AAFP State of Corps 070312.ppt

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  • Standard LOS Graph Bands: OPA-INV + or – 5% = Green; >5% and < or = 10% = yellow; greater than 10% (+ or -) = red Address training portion of stacks – although this community appears healthy – necessary to note that there is a significant training pipeline. MC is 99% manned. As you saw, reduced HPSP accession in FY05 will cause FY09 figures to decrease. 4009 Billets = 45 TPPH + 19 Executive Medicine + 2890 billets + 1055 Training billets as of 28 October 2005 web target data. (Not included 137 Unfunded billets + 9 ADM billets = 146 billets) 3787 OPA = 372 CAPT + 492 CDR + 1274 LCDR + 1649 LT new OPA spread as of 1 October 2005. (Not included 19 Flag + 203 ENS = 222)
  • Medical Corps The Medical Corps has been rapidly loosing end strength for several years. The impact has been minimal because of the reduction in billets as a result of military to civilian conversions and personnel “tools” (bonuses, training, threat of a Selective Early retirement, etc.) which have been used to shape the Corps to its billet requirements. Because the training pipeline is as long as 11 years for some specialties, it is difficult to increase or decrease personnel quickly. This slide shows the decrease in billets yet the steady state of personnel. The difference between the billets and end of year manning is an artifact. Authorized billets is taken as of 31 September 2005. Because of specialty bonus timing, total Medical Officer loss for FY05 cannot be counted until 31 October. As of 30 November 2005, Medical Corps was 23 undermanned. Extending the graph to December 2005 reveals the continuing decrease in physicians below authorized billets. Ending Inventory: FY03 - 4067 ; FY04 – 3968; FY05 - 3865 The bar graphs indicate the inability of accessions to keep up with losses. The Health Professions Scholarship Program (HPSP) is the Medical Corps’ primary accession source, accessing 85% (approx 300/year) of its total accessions, followed by the Uniformed Services University (approx. 50/year). Direct accessions and Financial Assistance Program (FAP) access less than 20/year. For the past three years, Recruiting Command has not recruited to the year’s goal, with FY05 being the most significant shortfall in history. This huge shortfall will have a dramatic impact on Navy Medical Corps manning starting in FY 2009 and beyond. Shortfalls in this program affect internships, residencies, GMO manning and specialty manning in the out years. Fewer graduating medical students means no NADDS because all graduates are needed to fill internships in 2009. These interns will all have to go to operational tours with no straight thru training in 2010. This will have a dramatic impact on Pediatrics, Psychiatry, Internal Medicine and Family Practice communities. HPSP Recruiting: FY02 -289 recruited/290 goal - delta= -1; FY03 – 232 recruited 275 goal- delta = -43; FY05 - 154 recruited/295 goal-delta = 141
  • This graph displays cumulative retention by month throughout whatever period you measure retention. Color band: Actual Retention – 3 year Expected value (may be your 3 year average if that’s healthy for your community; or, you may expect a 3 year value higher or lower than your 3 year average if your community needs to keep or lose a lot of people). If Actual Retention – 3 year Expected value is < 3% = Green; > or = 3% and < or = 6% = Yellow; Greater than 6% = Red
  • Medical Corps is the only Corps that showed a slight improvement in FY06, though this improvement is not statistically significant.
  • 10 Specialties below optimal manning, 17 at or above 100%. Though this might suggest an overall healthy Corps, the mix is a problem, as only 3 of the 8 specialties most heavily tasked for OIF/OEF are at good manning levels. Preventive Med, Dermatology, Urology, General Surgery, Radiology, Family Practice, Anesthesia continue to be our problem areas. Specialties currently being deployed at high optemp concentrate in our shortage areas Last two columns are our smallest with combined total of 11 physicians in both categories GMO (#24) over-manning serves as one potential mitigation for HPSP shortfall
  • MSC – End FY06 projections. In addition PA’s are increasing by 26 BA over the next three years.
  • Medical Corps HPSP comparison of goal vs. attainment. We improved in 2006 over 2005, but still short
  • Point of Departure for discussing mitigation strategies: 2009, 2010 are leanest years IF NOT FURTHER MITIGATION ACHIEVED
  • Current status of non-residency trained physicians in Navy (taken from data of GMO IPT)
  • Recommendation of GMO IPT (still pending SG approval) Convert 37 current Flight Surgeons to Aviation Medical Examiners (reduces time in training) Convert all 38 BSO-18 positions to FNP/PA (28) or Primary Care MO (10) Convert 3 USMC GMO positions to PCMO Convert 15 Fleet GMO positions to PCMO
  • AAFP State of Corps 070312.ppt

    1. 2. Medical Corps Update James R. Bloom CAPT, MC, USN Deputy Chief, Navy Medical Corps 14 March 2007 World Class Care…Anytime, Anywhere
    2. 3. Status of Personnel
    3. 4. Medical Corps Stats (as of 30 Sep 2006) <ul><li>Total Officers as of Feb 2007 = 3728 </li></ul><ul><ul><li>Staff - 2656 </li></ul></ul><ul><ul><li>Training - 1072 </li></ul></ul><ul><li>Funded Billets - 3824 </li></ul><ul><ul><li>Staff - 2769 </li></ul></ul><ul><ul><li>Training -1055 </li></ul></ul><ul><li>Percent Manned – 97.5% </li></ul>World Class Care…Anytime, Anywhere
    4. 5. Source: OMF data as of end September 2006 Inventory Years of Commissioned Service Statistics : Inventory: 3802 OPA: 3807 Manning: 100% 0-4 0-5 0-6 FY06 Projected Losses: 375 Losses to date: 380 FY06 Projected Gains: 348 Gains to date: 337 Medical Corps Community Current Status Accessions Attrition Retention Resigs Fit OCM Notes
    5. 6. Medical Corps Force Structure FY03 - FY06 Actual Inventory Source - BUMIS, PERS Billet Source - TFMMS extract 30 SEP of Applicable Year.
    6. 7. FY06 Medical Corps Losses M C LOS <ul><li>FY06 Losses = 368 </li></ul><ul><li>FY07 Projected Losses = 387 </li></ul>
    7. 8. Active Duty Medical Department Retention Rates
    8. 9. Manning by Specialty February 2007 1. Prev Med 15. FS 2. UMO 16. Pathology 3. RAM 17. IM 4. Derm 18. Neurosurg 5. Urology 19. Occ Med 6. G Surg 20. ENT 7. Radiology 21. Rad Onc 8. FM 22. Ophthalmol 9. Anesth 23. Peds 10. Psych 24. GMO 11. ER 25. Neurology 12. Ortho 26. PM&R 13 OB/GYN 27. RUM 14. Nuc Med Heavily Tasked for OIF/OEF
    9. 10. Critically Undermanned Specialties by Corps <ul><li>Nurse Corps </li></ul><ul><li>Critical Care – 52% </li></ul><ul><li>FNP – 78% </li></ul><ul><li>Nurse Anesthetist – 86% </li></ul><ul><li>Peri-Operative – 88% </li></ul><ul><li>Medical Service Corps </li></ul><ul><li>Podiatry – 76% </li></ul><ul><li>Pharmacy – 83% </li></ul><ul><li>Clinical Psychology – 85% </li></ul><ul><li>Dental Corps </li></ul><ul><li>Prostodontist – 75% </li></ul><ul><li>General – 78% </li></ul><ul><li>Oral Surgery – 86% </li></ul><ul><li>Medical Corps </li></ul><ul><li>Preventive Medicine – 62% </li></ul><ul><li>Dermatology – 77% </li></ul><ul><li>Surgery – 82% </li></ul><ul><li>Urology – 84% </li></ul><ul><li>Anesthesia – 84% </li></ul><ul><li>Family Practice – 84% </li></ul><ul><li>Dx Radiology – 85% </li></ul><ul><li>Psychiatry – 88% </li></ul>
    10. 12. Historic FM Attrition
    11. 13. Status of HPSP
    12. 14. Medical Corps HPSP Statistics Goal VS Actual
    13. 15. Minimum number of graduates needed to meet annual operational medical officer (GMO+FS+UMO) requirements Minimum number of graduates needed to meet annual operational requirements + meet inservice GME-2 program selection goals Minimum number of graduates needed to meet operational requirements + meet inservice GME-2 program selection goals + defer appropriate number of graduates to train in critical shortage specialties
    14. 16. Active Medical Programs Goal/Accessed 23 February 2007 330/13 335/220 325/189 300/250 330/321 396/381 357/337 Total 115 136 50 9 15 20 Shortfall 20/1 20/11 20/13 20/8 28/20 19/19 37/19 MC FAP 300/9 300/199 291/162 265/232 290/289 362/346 300/300 MC HPSP 10/3 15/10 14/14 15/10 12/12 15/16 20/18 MC DA/Recall FY07 FY06 FY05 FY04 FY03 FY02 FY01  
    15. 17. Status of the GMO
    16. 18. GMO Billets by Type Total = 553 FMF 116 Flight Surgeons 238 UMOs 95 BSO-18 39 Fleet 65
    17. 19. GMO Billet conversions 2007 FMF 116 Flight Surgeons 238 UMOs 95 BSO-18 39 Fleet 65 To PCMO To FNP/PA 11 28 New Total = 447 To AMP 37 To PCMO 3 15
    18. 20. 106 billets converted <ul><li>28 to MSC/NC </li></ul><ul><li>1 to EM </li></ul><ul><li>77 to PCMO </li></ul><ul><li>447 remaining GMO </li></ul><ul><li>“ Fair Share” to </li></ul><ul><ul><li>Pediatrics </li></ul></ul><ul><ul><li>Family Medicine </li></ul></ul><ul><ul><li>Internal Medicine </li></ul></ul><ul><li>Individuals with PCMO </li></ul>
    19. 21. Other Hot Issues <ul><li>Special Pays </li></ul><ul><li>All Board-Eligible Force </li></ul><ul><li>Career Path </li></ul><ul><li>EMF Kuwait </li></ul><ul><li>PCOLA </li></ul><ul><li>MRR </li></ul>
    20. 22. Rumors of PCOLA <ul><li>No decision to close GME </li></ul><ul><li>Narrowest scope of teaching pathology </li></ul><ul><li>No decision to close GME </li></ul><ul><li>Lowest volume of patient care </li></ul><ul><li>No decision to close GME </li></ul>
    21. 23. Status of the MRR
    22. 24. 2008 Cuts (Proposed) <ul><li>43 MC out of 486 Med Dept for FY2008 </li></ul><ul><li>Fam Med 10 Plastics 1 </li></ul><ul><li>Derm 6 Pathology 1 </li></ul><ul><li>Radiology 7 IM 2 </li></ul><ul><li>OB/GYN 4 GMO 1 </li></ul><ul><li>Peds 3 ENT 1 </li></ul><ul><li>Ortho 4 Urology 1 </li></ul>
    23. 25. <ul><li>Charleston 3 </li></ul><ul><li>Bethesda 2 </li></ul><ul><li>Annapolis 1 </li></ul><ul><li>Pax River 1 </li></ul><ul><li>Fallon 1 </li></ul><ul><li>Bridgeport 1 </li></ul><ul><li>Oak Harbor 1 </li></ul>Family Medicine Cuts (proposed)
    24. 26. Observations so far <ul><li>Modest push-back from Specialty Leaders </li></ul><ul><li>Gapped billets were targeted </li></ul><ul><li>Regions and Detailers had distributed gaps as per SL input </li></ul><ul><li>Await FY2009 distributions… </li></ul>
    25. 27. Final MRR Cuts ?

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