New Medical Corps Special Pay Guidance?

[pgg]

Any believable rumors on this year's changes? Anyone care to place bets on what those changes will be?

Last year's NDAA raised the ceilings on authorized medical pays, but as is always the case, actual implementation was left to the services. And historically, the services have not always chosen to do everything Congress has permitted. A year ago, there were essentially no changes, but there was an expectation that this year there would be increases.

Specific speculation 🙂 was that BCP was going to increase to $15K. Optimistic people are hoping that since the ceilings were doubled, IP would double too. I figure there might be some modest, targeted increases to certain specialties, but I'm skeptical that there will be large across the board increases.

IP increases for everyone?
IP increases for war-bucket specialties?
IP increases ... but only if associated with a RB?
Non-war-bucket specialty force shaping via elimination of longer RB contract options?
Sad trombone?

---

Members don't see this ad.

 

[DrMetal]

And historically, the services have not always chosen to do everything Congress has permitted. A year ago, there were essentially no changes, but there was an expectation that this year there would be increases.

Why is that? If Congress allows you the raise, why wouldn't the services implement it? (If the the owner of a company allows the manager to pass out raises, and he passes out nothing, that'd be pretty screwed up!) Are we that self-loathing?!

 

[armytrainingsir]

Why is that? If Congress allows you the raise, why wouldn't the services implement it? (If the the owner of a company allows the manager to pass out raises, and he passes out nothing, that'd be pretty screwed up!) Are we that self-loathing?!

I think it is more like the company allocates extra money and allows managers to spend the extra money on either raises OR new manager perks. So guess which one wins?

 

[pgg]

Why is that? If Congress allows you the raise, why wouldn't the services implement it? (If the the owner of a company allows the manager to pass out raises, and he passes out nothing, that'd be pretty screwed up!) Are we that self-loathing?!

Congress permitting something doesn't mean Congress allocated additional funds to actually do it.

Example, 10+ years ago there was such a thing as ECISP ("early career incentive special pay") which was a way to sign a MSP contract before you had the required 8 years of service. This was "authorized" but to my knowledge never actually implemented by any of the services. And that was simply shifting money the physician was going to get anyway to the left by 18 months, not allocating new funds.

8 or 10 years back when they increased the ISP for FP and IM from $12K to $20K that money came from some budget, somewhere. I don't know how they did it. I think that ultimately the services will have to decide which budget BCP/IP increases will come from, if they choose to increase BCP/IP across the board.

Caveat - I have no special insight into this process. I hope everyone gets a well deserved and very long overdue raise. I also hope nobody's spent that pay raise money yet ...

 

[residentphysician20]

I have a quick question for special pay in general - when exactly do we start getting them?

My understanding is that it will not show up on our paycheck/LES until 90 days after graduation from residency. Does this mean we won't get special pay until Oct 1st? In other words, we will make 'resident pay' for the first three months of being an attending?

Reason I am asking is that I know a few people who completed residency this June, and that a few of them said they started getting their full attending-level special pay as soon as they arrived at their new duty station in July. Others however are still waiting. So is it location dependent on when the exact start date is? I thought it would be a consistent army-wide policy of starting the special pay in October.

 

[SirGecko]

I have a quick question for special pay in general - when exactly do we start getting them?

My understanding is that it will not show up on our paycheck/LES until 90 days after graduation from residency. Does this mean we won't get special pay until Oct 1st? In other words, we will make 'resident pay' for the first three months of being an attending?

Reason I am asking is that I know a few people who completed residency this June, and that a few of them said they started getting their full attending-level special pay as soon as they arrived at their new duty station in July. Others however are still waiting. So is it location dependent on when the exact start date is? I thought it would be a consistent army-wide policy of starting the special pay in October.

You don’t get your specialty incentive pay till October. You can get the gmo incentive pay in the interim. (So higher than resident pay but not the full incentive pay, this may be the source of the confusion where some of the people you know thought they were getting their full attending pay) Both are predicated on you actually submitting a request for the pay to pers.

 

[residentphysician20]

You don’t get your specialty incentive pay till October. You can get the gmo incentive pay in the interim. (So higher than resident pay but not the full incentive pay, this may be the source of the confusion where some of the people you know thought they were getting their full attending pay) Both are predicated on you actually submitting a request for the pay to pers.

Thanks for the info. That GMO incentive pay does make sense...

Regarding the request for special pay part - is this just another contract you have to sign and then forward to finance for them to process? In residency, we have to sign a contract every year to keep getting our version of special pay - so I am assuming it'll be the same process once we become attendings.

 

[Trefoil]

As an FYI for any Army docs reading this, the policy has been updated for the Army. You are entitled to special pay as soon as you are credentialed at your duty station. It won’t arrive for a month, but you should get back pay.

 

[SirGecko]

As an FYI for any Army docs reading this, the policy has been updated for the Army. You are entitled to special pay as soon as you are credentialed at your duty station. It won’t arrive for a month, but you should get back pay.

Is there an instruction that says this? My understanding is the three months is in the DOD instruction so I would be curious to see where the Army is saying something different.

 

[SirGecko]

Btw the special pays guidance for FY2022 is up on DFAS. (Navy specific memo still pending but should be the same)

Special Pays

I believe it’s essentially unchanged. Only difference is how the structure of the 4 and 6 year retention bonuses work for the specialties that used to have a higher IP associated with those RP. (The rate is now contained entirely in the RP)

 

[pgg]

I don't see Board Certified Pay listed anywhere. Did I miss it? We were told that was going to increase (from $6K to $15K?) for everyone.

I can't say I'm surprised that the services elected not to increase physician pay to make up for 30+ years of stagnant losses to inflation. The money would've had to come from somewhere.

 

[militaryPHYS]

I don't see Board Certified Pay listed anywhere. Did I miss it? We were told that was going to increase (from $6K to $15K?) for everyone.

I can't say I'm surprised that the services elected not to increase physician pay to make up for 30+ years of stagnant losses to inflation. The money would've had to come from somewhere.

Still says this:

050502. Amount The annual amount payable is $6,000, to be prorated monthly


womp womp womp

 

[pgg]

Still says this:

050502. Amount The annual amount payable is $6,000, to be prorated monthly


womp womp womp

That's from the linked PDF that has the blue text proclaiming it was last updated in 2019 ... I don't know what to make of that.

 

[militaryPHYS]

That's from the linked PDF that has the blue text proclaiming it was last updated in 2019 ... I don't know what to make of that

Ah yeah. Missed that. Sorry.

 

[Trefoil]

Is there an instruction that says this? My understanding is the three months is in the DOD instruction so I would be curious to see where the Army is saying something different.

I don’t know where the specific update was listed, but I know that last year everyone started getting paid based on when they received credentialing at the hospital.

 

[Chonal Atresia]

I don't see Board Certified Pay listed anywhere. Did I miss it? We were told that was going to increase (from $6K to $15K?) for everyone.

I can't say I'm surprised that the services elected not to increase physician pay to make up for 30+ years of stagnant losses to inflation. The money would've had to come from somewhere.

While I completely agree with you that physician pay in the military is a joke (especially since incentive pay has not meaningfully increased in over 30 years), nobody is making you stay in and accept this blatant disrespect for your skills.

You could have/can leave at any time. I suspect that the “pension carrot” has kept you in for at least 20. Speak with your feet as they say.

While the pension is significant ($50k/yr for 35+ years on average), missing your prime earning years (late 30s to late 40s) by staying in an organization that woefully underpays/undervalues you is masochistic.

My anesthesia colleagues easily make $500k +/yr while my ortho colleagues almost all are over $1M/yr. They work their tails off but are rewarded for it. There is no financial reward on active duty, just hard feelings.

 

[pgg]

While I completely agree with you that physician pay in the military is a joke (especially since incentive pay has not meaningfully increased in over 30 years), nobody is making you stay in and accept this blatant disrespect for your skills.

You could have/can leave at any time. I suspect that the “pension carrot” has kept you in for at least 20. Speak with your feet as they say.

While the pension is significant ($50k/yr for 35+ years on average), missing your prime earning years (late 30s to late 40s) by staying in an organization that woefully underpays/undervalues you is masochistic.

My anesthesia colleagues easily make $500k +/yr while my ortho colleagues almost all are over $1M/yr. They work their tails off but are rewarded for it. There is no financial reward on active duty, just hard feelings.

Don't worry about me.

Most of the last 10 years moonlighting has added $150-200K to supplement the $250Kish Navy 4yr RBs. Also was able to do a FTOS fellow year making $250K (vs $70-80K civilian going rate) while accruing credit toward the ~$1.5M pension I'll start collecting in 220 days. Making $400-450K/year while ticking closer to the 20-year pension (plus USUHS kicker) isn't awful. Sure, I wish the Navy paid a fair market wage all by itself.

The opportunity to serve is worth something too. How much is obviously subjective but it's equally obvious we value that opportunity differently.

I know you're incredulous that anyone could possibly have had a good experience as a military physician.

I had the option of getting out 8 years ago and being one of those $500K tail-off-working anesthesiologists you know, but it was clear I'd come out ahead by staying in and working fewer hours on the whole, between the "full time" military job and part time moonlighting jobs.

(The only real caveat there is the deployment burden, something unique to the military, but that's a part of the deal I've never really had any trouble accepting.)

Yes, I'm annoyed by the DFAS pay scales for physicians. It is insulting. No disagreement there. There are dozens of other ways the military shows that it doesn't value physicians, ranging from the trivial (no physician parking) to the serious (inadequate support staff).

But that's not why I'm getting out. I'm getting out because I've passed my threshold of deployment tolerability, because the Navy got rid of my subspecialty and moonlighting has become a must instead of a nice diversion, and because not taking the pension and leaving the day I'm eligible to take it is actually a massive pay cut.

I'm out in 220 days and joining an awesome private group where (get a load of this!) I will earn about $200K/year less than I would have at another superb group that offered a me a position. But the practice is a better fit for me, and money ... isn't ... everything.

I'm glad you're making bank being respected at your gig and selling hearing aids on the side. I reserve the right to gripe about the annoyances and disadvantages of military service, but don't worry, I'll be all right.

 

[Chonal Atresia]

Don't worry about me.

Most of the last 10 years moonlighting has added $150-200K to supplement the $250Kish Navy 4yr RBs. Also was able to do a FTOS fellow year making $250K (vs $70-80K civilian going rate) while accruing credit toward the ~$1.5M pension I'll start collecting in 220 days. Making $400-450K/year while ticking closer to the 20-year pension (plus USUHS kicker) isn't awful. Sure, I wish the Navy paid a fair market wage all by itself.

The opportunity to serve is worth something too. How much is obviously subjective but it's equally obvious we value that opportunity differently.

I know you're incredulous that anyone could possibly have had a good experience as a military physician.

I had the option of getting out 8 years ago and being one of those $500K tail-off-working anesthesiologists you know, but it was clear I'd come out ahead by staying in and working fewer hours on the whole, between the "full time" military job and part time moonlighting jobs.

(The only real caveat there is the deployment burden, something unique to the military, but that's a part of the deal I've never really had any trouble accepting.)

Yes, I'm annoyed by the DFAS pay scales for physicians. It is insulting. No disagreement there. There are dozens of other ways the military shows that it doesn't value physicians, ranging from the trivial (no physician parking) to the serious (inadequate support staff).

But that's not why I'm getting out. I'm getting out because I've passed my threshold of deployment tolerability, because the Navy got rid of my subspecialty and moonlighting has become a must instead of a nice diversion, and because not taking the pension and leaving the day I'm eligible to take it is actually a massive pay cut.

I'm out in 220 days and joining an awesome private group where (get a load of this!) I will earn about $200K/year less than I would have at another superb group that offered a me a position. But the practice is a better fit for me, and money ... isn't ... everything.

I'm glad you're making bank being respected at your gig and selling hearing aids on the side. I reserve the right to gripe about the annoyances and disadvantages of military service, but don't worry, I'll be all right.

Sounds like you made the military work - hats off to you.

My military experience was very different. As I have said in the past, I was almost forced into a brigade surgeon position (army) 11 years ago through blatant deceit of my specialty leader. When I expressed my concerns about skill atrophy for 2 years as a subspecialty surgeon, it fell on deaf ears (the two year tour would have ended at the end of my ADSO making securing a civilian job impossible). My career was only saved through the action of a future President of USUHS (I’m sure you can figure out who that is).

I see how the military now dumps dependent, retiree and even some active duty patients into the “network” after previously promising to take care of them. When I try and get records, no one responds to my inquiries. When I try to send records back (notes, pathology, op resorts), there is no one to receive them.

Hard to respect respect an institution like this.

 

[residentphysician20]

Sounds like you made the military work - hats off to you.

My military experience was very different. As I have said in the past, I was almost forced into a brigade surgeon position (army) 11 years ago through blatant deceit of my specialty leader. When I expressed my concerns about skill atrophy for 2 years as a subspecialty surgeon, it fell on deaf ears (the two year tour would have ended at the end of my ADSO making securing a civilian job impossible). My career was only saved through the action of a future President of USUHS (I’m sure you can figure out who that is).

I see how the military now dumps dependent, retiree and even some active duty patients into the “network” after previously promising to take care of them. When I try and get records, no one responds to my inquiries. When I try to send records back (notes, pathology, op resorts), there is no one to receive them.

Hard to respect respect an institution like this.

Sorry to butt into the conversation, but if you are assigned as a "battalion surgeon" or other position with a line unit as an attending, will you still receive your special pay?

I believe hospital credentialing is the requirement for the special pay, so if your job doesn't require credentialing, does it mean you forfeit your special pay? I am concerned given the overall trend of assigning physicals to line units.

 

[DrMetal]

Btw the special pays guidance for FY2022 is up on DFAS. (Navy specific memo still pending but should be the same)

Special Pays

I believe it’s essentially unchanged. Only difference is how the structure of the 4 and 6 year retention bonuses work for the specialties that used to have a higher IP associated with those RP. (The rate is now contained entirely in the RP)

we still have to wait for the NAVADMIN to come out before submitting anything, right?

 

[SirGecko]

we still have to wait for the NAVADMIN to come out before submitting anything, right?

Yes

 

[Chonal Atresia]

Sorry to butt into the conversation, but if you are assigned as a "battalion surgeon" or other position with a line unit as an attending, will you still receive your special pay?

I believe hospital credentialing is the requirement for the special pay, so if your job doesn't require credentialing, does it mean you forfeit your special pay? I am concerned given the overall trend of assigning physicals to line units.

When I was active duty from 2007-14, all positions with line units (battalion, brigade and division surgeons) still received all eligible special pays.

Not sure what the current policy is.

 

[residentphysician20]

When I was active duty from 2007-14, all positions with line units (battalion, brigade and division surgeons) still received all eligible special pays.

Not sure what the current policy is.

That would make sense. I am not aware of any changes in policy, but then again I know very little about policies, etc.

 

[militaryPHYS]

That would make sense. I am not aware of any changes in policy, but then again I know very little about policies, etc.

As long as you maintain your credentials to practice in your specialty then you receive special pays. Any operational tour will allow you to still maintain your credentials to practice. Maintaining surgical skills or sub-specialty skills? Often times no...but at least you'll still have your credentials 🙂

 

[pgg]

Sorry to butt into the conversation, but if you are assigned as a "battalion surgeon" or other position with a line unit as an attending, will you still receive your special pay?

I believe hospital credentialing is the requirement for the special pay, so if your job doesn't require credentialing, does it mean you forfeit your special pay? I am concerned given the overall trend of assigning physicals to line units.

Getting specialty pay is never an issue, barring clerical errors. 🙂 Everyone maintains credentials at the local military hospital or clinic. ("Never" and "everyone" are perhaps overstating things. I'm sure there's someone out there who didn't but that person is a rare outlier.)

The larger problem is maintaining a sufficient volume of practice when in those positions. For my current department, we have perhaps a dozen people who are part timers because they are assigned to operational units nearby. They come work with us a day or maybe two per week, sometimes less. It varies a lot. Some specialties are easier or harder to do irregular part-time work in - my specialty, anesthesiology, is really easy to squeeze in random days. It's much harder for surgeons or other specialties that are dependent upon some degree of continuity of care and clinic visits.

The challenge with these operational billets isn't getting paid, but rather skill atrophy. It's a hard problem. The army, navy, and air force approach it differently and honestly there's no easy solution.

 

[Trefoil]

Getting specialty pay is never an issue, barring clerical errors. 🙂 Everyone maintains credentials at the local military hospital or clinic. ("Never" and "everyone" are perhaps overstating things. I'm sure there's someone out there who didn't but that person is a rare outlier.)

The larger problem is maintaining a sufficient volume of practice when in those positions. For my current department, we have perhaps a dozen people who are part timers because they are assigned to operational units nearby. They come work with us a day or maybe two per week, sometimes less. It varies a lot. Some specialties are easier or harder to do irregular part-time work in - my specialty, anesthesiology, is really easy to squeeze in random days. It's much harder for surgeons or other specialties that are dependent upon some degree of continuity of care and clinic visits.

The challenge with these operational billets isn't getting paid, but rather skill atrophy. It's a hard problem. The army, navy, and air force approach it differently and honestly there's no easy solution.

Congrats! Sounds like you made the best of the situation. Moonlighting is certainly possible, but there is a diminishing return to some degree. In my field, it’s easiest to moonlight for a skill that we can easily maintain in the military, so it really doesn’t make sense to moonlight unless you are interested in making more money at the expense of leave and increase administrative pains.

 

[DrMetal]

The army, navy, and air force approach it differently and honestly there's no easy solution.

The solution would be to turn the entire medical corps (or the vast majority of it) into a reserve force. And mobilize those reservists only when there's a true operational need.

Especially at the rate we're deferring dependents/retirees out the network, there's no need for this many physicians on active duty, sitting around masquerading as line officers (touting 'leadership' and admin roles, but not actually doing any medicine).

Quite frankly it's waste fraud and abuse. I'm surprised we haven't had a major 'whistle-blower' scandal; maybe we're too small a fish for the media (public) to care.

 

[armytrainingsir]

The solution would be to turn the entire medical corps (or the vast majority of it) into a reserve force. And mobilize those reservists only when there's a true operational need.

Bingo.

Practically speaking, with no retirees or veterans in the MTF, 90% of the MTF needs to go to reserve.

If the .gov simply must waste money, then TDY AD AMEDD to every inner city hospital that can't staff itself and those docs can see Medicaid and indigent to keep their skills up and solve the healthcare 'crisis'.

(I'm sure #2 will be enthusiastically received )

 

[eagledriver]

Welp, the AF released the board certification pay contracts for FY22 and it remains unchanged ($6k/year). I was holding out some hope for a raise based on the increased allowable from congress up to $15k/year, but doesn't look like it's happening any time soon.

 

[milmed14]

Welp, the AF released the board certification pay contracts for FY22 and it remains unchanged ($6k/year). I was holding out some hope for a raise based on the increased allowable from congress up to $15k/year, but doesn't look like it's happening any time soon.

I got the email but can’t access mypers right now, did anything at all change?

You’d think with inflation and all these covid taskings they’d finally boost CSP…

 

[eagledriver]

I got the email but can’t access mypers right now, did anything at all change?

You’d think with inflation and all these covid taskings they’d finally boost CSP…

Just got the whole plan, attached. Doesn't seem much different, at least not in my specialty.

 

[DrMetal]

WTF is this NAVADMIN for FY22 Specialty pay coming out?! We all know there aren't going to be any changes, its the same carbon copy message they put out last year. Why does it take so long to do the same thing year after year?

 

[Mad Jack]

I find it interesting that a school must be accredited by the AMA or AOA to receive an accension bonus, given that the LCME and COCA are the actual accrediting bodies

 

[narcusprince]

Womp womp womp…..

 

[Kingfisher]

Thanks for the info. That GMO incentive pay does make sense...

Regarding the request for special pay part - is this just another contract you have to sign and then forward to finance for them to process? In residency, we have to sign a contract every year to keep getting our version of special pay - so I am assuming it'll be the same process once we become attendings.

There is some paperwork involved. They put out a message each year to assist you in filling it out. Hopefully you get a good admin department that has done it before.

 

[SirGecko]

Navy special pays instruction is out:

FY22 Special Pay Plans Released

Here’s the message from the Medical Corps Chief’s Office and plans: The special pays program manager highlighted changes from last year in yellow. This year’s pay plan includ…

mccareer.org

Looks like some RB have gone up? Also the specialties they previously took four year retention bonuses away from have them back. Board certification pay didn’t go up, nor did any IP.

 

[militaryPHYS]

Quote from my specialty leader which was already posted in a public forum:

“A little additional background. The Navy, by rule, was unable to raise board certification or ortho pay for FY22. All services' special pay plans are based off of the DoD medical special pay plan, set by the SECDEF, which comes out a year earlier. While each service is permitted set pays where it wants, it cannot exceed the maximums permitted by the DoD plan. Currently the Navy board cert pay and ortho pay is at the maximum permitted by DoD.

The FY22 DoD plan was created before the 2021 NDAA was released. So, there was no reasonable way to go back and incorporate the new ceilings. The FY23 DoD plan is being worked now. There is hope that this go-around will permit new maximums, but it would still need to be approved at the service level.

I do believe that the Corp Chief's office is advocating hard for pay increases to the maximum extent possible. But BUMED has to compete for the money with the line and other priorities. Time will tell...”

 

[Barrel Proof]

But essentially this is an overall pay decrease given that these numbers aren’t even attempting to keep up with inflation. Cool

 

[Chonal Atresia]

Navy special pays instruction is out:

FY22 Special Pay Plans Released

Here’s the message from the Medical Corps Chief’s Office and plans: The special pays program manager highlighted changes from last year in yellow. This year’s pay plan includ…

mccareer.org

Looks like some RB have gone up? Also the specialties they previously took four year retention bonuses away from have them back. Board certification pay didn’t go up, nor did any IP.

This is unfortunate but not at all unexpected.

The military continues to talk out of both sides of its' mouth saying that it values the medical corps and everything that it brings to the table but at the same time continuing to allow the pay gap between military and civilian physicians to increase.

There will come a point where this devastates recruitment (everybody already knows about the horrendous retention rates near 0% for most non-primary specialties). And if a full scale conflict breaks out in the Ukraine, y'all are going to be staring down deployment cycles similar or worse to 15 years ago.

The only way to hurt them is to speak with you feet and GTFO ASAP at the end of your ADSO.

 

[SirGecko]

But essentially this is an overall pay decrease given that these numbers aren’t even attempting to keep up with inflation. Cool

The argument I’ve seen them make to this is that your base pay is supposed to adjust for inflation. Obviously this is inadequate and ignores the fact that special pay is a significant percentage of our salary but that’s what I’ve heard the pay guys say. (These are the same people that argue that they shouldn’t have to pay you more if you are already obligated because special pay is a force shaping tool)

 

[DrMetal]

How is Preventive Medicine (the most non-clinical, non-surgical) a wartime specialty? No one's driving this ghost ship.

 

[Gastrapathy]

Wait, this is the announcement for FY22? That has to be a record for DGAF from leadership. Remember when we used to get worried about the tax year implications because it came out sooo late in Dec?

I love the comments in the blog too. The very recently former Deputy Corp Chief stating that the “raises” they tout was fake news.

 

[Trefoil]

I don’t think they are ever going to raise special pay, so it seems farcical to expect it. Just wait until you can get out and vote with your feet.

 

[pgg]

Quote from my specialty leader which was already posted in a public forum:

“I do believe that the Corp Chief's office is advocating hard for pay increases to the maximum extent possible. But BUMED has to compete for the money with the line and other priorities. Time will tell...”

Aye, there's the rub. Same as it ever was - the line always resents overpaid doctor-officers, but especially during peacetime when they don't need us in the field.

I totally believe that the Medical Corps Chief is truthfully, earnestly advocating for pay raises. I also believe the line has, is, and will reluctantly decline.

The phrase they don't hear is "we can raise doctor salaries" but rather "we'd have to cut ______ in order to raise doctor salaries" ...

The last 25-30 years have been characterized by ballooning non-combat expenditures in PENSIONS and HEALTHCARE. They took a bite out of future pension costs with the BRS scheme in 2018. They've been trying to take a bite out of healthcare with Tricare network deferrals, facility rightsizing, ill-fated specialty "tiering" cuts to rid the medical corps of perceived non-combat dead weight, and of course there are all of those smoky DHA tri-service mirrors ... but we still cost a whole lot of money, and in the grand scheme of things we're one bit of the supporting cast to the kill-people-and-break-things lead actors.

It was always a longshot to hope for across-the-board pay raises. Narrowly targeted RBs - maybe more likely. But so long as the HPSP/USUHS/etc pipelines are full I struggle to come up with a compelling argument to lay at the feet of the line.

 

[Apollyon]

but we still cost a whole lot of money, and in the grand scheme of things we're one bit of the supporting cast to the kill-people-and-break-things lead actors.

It was always a longshot to hope for across-the-board pay raises. Narrowly targeted RBs - maybe more likely. But so long as the HPSP/USUHS/etc pipelines are full I struggle to come up with a compelling argument to lay at the feet of the line.

One of my attendings in residency was Army med (and you've likely heard of him), and he said something that stuck with me: "staff corps exist to keep the war machine rolling". That's all one needs to know.

 

[narcusprince]

The disingenuous “ndaa” pay raise that never saw its way to the intended audience is a major reason folks are jumping ship. The bonuses are not even inflation adjusted which equates to a 8% pay cut. The increase in salary based on rank pales in comparison to specialty bonuses. Promising “fake new pay raises” is death by 1000 paper cuts.

 

[pgg]

The disingenuous “ndaa” pay raise that never saw its way to the intended audience is a major reason folks are jumping ship. The bonuses are not even inflation adjusted which equates to a 8% pay cut. The increase in salary based on rank pales in comparison to specialty bonuses. Promising “fake new pay raises” is death by 1000 paper cuts.

Capt Schofer replied to a comment about the med special pays and inflation below the spec pay post on mccareer.org -

We have had that discussion every year for the last 3 years, and the majority of people at the DoD level who govern these special pays do not believe these pays should be inflation adjusted. As you might suspect, I/we do not agree with them.

So again this is THE friction point - we have good people in our leadership chain making good faith efforts to correct these pay problems, but the line just sees the issue completely differently. They don't perceive a problem exists, therefore they have no impetus to cut THEIR budgets to increase OURS just to fix what they think ain't broke.

The path toward swaying the line to our point of view has to pass through these points:
1) clearly documented, year-over-year, undermanning of medical specialists that have obvious (to the line) operational uses
2) evidence that the reason we're short is non-competitive pay

(1) looks easier than it sounds. We may be 66% manned in Navy Anesthesiology but you can bet your last IP dollar that if a USMC Col regimental commander was told his FRSS is non-operational because we don't have enough anesthesiologists on active duty, the medical corps would find one to deploy by 0600 the next day. So are we really short/undermanned? Will the line ever feel the pain of our undermanning? The answer is just, simply put, no.

The deployed line gets what it needs (as it should) and the understaffed MTFs back home can always just defer patients to the network.



It took repeatedly crashing ships into other ships for the Navy to begin to understand that there was a problem with SWO training, retention of experienced personnel, and overall manning / deployment schedules. That's the kind of signal the line sees.

There is no such signal for the Medical Corps - we've been operationally crushing it throughout the whole War On Terror. Battlefield survival is the best it's ever been (for lots of reasons but we should take credit).

The crux of the problem is that we honestly can't point to anything that the line would perceive as a problem in need of a solution.

 

[narcusprince]

I do not fault MC, army, air force leadership. However the advancement of leadership IE my record is better than yours acts contra to the togetherness and union of the Corps. If the MC banded together and demanded greater pay or face a mass exodus of providers than the line or brigade or company would be forced to increase the pay. The problem is the pipeline is full of eager hpsp folks and plenty of ambitious O5s, O6s to fill leadership shoes. You go where you are valued most.
I wish all military medical/supply/dental/nurse corps all get a raise. We have protected our respective services admirably and are long due tangible incentives vice participation trophies and awards.
The system isn’t fair or even level. Use it for what you can gain and move on!

 

[Onefellswoop87]

Capt Schofer replied to a comment about the med special pays and inflation below the spec pay post on mccareer.org -



So again this is THE friction point - we have good people in our leadership chain making good faith efforts to correct these pay problems, but the line just sees the issue completely differently. They don't perceive a problem exists, therefore they have no impetus to cut THEIR budgets to increase OURS just to fix what they think ain't broke.

The path toward swaying the line to our point of view has to pass through these points:
1) clearly documented, year-over-year, undermanning of medical specialists that have obvious (to the line) operational uses
2) evidence that the reason we're short is non-competitive pay

(1) looks easier than it sounds. We may be 66% manned in Navy Anesthesiology but you can bet your last IP dollar that if a USMC Col regimental commander was told his FRSS is non-operational because we don't have enough anesthesiologists on active duty, the medical corps would find one to deploy by 0600 the next day. So are we really short/undermanned? Will the line ever feel the pain of our undermanning? The answer is just, simply put, no.

The deployed line gets what it needs (as it should) and the understaffed MTFs back home can always just defer patients to the network.



It took repeatedly crashing ships into other ships for the Navy to begin to understand that there was a problem with SWO training, retention of experienced personnel, and overall manning / deployment schedules. That's the kind of signal the line sees.

There is no such signal for the Medical Corps - we've been operationally crushing it throughout the whole War On Terror. Battlefield survival is the best it's ever been (for lots of reasons but we should take credit).

The crux of the problem is that we honestly can't point to anything that the line would perceive as a problem in need of a solution.

From the line’s perspective, we aren’t undermanned at all (which is essentially what you said, just agreeing with you). Those operational units get priority then OCONUS then stateside MTFs. Those stateside MTFs are where the greatest percentage of medical corps is so we feel the undermanned aspect and we feel the hurt but not the line.
I think similar to the PR fiasco if civilian physicians walk out or strike, the layperson only see greedy, already high earning doctors. I could only imagine being at that boardroom with the medical corps asking for more money. It worked from a PR perspective when the last administration asked for more money cause the generals didn’t have any ammunition, but to give up those rounds for more money for the medical corps salary? Nope. Unless Congress gives the DoD a bigger wallet, it’s a zero sum game that we only get more if someone gets less.

 

[Trefoil]

Capt Schofer replied to a comment about the med special pays and inflation below the spec pay post on mccareer.org -



So again this is THE friction point - we have good people in our leadership chain making good faith efforts to correct these pay problems, but the line just sees the issue completely differently. They don't perceive a problem exists, therefore they have no impetus to cut THEIR budgets to increase OURS just to fix what they think ain't broke.

The path toward swaying the line to our point of view has to pass through these points:
1) clearly documented, year-over-year, undermanning of medical specialists that have obvious (to the line) operational uses
2) evidence that the reason we're short is non-competitive pay

(1) looks easier than it sounds. We may be 66% manned in Navy Anesthesiology but you can bet your last IP dollar that if a USMC Col regimental commander was told his FRSS is non-operational because we don't have enough anesthesiologists on active duty, the medical corps would find one to deploy by 0600 the next day. So are we really short/undermanned? Will the line ever feel the pain of our undermanning? The answer is just, simply put, no.

The deployed line gets what it needs (as it should) and the understaffed MTFs back home can always just defer patients to the network.



It took repeatedly crashing ships into other ships for the Navy to begin to understand that there was a problem with SWO training, retention of experienced personnel, and overall manning / deployment schedules. That's the kind of signal the line sees.

There is no such signal for the Medical Corps - we've been operationally crushing it throughout the whole War On Terror. Battlefield survival is the best it's ever been (for lots of reasons but we should take credit).

The crux of the problem is that we honestly can't point to anything that the line would perceive as a problem in need of a solution.

I am 100% convinced that the MC leadership wants and argues for them to adjust the special pay (I’m pretty sure George H W. Bush was president the last time they did so). The reality is that it’s never going to happen. The line benefits when MTF’s appear dysfunctional due to understaffing. Why would they stop cutting? They get more warm bodies when they shut down MTFs. Give me 15 minutes with any med student, and I will show them how HPSP no longer makes financial sense and makes less sense every year. I’m not sure why someone would sign up for it now especially given the massive cuts projected in the future. USUHS makes sense for active duty with families, but HPSP makes sense for almost no one at this point.

I think the writing is on the wall. This ship isn’t stopping until it’s on the ocean floor. Give it another 10 years.