?

 

[FutureNavyFP]

On my first rotation I spent most of my time with an old Army medic turned PA. Great guy. I learned a ton working with him. He was better with his patients and did more proceedures than the other docs in the office. I think this would be a great answer to filling GMO's. Are there enough non-operational billets to let them rotate with so they don't have to stay operational for their whole career? 😕

 

[The White Coat Investor]

Every battalion: FP physician, FP nurse practitioner, corpsmen, physical therapy tech, psych tech... Will be bored during peace time but mission critical at war time.

What do you think?

Having deployed as part of a team that was "mission critical at war time" but actually sat on our asses for four months, I'm not sure that's the best solution. The military is generally over-prepared/equipped/staffed for what they will see in a deployed environment and under-prepared/equipped/staffed to do their non-combat role.

 

[IgD]

I think the other part of this is that the MTFs should be staffed by hospitalists and families should received primary care through the unit's aid station. This would improve the cohesion between the unit and families. Would this be a true community approach to healthcare delivery?

 

[73BARMYPgsp]

Having deployed as part of a team that was "mission critical at war time" but actually sat on our asses for four months, I'm not sure that's the best solution. The military is generally over-prepared/equipped/staffed for what they will see in a deployed environment and under-prepared/equipped/staffed to do their non-combat role.

This is a tough one in the philisophical sense. As a second ammendment fan, it reminds me of the "you can never have too many guns or too much ammo" argument. If I have a magazine that only holds ten rounds because of some stupid law, rest assured, one night 11 guys will break into my house, and I will not have enough. It is not a perfect analogy, I know. I am just bringing up the point that I would rather be over prepared than underprepared.

I also don't like wasting resources and taxpaer money either, so I guess it seems like striking the right balance is the thing.

 

[ILUvRVUs]

I think its a tough question in regards to who should be at the battalion level. As a GMO its hours/days/months of boredom followed by moments of terror. Both in the sandbox and MTF. Depending on the PA there are occasionally patients that a GMO should handle and the PA may not be able. Of course the same is true for the GMO versus attending physician.

As far as offering PA's HPSP scholarships.....awesome! 👍Bring it on. The majority of the PAs are mustangs going for retirement. They trade in their anchors and chevrons for a career that translates into civilian medicine. They are salty and I love working with them. However, they have similar complaints and are fustrated.

It will be interesting to see how PA's coming from a civilian school and HPSP pipeline adjust to military medicine.

 

[deleted6669]

no military experience myself(civilian medic before pa school) but I work with an army lt. col pa who is very well trained and respected. the military paid for his pa training after he proved himself as an sf medic. he's had tours in the gulf and a-stan as medical officer in charge as well as a few months in new orleans for katrina. flight surgeon and hyperbaric medicine rated. the guy is likely to be the army's 1st 1 star pa...it's in the cards...he's not even 40 yet...

 

[notdeadyet]

As a second ammendment fan, it reminds me of the "you can never have too many guns or too much ammo" argument. If I have a magazine that only holds ten rounds because of some stupid law, rest assured, one night 11 guys will break into my house, and I will not have enough.

If 11 guys break into your house one night, you don't need a bigger magazine, you need better locks.

 

[Perrotfish]

As a second ammendment fan, it reminds me of the "you can never have too many guns or too much ammo" argument. If I have a magazine that only holds ten rounds because of some stupid law, rest assured, one night 11 guys will break into my house, and I will not have enough.

I rememer, when taking my first basic firearms class, the teacher was a cop who strongly advocated civilians buy revolvers rather than semi-autos which would hold more ammo. The reason that he gave was that most civilians who get the chance to use their semi-auto in self-defense have a tendancy to get their thumb behind the chamber (because they´re in a panic) an cut halfway through their thumbs while shooting the intruder. As he put it ¨and if you ever need more than 6 bullets, it´s time for you to run´.

 

[73BARMYPgsp]

I rememer, when taking my first basic firearms class, the teacher was a cop who strongly advocated civilians buy revolvers rather than semi-autos which would hold more ammo. The reason that he gave was that most civilians who get the chance to use their semi-auto in self-defense have a tendancy to get their thumb behind the chamber (because they´re in a panic) an cut halfway through their thumbs while shooting the intruder. As he put it ¨and if you ever need more than 6 bullets, it´s time for you to run´.

That's pretty funny. My first auto was a Browning Hi-Power and when I took it to the range for the first time--I did exactly that. I shot about 4 rounds before I started asking "why does my thumb hurt like that?" Then I looked at it and a bunch of skin was missing from it. I just lowered my thumb and acted like nothing happened in front of my wife.

 

[73BARMYPgsp]

If 11 guys break into your house one night, you don't need a bigger magazine, you need better locks.

In a country where we still (thank God) have the basic right of self-defense, I disagree.

 

[MacGyver]

PAs competing for the HPSP is irrelevant, because as somebody else pointed out there arent too many suckers who are willing to be fooled into signing that contract and there are tons of open spaces every year.

However, the NHSC program is different. Unlike HPSP, its a highly competitive program and not everybody gets accepted. Over the past couple of decades, the NHSC has greatly expanded the number of people who can apply for it. Its not just PAs and NPs, its social workers, psychologists and god knows who else.

The net result is that the number of NHSC slots has remained flat while the categories of people applying for it has greatly expanded and it has essentially barred a lot of doctors from working in rural areas to get loan repayment.

 

[alpha62]

You're right. who they think they're fooling.

I don't care if you retire at 40 as 1 star general, your *** is going to a doc-in-box, or ER Fast Track and the most you'll ever make is around 150 K

I get quite a few ex-military come through, they just never seem to let go of the dog and pony show.

They also never really seem to get it's for profit outfit they've found themselves in and their productivity sucks because they've been nutured in a gov't system for 2 decades.

PAs competing for the HPSP is irrelevant, because as somebody else pointed out there arent too many suckers who are willing to be fooled into signing that contract and there are tons of open spaces every year.

However, the NHSC program is different. Unlike HPSP, its a highly competitive program and not everybody gets accepted. Over the past couple of decades, the NHSC has greatly expanded the number of people who can apply for it. Its not just PAs and NPs, its social workers, psychologists and god knows who else.

The net result is that the number of NHSC slots has remained flat while the categories of people applying for it has greatly expanded and it has essentially barred a lot of doctors from working in rural areas to get loan repayment.

 

[AFmedic2PAC]

Were you hoping for some kind of anti-PA diatribe here? Most of us think highly of the PAs we work with. A PA could (and does) do 1 of my 2 jobs and could have handled 98% of what I saw while deployed.

The fastest provider in my group is a PA (civilian.)

Thank you Sir/Ma'am. Team players ladies and gentlemen...

I would hope that intelligent professionals such as the Medical Corps Officers would recognize that the military is trying to fill a shortage to help the Sailors, Marines, Airmen and Soldiers. We are trying to meet a mission.

I realize that there are a lot of non-priors in HPSP and on this forum. I am talking about people that have never seen a combat zone or been down range without an attending or chief resident around and no Starbucks. To those persons I would say that I welcome you to see how the military utilizes PAs in forward locations and how PAs contribute to the management of pt panels in understaffed MTFs. If you really see what the new PA HPSP is trying to accomplish then you may develop a different perspective.

Semper Fi!

Navy PA-S HPSPer
Prior service military medic 11yrs.

 

[AFmedic2PAC]

PAs competing for the HPSP is irrelevant,

Are you implying that PAs and Docs compete for the same HPSP slots?
If you are then this is not accurate.

I was one of the first (ever) Navy HPSP Scholarship recipients. I can tell you that my designation is (1995X) not (1975X) which is the designator for Medical AFHPSP students. Therefore I did not "compete" for a slot with anyone else than other PA students.

A GMO-type slot is just fine with me. I have a three year commitment and am looking forward to getting as much experience as possible.👍

 

[dry dre]

PAs competing for the HPSP is irrelevant, because as somebody else pointed out there arent too many suckers who are willing to be fooled into signing that contract and there are tons of open spaces every year.

However, the NHSC program is different. Unlike HPSP, its a highly competitive program and not everybody gets accepted. Over the past couple of decades, the NHSC has greatly expanded the number of people who can apply for it. Its not just PAs and NPs, its social workers, psychologists and god knows who else.

The net result is that the number of NHSC slots has remained flat while the categories of people applying for it has greatly expanded and it has essentially barred a lot of doctors from working in rural areas to get loan repayment.

This is incorrect. There is no limit on physicians who can apply for working in qualifying loan repayment sites. The amount of funding for the program is, though, limited, and only the sites in most need will have funding. This is a function of money available in this specific program, not a function of "how many med school NHSC scholarships are available."

If you research the issue of loan repayment in exchange for working in medically underserved areas (or even non-underserved areas) you'll find that there is plenty of sources available that offer repayment (e.g. tribal/IHS, state/local gvmt).

NHSC scholar recipients have their med school paid for and thus should have less, if any, loans to be repayed in the first place.

 

[pgg]

Every battalion: FP physician, FP nurse practitioner, corpsmen, physical therapy tech, psych tech... Will be bored during peace time but mission critical at war time.

What do you think?

I think they'd be bored on deployment too. I've posted my opinions on this before, but here they are again, broken down differently.

There are a few broad categories of patient care that need to be delivered at the battalion level.

• Basic, uncomplicated, non-emergent sick call. Sprained ankles. URIs. Rashes. These can all be handled by an IDC, PA, or nurse practitioner. The worst that can happen here is that something serious could get blown off as nothing ... but one thing midlevels are good at is watching for red flags and turfing care to a physician. If we trust civilian PAs to appropriately consult physicians at the local ER, we can trust PAs to do military sick call at home or abroad.
• Trauma. At the battalion level, 100% of nontrivial trauma is stabilization and packaging for transfer to echelon 2 (or 3). You need good Corpsmen in the field for this, and not much more. It'd be helpful but not essential to have someone IDC-level or above at the BAS level to direct triage or throw in the occasional chest tube prior to putting them on a helicopter.
• MEDCAPs, free clinics for the locals, hearts & minds missions. This stuff simply shouldn't be done at the battalion, or even the regimental level. This is a task-force level job for civil affairs people and public health specialists. If anything, doctors at the battalion level just give commanders an inflated sense of medical capability.
• Staff meetings, supply issues, training of Corpsmen. You don't need a doctor for this.

After 14 months in Afghanistan and Iraq as a GMO with a Marine infantry battalion, I am not convinced that I did anything that couldn't have been done by a good PA.

Anyone who was sick, or who just looked sick, got seen by colocated board certified physicians, or medevac'd if I was the most senior medical guy present. Anyone who was wounded was triaged through the FRSS, or if I was alone, medevac'd if I had the slightest concern about anything.

Battalion surgeon is an archaic title that probably dates back to the time when barbers with butcher smocks did field amputations with wood saws. The line has clued in to the fact that we don't need surgeons at the battalion level, and they need to take the next step and understand that we don't need board certified primary care physicians there, either.

Maybe - just maybe - if battalion sized units were being sent off alone, to isolated areas without nearby support or the ability to call in a quick medevac, then it would make sense to have a doctor assigned to the unit. But that's not the way the modern US military works. We have radios, and echelon 2 is always a short flight away. Doctors at the battalion level are an unnecessary use of a scarce resource.

 

[FutureNavyFP]

Maybe - just maybe - if battalion sized units were being sent off alone, to isolated areas without nearby support or the ability to call in a quick medevac, then it would make sense to have a doctor assigned to the unit. But that's not the way the modern US military works. We have radios, and echelon 2 is always a short flight away. Doctors at the battalion level are an unnecessary use of a scarce resource.

Excellent points. Thank you. 🙂

I hear talk of replacing these billets with board cert. guys. Any wind of simply eliminating some of the billets all together?

 

[pgg]

Excellent points. Thank you. 🙂

I hear talk of replacing these billets with board cert. guys. Any wind of simply eliminating some of the billets all together?

What seems more likely to me is that rather than eliminating those billets, they just won't fill them until the unit deploys. Two physicians per battalion is a huge luxury while in garrison (especially since responsibility for med boards was shifted away from GMOs).

This is how the Navy handles Corpsman shortfalls ... in garrison, we'd be lucky to have 40 of the specified 65 Corpsman, but a couple weeks before we go, 20 or 25 lucky guys get yanked from clinic duty at a medcen, issued brown uniforms, and join us for the deployment. Upon returning, within days they're returned to their parent commands.

One thing I failed to mention in my post was that for USMC infantry battalions, GMOs are not responsible for any dependents. I've heard some non-USMC GMOs get roped into doing primary care for dependents (including kids) ... that's an area that probably deserves an FP doc. So if it wasn't clear, my statement that physicians aren't needed at the battalion level assumes that a 4-year-old LCPL Jr won't be getting his fever checked out after dad's ingrown toenail visit.

 

[AFmedic2PAC]

pgg:

Can you (or anyone else) please elaborate more on what your experiences have been with Navy PAs both CONUS and on overseas deployments?
I am prior AF so most of my experiences in milmed have been with AF and Army PAs. Thank you.