Navy FP Questions

[SF49ers Fan]

I have a couple of questions about practicing family medicine in the navy:

1. I have been told by some that Navy FP programs teach heavy in proceedures. Surgery, scopes, etc.. Is this true, and do you get a chance later in operational billets, clinics, or elsewhere to maintain these skills?

2. Are there any FP residency programs that may be more family friendly than others?

3. Has anyone done a tour overseas as a FP doc?

Thanks a bunch

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[NavyFP]

I have a couple of questions about practicing family medicine in the navy:

1. I have been told by some that Navy FP programs teach heavy in proceedures. Surgery, scopes, etc.. Is this true, and do you get a chance later in operational billets, clinics, or elsewhere to maintain these skills?

2. Are there any FP residency programs that may be more family friendly than others?

3. Has anyone done a tour overseas as a FP doc?

Thanks a bunch

1. Yes, they are heavy in procedures. If you are willing to work at it, you can keep up with them.

2. They are all pretty family friendly.

3. I have.

 

[simpleman]

Dr. NavyFP

I just want to thank you for all your responses in regards with Navy questions. You open my mind to many things and you are always prompt in your replies. I appreciate your time in typing out the responses to everything.

~Simpleman

1. Yes, they are heavy in procedures. If you are willing to work at it, you can keep up with them.

2. They are all pretty family friendly.

3. I have.

 

[SF49ers Fan]

1. Yes, they are heavy in procedures. If you are willing to work at it, you can keep up with them.

2. They are all pretty family friendly.

3. I have.

NavyFP,

With regards to your tour overseas:

1. Where did you do it?
2. Did you have a good/poor experience?
3. Would you recommend it over some other operational billets like ship or marines?

Thank you for your input.

 

[FutureNavyFP]

With GMO billets going to FP/IMs does this mean that all of the good FP billets are going to be outsourced to civilians?

 

[NavyFP]

With GMO billets going to FP/IMs does this mean that all of the good FP billets are going to be outsourced to civilians?

I seriously doubt it. What I envision is more of an augmentee program. We will have FPs in the clinics doing full spectrum FP work and augmenting units as they deploy. I see a 75% clinical/ 25% operational split. The unit readiness will still be done by the IDCs and senior enlisted and an MSC providing admin support.

There was a move a few years ago to outsource stateside billets and it proved a disaster. Those that could be hired were on average, frightening and many active duty voted with their feet and got out.

Senior leadership recognizes (or at least pays lip service) to the idea that there needs to be a balance.

 

[FutureNavyFP]

I seriously doubt it. What I envision is more of an augmentee program. We will have FPs in the clinics doing full spectrum FP work and augmenting units as they deploy. I see a 75% clinical/ 25% operational split.

Is this kind of like how fleet hospital units work or maybe airwing detachments (I'm not exactly sure about any specifics)? I spoke to a couple of docs (nonFP's) in norfolk, VA assigned to fleet hospital spots and it seemed like they just stayed stateside until it was their turn to deploy overseas.

Would your model be like: Several docs in the clinic, each assigned to a team, and when it's time for their team to go operational, then they deploy? Meanwhile, keeping the numbers perminently assigned to operational units low?

 

[NavyFP]

Is this kind of like how fleet hospital units work or maybe airwing detachments (I'm not exactly sure about any specifics)? I spoke to a couple of docs (nonFP's) in norfolk, VA assigned to fleet hospital spots and it seemed like they just stayed stateside until it was their turn to deploy overseas.

Would your model be like: Several docs in the clinic, each assigned to a team, and when it's time for their team to go operational, then they deploy? Meanwhile, keeping the numbers perminently assigned to operational units low?

In a broad sense, yes.

 

[FutureNavyFP]

According to the AAFP there are only 7 current PGY-2s and 9 PGY-3s (out of 12 positions each year) at Jax FP residency program. Does anyone know if these numbers are correct? If they are, why is Jax having such a hard time filling their FP spots? The rest of the Navy's FP residency programs seem to be filled (according to the AAFP website).

http://www.aafp.org/residencies/520810002.html

http://www.aafp.org/residencies/us.html

 

[NavyFP]

According to the AAFP there are only 7 current PGY-2s and 9 PGY-3s (out of 12 positions each year) at Jax FP residency program. Does anyone know if these numbers are correct? If they are, why is Jax having such a hard time filling their FP spots? The rest of the Navy's FP residency programs seem to be filled (according to the AAFP website).

http://www.aafp.org/residencies/520810002.html

http://www.aafp.org/residencies/us.html

Part of the problem is that interest in FM has lagged over the last few years and Jax has been the least popular spot. (why I am not sure as it is a great program).

 

[Gastrapathy]

Part of the problem is that interest in FM has lagged over the last few years and Jax has been the least popular spot. (why I am not sure as it is a great program).

JAX is less popular than Lejeune? Amazing.

 

[FutureNavyFP]

I noticed that only 4 of 6 internship spots were filled this year for Camp Lejeune. Does this mean that life will suck for them and call will be horrendous? Will they try and fill the empty spots with civilians?

 

[IgD]

We will have FPs in the clinics doing full spectrum FP work and augmenting units as they deploy.

Are you saying operational units should not have an embedded/organic physician? I suggest its important for a physician to be part of the unit. The physician and unit need time to build a relationship and trust to be effective. The physician needs to be in tune to how the unit operates. If healthcare personnel show up halfway through pre-deployment training that is not the optimal solution.

There was a move a few years ago to outsource stateside billets and it proved a disaster. Those that could be hired were on average, frightening and many active duty voted with their feet and got out.

Is this policy still in place? Many of my colleagues have left the military to take more lucrative GS or contracting positions at the MTFs while the remaining uniformed providers are going on more deployments. I saw a recent position paper from the Army that suggested hiring contract medical officers for deployment!

 

[BOHICA-FIGMO]

Okay, NavyFP...a few more questions related to, well, Navy FP. First, how much OB, how much peds, and how much inpatient care do Navy FPs do? Thanks in advance again!

 

[NavyFP]

I noticed that only 4 of 6 internship spots were filled this year for Camp Lejeune. Does this mean that life will suck for them and call will be horrendous? Will they try and fill the empty spots with civilians?

All the slots were filled. Resiterns don't show up on the list.

Are you saying operational units should not have an embedded/organic physician? I suggest its important for a physician to be part of the unit. The physician and unit need time to build a relationship and trust to be effective. The physician needs to be in tune to how the unit operates. If healthcare personnel show up halfway through pre-deployment training that is not the optimal solution.



Is this policy still in place? Many of my colleagues have left the military to take more lucrative GS or contracting positions at the MTFs while the remaining uniformed providers are going on more deployments. I saw a recent position paper from the Army that suggested hiring contract medical officers for deployment!

I agree that being apart of the unit is important, but so is keeping up skills. The basic admin of the unit's medical department does not need to be done by a doc. There will need to be a happy mix between the two.

Okay, NavyFP...a few more questions related to, well, Navy FP. First, how much OB, how much peds, and how much inpatient care do Navy FPs do? Thanks in advance again!

All of the answers depend on where you are stationed. If you are attached to a hospital, you will do 2-10 deliveries per month, a decent mix of kids and 1 week on the inpatient service rotated with the other FPs at the hospital. At a clinic, it will depend on who is enrolled, but you should still get a decent mix. I have been stationed at clinics that were all active duty and I would go to another military hospital to get peds and OB. If it is important to you, you can find a way to get the patient mix you need.

 

[IgD]

I agree that being apart of the unit is important, but so is keeping up skills. The basic admin of the unit's medical department does not need to be done by a doc. There will need to be a happy mix between the two.

The base admin of the units is not done by the physician. It's done by the chiefs. I really hope you aren't suggesting removing the physician from the operational unit!!

 

[NavyFP]

The base admin of the units is not done by the physician. It's done by the chiefs. I really hope you aren't suggesting removing the physician from the operational unit!!

Oh no, but we can change the method of practice to add the units family members, give docs some hospital time, rather than doing unit sick call. When I was in Oki, thats what I did.

 

[FutureNavyFP]

All the slots were filled. Resiterns don't show up on the list.

Are resiterns guys coming from GMO tours that are redoing their internship year?

 

[NavyFP]

Are resiterns guys coming from GMO tours that are redoing their internship year?

yes

 

[IgD]

The other part of this is that the battalion FP physician should provide medical care for dependents in garrison. This would create better unit/family cohesion...