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Internal Medicine Specialty Leader Update Navy ACP 2014

Internal Medicine Specialty Leader Update Navy ACP 2014. Daniel Seidensticker, MD, FACP, FACC CDR, MC, USN. Navy Medicine. Mission We enable readiness, wellness, and health care to Sailors, Marines, their families, and all others entrusted to us worldwide – be it on land or at sea.

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Internal Medicine Specialty Leader Update Navy ACP 2014

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  1. Internal Medicine Specialty Leader UpdateNavy ACP 2014 Daniel Seidensticker, MD, FACP, FACC CDR, MC, USN

  2. Navy Medicine • Mission • We enable readiness, wellness, and health care to Sailors, Marines, their families, and all others entrusted to us worldwide – be it on land or at sea

  3. Navy Medicine Strategy Map

  4. Internal Medicine Leads the Way RADM Colin Chinn Command Surgeon, US PaCom RADM Brian Monahan The Attending Physician for US Congress and US Supreme Court RDML Brian Pecha Medical officer of Marine Corps CAPT John Sanders CO, Naval Medical Research Center CAPT Mark Turner 5th Fleet surgeon CAPT Chris Culp Pacific Fleet Surgeon

  5. CAPT Jeff Timby Deputy Medical Officer of USMC FMF Specialty Leader CAPT Kyle Petersen CO, NAMRU-6 Lima CAPT John Gilstad CO, NAMRU 3-Cairo EXECUTIVE OFFICERS: CAPT Michael McGinnis NH Guam CAPT Adam Armstrong NAMRU-6 Lima CAPT Fred Yeo Naval Submarine Medical Research Laboratory

  6. Internal Medicine Leads the Way • Who is your mentor? • Whom are you mentoring? • How should a mentor help you?

  7. Medical Corps Manning • Overall manning is 110% of billeted end strength • Increased retention • Normal attrition 10%/year • Currently 8%/year Total MC billets in 2013: 3740 Total staff billets in 2013: 2706 Source: Worldbook october 2013

  8. Medical Corps Manning By Specialty

  9. Internal Medicine by Specialty Source: Worldbook Sep 2014

  10. Is IM really overmanned? • Probably close to being right sized • The billet structure is not current with hospital needs • NH Camp Pendleton: 1 GIM billet, 5 IM staff • NH Beaufort: 1 GIM billet, 3 IM staff • Several other Specialties have same issues

  11. From the OOMC • RADM Raquel Bono • Chief of the Medical Corps • CAPT Mae Pouget • Deputy Chief of the MC • October 21 FACEBOOK TOWNHALL meeting with RADM Bono • 21 October 1200-1300 • https://www.facebook.com/USNavymedicine

  12. From the OOMC • No change in special pays • Static since 2010 • HPSP has met recruiting goal (FY08-14)

  13. From the OOMC • MEDHOME • Empanelment targets 1100-1300

  14. MedHome and the Neighborhood • MGMA Standards based on 2012 report • 40% of nationwide average for each specialty • Intentionally low to account for deployments, clinical inefficiencies

  15. Conference Travel • Google “bumed travel policy” • “Mission critical” to attend conferences (board review ‘courses’ already approved) • ALL attendees MUST be named with conference submission package. • EACH ATTENDEE must be mission critical reason • Commands are referring to submitted lists

  16. Professional Milestones

  17. MC Promotion Opportunity ** 88% in zone select rate

  18. FY14 Promotions - LCDR FY14 O-4 Selection Results • Precept: 100% selection of IZ candidates • 186 x 1.0 = 186 = max # of selects • 4 (AZ) + 168 (IZ) + 14 (BZ) = 186 • IM: 0 AZ 16/17 IZ; 1 BZ selected http://www.public.navy.mil/bupers-npc/boards/activedutyofficer/05staff/Documents/FY-14/FY14%20AO5S%20STATS.pdf

  19. FY15 Promotions - CDR FY15 O-5 Selection Results • Precept: 70% selection of IZ candidates • 159x 0.7 = 111 = max # of selects • 78 (IZ) + 33(AZ) = 111 • IM: 66% IZ (10/15) 8 AZ selected http://www.public.navy.mil/bupers-npc/boards/activedutyofficer/05staff/Documents/FY-15/FY-15%20AO5S%20CONVENING%20ORDER.pdf

  20. FY15 Promotions - CAPT FY15 O-6 Selection Results • “Precept: 60% selection of IZ candidates” • 112 x 0.6 = 67 max # of selects • 53(IZ) + 14(AZ) = 67 • IM: 11/14 IZ 1/10 AZ 0/36 BZ http://www.public.navy.mil/bupers-npc/boards/activedutyofficer/06staff/Pages/default.aspx

  21. PROMOTION BOARDS • Google “BUPERS “ • “about BUPERS – us navy”  “boards”  “active duty staff officer “  “05 staff” • Timing of sub-specialty training must be considered for O-5/O-6 • Competitive FITREPs • Breaking out in COMPETETIVE peer group • “rightward progression” while in rank • Increasing leadership role and positional responsibility! • Ensure your photo is up to date, in current rank! • Document Board Certification • Manage your online Officer record, OSR/PSR • Document accomplishments during FTOS training • Publications, Research Presentations Class rankings

  22. From the OOMC • MilSuite • One place to organize key data to answer frequent questions or find points of contact • Reduce reliance on email • More communication between the hospitals • We shouldn’t have to recreate the wheel

  23. 2014 Change…2015 uncertainty • Ebola is an evolving problem • ISIS -- Syria, Iraq? • How will transition in Afghanistan go? • 2016 budget: what will it be, and how will it affect us? • Another year into e MSM’s • GMO Conversions ??

  24. Unique Opportunities • CAPT Matthew Lim • BUMED liaison, Global affairs,DHHS • LCDR Jamie Peterson • BUMED Medical Student Recruiting/Admin Fellow • CAPT Utz • Health attache to VietNam • MBA program • Navy PG School distance learning program

  25. Billets 2015 • Currently • NMCP • NMCSD • WRNMMC • NH Beaufort • NH Camp Lejeune • NH Jacksonville • NH 29 Palms • NH Guam • NH Okinawa • NH Guantanamo • NAMI (Pensacola) • FHCC (Great Lakes) • Bremerton

  26. Billets 2014 • Priority will be given to Staff • Returning from OCONUS, arduous sea duty • Deployment • Rank • GMESB is next milestone, results released Dec 2014 • Board certification required for MEDCEN billets • Residents will be slated in January • Specialty leaders are working closely with BUPERS for best fit for each individual, Command and Navy

  27. Deployments • Navy Medicine personnel currently deployed: 262 (610) • Pending deployment: 52 (331) • Internists deployed: 9 (9) • At this time 2011, 15 deployed • Internists pending deployment: 4 Data source: EMPARTS 12 Oct 2014

  28. Deployments 2013

  29. Deployment • 50Internists with >300 days of deployment • 99Internists with zero days of deployment (includes trainees) • Navy Medicine tracks deployed days via EMPARTS • Not a perfect database, requires manual data entry • Ensure your deployments are correctly reflected in the system Data source: EMPARTS 12 Oct 2014

  30. Deployment • IM has/had habitual relationships for specific IAs • Pacific Partnership • Continuing Promise • EMF Kandahar (pulm/cc) • JTF GTMO (NE-2213) • EMF Djibouti (NE-2089) • Embedded Training Teams (NE-4255) • Forward Surgical Teams (NE-5326, NE-5254)

  31. Deployment Forecast FY15 • Discussion with POMIs, nothing imminent • Any Surprises in Afghanistan next spring? • Syria, ISIS, Ebola…. • Fiscal Climate affecting Humanitarian Missions • Our Primary Role Is to Support These Deployments. We all must be ready….

  32. Deployments • For IM, what does it mean to be “operationally ready” (currency)? • How do we measure that? • What type of training would that require? • What impact would that have?

  33. IM Deployment Business Rules • No position is too important to deploy (except CO). • No one shall be recommended for deployment until everyone has deployed a first time. • Total deployed days taken in to account for deployment recommendation • In order to facilitate consolidation of knowledge and board passage, recently graduated fellows should be protected from deployment during their first post-GME year. • Prior overseas PCS moves will not count towards IAs. • Deployer order may be modified based upon extenuating circumstances and the needs of the Navy (i.e. a specific specialty is required or a particular institution is already heavily deployed). • Volunteers will always be solicited prior to assigning deployers. • Volunteering for one assignment, does NOT move you higher on the list for the next available assignment. • Chain of Command (and subspecialty SL if applicable) will be engaged prior to SL recommendation. 10. Will avoid by name requests, if possible, to sourcing MTF.

  34. THANK YOU! • Thank you for your professionalism • Thank you for your hard work and dedication to our patients • Thank you for constantly striving to improve Navy Medicine

  35. Points of Contact • CDR Daniel Seidensticker IM Specialty Leader Daniel.seidensticker@med.navy.mil • CDR Joel Schofer Detailer Joel.Schofer@navy.mil • CAPT Harry Ward Reserve IM SL Harryj.ward@yahoo.com

  36. Thank you for your service! “Cogito ergo I.M.”

  37. Supplemental slides

  38. Also note, for a general internist each paRVU is worth $46.35 a Navy general internist to generate $88,899 in equivalent production.2012 MGMA report (below),Navy MGMA 40% targets (right)

  39. Promotion Guidance Professional Guidance • Timing of sub-specialty training must be considered if coming in to zone for O-5/O-6 • Ensure your photo is up to date, in current rank! • Manage your online Officer record, OSR/PSR • Document accomplishments during FTOS training • Publications, Research Presentations Class rankings

  40. From the OOMC Professional Guidance • FITREPs are written for Promotion Board members • Expectations • All MC Officers will complete residency • All MC Officers will achieve board certification • O-6 board looks for demonstrated leadership • Clinical • Academic • Operational • Executive • Pass PRT/BCA

  41. Change is coming to Navy Medicine • Enhanced Multiservice Markets (eMSM’s) • PUGET Sound, Hampton Roads • National Capital Region • San Antonio, National Capital, Colorado Springs, Pearl Harbor • NMCSD, Camp Lejeune considered their own mini markets • CO of that eMSM will have operational control of all facilities

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