Navy Consultant’s Report
12/05/2016

Navy Consultant’s Report

Timothy Mott, MD
Naval Hospital Pensacola, FL
timothy.f.mott.mil@mail.mil

Navy Family Medicine Physicians, thank you in advance for your time reading some important community updates as well as for your consideration on how you may continue to positively impact Navy Family Medicine.

 Chief of the Medical Corps—Our new Chief of the Medical Corps, RDML Pearigen, and I recently had a one-on-one session to cover many of the issues I am going to outline. I think it is important for our community to know that in addition to his being an Emergency Medicine Physician (we’ll give him a pass on that), Residency Program Director and Director of Medical Education at NMCSD, he was the Commanding Officer of the Naval Hospital Camp Pendleton, home of one of our largest Family Medicine residencies. Additionally, his operational experience as Commander Amphibious Task Force (CATF), Expeditionary Strike Group (ESG) and Naval Surface Forces, Pacific Fleet Surgeons has afforded multiple opportunities to interact with and deeply understand the value of Family Medicine to the overall Navy mission. We are very fortunate to welcome him as our new Corps Chief.

Manning—Unfortunately, we remain undermanned. Currently we are just under 90% manned for roughly 400 billets. Additionally we have 27 FPs in non-FP leadership/executive medicine billets that decreases our manning to about 82%. This is not healthy, but it affords opportunity if Family Docs are willing to take them. Board certified operational FP leaders recently promoted to CAPT at the highest rate of any community. Also, the odds of obtaining senior leadership/Director roles at MTFs overseas as a CDR favor Family Medicine. Why? On average, our orders are at least 12 months longer to overseas MTFs than other physicians—that simply puts us into the “known performer” and “corporate knowledge” preference. I strongly encourage senior LCDRs and all levels of CDRs to look at OCONUS locations both as wonderful career enhancing and “Family Medicine promoting” opportunities.

GME and Pipeline to Training—We continue to cultivate amazing Navy FPs from our GME training sites, and that was supremely exemplified with the honorable, courageous and unswervingly committed conclusion of training and decommissioning ceremonies at Bremerton and Pensacola (more on that later). Their graduating classes achieved a perfect ABFM certification exam pass rate. In fact, the pass rate for our graduates across all six programs was higher than any other year documented. To the FM faculty at each of these locations—BZ! Also, I have sent a letter to the Commanding Officers of each of these facilities expressing my gratitude and asking them to thank each and every person who positively impacts our training programs; they must know the same positive regard and results—BZ! To increase family medicine manning, our pipeline has opened up so that we will be accepting 40 medical students into our four in-service residencies next summer as well as 13 medical students into out-service training. Additionally, we continue to bring FPs onboard through financial assistance (FAP) and direct accession programs. On the other side of the pipeline, I am always interested in what I can do better to help more of you “stay Navy!” Please never hesitate to reach out to me with issues, concerns and feedback.

E-Comms: Navy Family Medicine still leads the way with use of the CACenabled resource, milSuite. More FP support is coming soon to help facilitate and promote this tool in each of our lives… stay tuned! Additionally, I’ll again plug Joel Schofer’s “Navy Medical Corps Career Blog”—an always timely and great resource for all things related to a career as a Navy Physician. Lastly, I continue to update my Family Medicine mailgroup list. In fact, due to gremlins in the system I had to completely reload the group from scratch. So, as always, if you or other FPs in your command are not receiving my e-mail updates, contact me.

Conference Approval— Sorry…Basically no changes. Feel free to reach out to me individually, but also check out the conference approval page that is still the place to go for the most recent updates:  http://www.med.navy.mil/Pages/Conference-Info-2.aspx The conference approval package for the upcoming USAFP has been submitted and if your name wasn’t included, there is a very small chance I may still be able to add you (as others fall out), but I cannot guarantee that. Remember that you can always request no-cost TAD or take leave to go to the conference, too.

Closing thoughts— There is sadness in FP land with Bremerton and Pensacola’s FMR closures. The fact of the matter is that Navy Medicine needed to indirectly close the programs at both Bremerton and Pensacola due to the impact of the “Small Hospital Study.” Personally, that hit Navy Family Medicine in the gut and for many it will take some time to get over that, but “getting over that” is what we do as Navy FPs. Some may say that we are great “multi-taskers,” but there is no such thing unless you are a computer. What we really are, is not just outstanding, but exceptional serial taskers! Exceptional serial tasking allows us to move from exam room to exam room performing a well-child in one and performing a dementia assessment in the other. Exceptional serial tasking allows us to see a patient on labor and delivery and then go take care of adult medicine patients on the ward. Exceptional serial tasking allows us care for troops in our shipboard medical or BAS spaces and then deliver a readiness update to our operational leadership.

Exceptional serial tasking is at the heart of who we are as FPs—it’s our primary dynamic and leads to our capacity for productivity and leadership. Yet, I hear on occasion that the demands on clinical production have made it such that your scope of practice may be limited. That concerns me and I need to hear more if that is the case. There certainly are many FP billets that inherently limit a scope of practice based upon facility limitations—I get that, but I challenge you as FPs to maintain your breadth of practice, and fight for such opportunities wherever you can.

Lastly, effective serial tasking hinges on the avoidance of task-saturation. An end result of chronic task-oversaturation can be burnout—a much discussed and increasingly prevalent scenario for physicians. If you, or one of your colleagues is precariously displaying symptoms of burnout, please notify your leadership, physician wellness point-of-contact and/or me. “M.D.” no longer needs to mean “Medical Deity”—indeed, safety for the individual physician, the patient care team and patients themselves demands that we take care of each other.

Thank you for the amazing work you continue to do across the globe—you Serial Taskmasters and Family Physicians Extraordinaire!

Be Well!