Military Physician Shortage

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SeminoleFan3

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DoD Physician Shortage May Cause Lapse in Patient Access to Care

Not surprising I guess considering retention never seems to be on their radar.

Also, I like how med students are in here saying their recruiters are telling them quotas have been met. Judging by the article, no service has met their quotas in years.

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The real gem is they couldn't criticize retention efforts because there wasn't enough data to analyze anything.

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Yeah, if only there were some way to determine retention rates. But, I guess we’ll never know.
 
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I thought that DoD was so able and willing to let their docs walk because they refill their numbers from HPSP/USUHS every year. Seems this is not the case.
 
Recruiting is the wrong tree to be barking up.

Obviously the shortages are not evenly distributed among all specialties. But unless and until HPSP and USUHS accessions are funneled into particular specialties against their will (and that can't happen), a shortage in specialty X can only be solved by recruiting or retaining physicians who are already trained in specialty X.

The answer is obvious. They just can't or won't spend the money to attract or retain already-trained physicians. It's especially absurd because a flexible mechanism already exists for doing so and they don't/won't use it: medical special pays.

With the exception of FM and IM (whose ISP was increased from $12K to $15K a few years ago) there hasn't been a single cent adjusted in any medical special pay in what, 25 or 30 years?

There is either no problem, or no interest in fixing it.
 
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That had always been my contention. It’s not even the money. As negative as I am about milmed, they could have gotten me to stay, and be positive about it, pretty easily and with very little expense. I think a lot of the guys I know who left feel the same. What makes it so absurd is just that: it would be easy and cheap to retain a lot of people, but they still don’t try. If they had to increase salaries by $100k, I would at least understand the reluctance to do it. But they don’t, in my opinion. Yes, that -would- increase retention, but if they’d just spend 2 minutes listening to why people are unhappy they could make a legitimate difference before they even got to pay.
 
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The ten recs (really 3 recs x3) are beyond pointless. The fact that USUHS couldn’t tell the GAO what it costs is classic.mil. Accessions as the source of specialty mismatch totally misses the point. Silly
 
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Flight pay scale hasn’t changed in 20 years either. Pretty silly.
 
From what I've seen in the Navy, it seems like a lot of specialties are 'overmanned'. And promotion to O-5, O-6 is dismal. That doesn't strike me as a shortage, that strikes me as a surplus (again, totally specialty dependent). What am I missing? [by comparison: promotion to O-5, O-6 in the dental corps is ~80%, they seem to be short at those ranks]
 
I’m not usually one to buy into conspiracies but this, along with other recent articles warning service members that the DoD could no longer promise care in the ‘golden hour’, just reeks of propaganda to me. Seems like government is starting the process of lowering expectations so when they gut MHS and civilianize it completely to the point where we barely have a ready medical force to support if/when we need to send our guys into another bad situation like Iraq or Afghanistan quickly. Seems like a concerted effort to make the military members and anyone else who is paying attention ‘okay’ with that.
 
I’m not usually one to buy into conspiracies but this, along with other recent articles warning service members that the DoD could no longer promise care in the ‘golden hour’, just reeks of propaganda to me. Seems like government is starting the process of lowering expectations so when they gut MHS and civilianize it completely to the point where we barely have a ready medical force to support if/when we need to send our guys into another bad situation like Iraq or Afghanistan quickly. Seems like a concerted effort to make the military members and anyone else who is paying attention ‘okay’ with that.
I don't know it's that much of a 'conspiracy'. By its nature, a military (and all of its support structure) tends to deescalate during peacetime. Ours did so after the Civil War, after WWI, WWII, etc. It's only in relatively-recent history (last 40-50 years or so) that we've maintained a sizable active duty force in the absence of a large conflict. How exactly to support that persistent AD force is always a question of debate (and this debate occurs in every support community: medical, legal, supply, etc).
 
Unfortunately, instead of this being a study that helps promote increases in IP to increase retention, etc. etc., this will likely just prove to DOD that the set "authorization levels" for funded positions during that time were too high and inappropriate anyway. Numbers will likely remain the same overall but there will be a shift from over-manned specialties to the unmanned critical wartime ones.
 
I thought reducing the number of active-duty physicians to only those necessary for readiness and support of operations and contracting out everything else was one of the goals set in the NDAA?
 
I thought reducing the number of active-duty physicians to only those necessary for readiness and support of operations and contracting out everything else was one of the goals set in the NDAA?

It is, but for the Navy at least, the initial gouge was that OVERALL number of MC officers will remain the same but the numbers within each specialty will be lateral moved to meet MEDMACRE estimates for operational needs.
 
Currently deciding what to do with my usuhs acceptance, with particular interest to the 2017 NDAA. The way I read part of it, any position that can be filled for less money by a civilian will be dissolved... So 4 years from now, will the military match be very different than it is today? Would I still be able to (sort of) choose any specialty I want? I'm concerned about how this will affect military GME.
 
So 4 years from now, will the military match be very different than it is today?

Pure speculation, but no. If military medicine were DRASTICALLY changing/shrinking for new applicants I think you would initially see decreased numbers of HPSP spots available to new applicants and then also decreased numbers/funding to USUHS. There will be changes in number of total billets for each specialty which could decrease your chances of getting a certain spot (i.e. not a critical wartime specialty), but there will likely still be spots available for every specialty to some extent. But again, nobody can tell you for sure...probably not even Admiral Bono if she was being perfectly honest with you.
 
Pure speculation, but no. If military medicine were DRASTICALLY changing/shrinking for new applicants I think you would initially see decreased numbers of HPSP spots available to new applicants and then also decreased numbers/funding to USUHS. There will be changes in number of total billets for each specialty which could decrease your chances of getting a certain spot (i.e. not a critical wartime specialty), but there will likely still be spots available for every specialty to some extent. But again, nobody can tell you for sure...probably not even Admiral Bono if she was being perfectly honest with you.

I have heard some early rumors (probably like a 2-3 out of 10 on the “this is the real deal” scale) that the GME programs may be truly integrated in the very near future. For example General Surgery at Balboa would be open to Army, Navy, and Air Force applicants.


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If they had to increase salaries by $100k, I would at least understand the reluctance to do it. But they don’t, in my opinion. Yes, that -would- increase retention, but if they’d just spend 2 minutes listening to why people are unhappy they could make a legitimate difference before they even got to pay.

Ask and ye shall receive: The most recent MC Newsletter includes a link to a physician survey.
 
Ask and ye shall receive: The most recent MC Newsletter includes a link to a physician survey.
I’m sure they’ll follow through with even a few of the suggestions, right? There have been surveys in the past. Many surveys. Many good surveys that ultimately are summarily ignored, or at least misinterpreted.
 
This all depends on the specialty, as others have said. Primary care is overmanned or at least manned to the levels they want. My specialty is about 40% and we are hurting, unable to cover the billets we have let alone the medmacare levels which are out of control.

I disagree that pay is appropriate. They need to redo bonuses as they aren’t realistic to the current market and people are bouncing at the first opportunity for fat contacts and a life free of military admin.

What I’m seeing on the ground is that DHA is having a very difficult time replacing contractors and GS that have been holding the line at medcens for years and are now retiring. GS physican pay in my specialty is just not competitive and it’s a pain to get a new hire. Contractors bounce around and often leave quickly. This is also a problem in nursing and mid level hiring.
 
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