A friend’s 16-year-old grandson is enamored with the prospect of joining the Army. His father, on the other hand, a Coast Guard warrant officer, would prefer he look at that primarily domestic-based service branch, so he would be more likely stationed within the United States’ jurisdiction. His view of the Army is it’s a hard life, with lots of battle scenarios, presenting potential harm to his son.
I suspect if you talk with friends and family, you will find lots of opinions about an Army career. But like many things, perception doesn’t always match reality. In fact, our recent work with the Raymond W. Bliss Army Health Center in Fort Huachuca, Arizona has turned my original thinking on its head.
Warm, dedicated people
During my first visit to the Center, my initial impression of the base’s “brick and mortar” was what I expected. But my sense of the people was somewhat different than I anticipated. This dedicated team of healthcare professionals provide primary care, general and orthopedic surgery, rehab, and other preventive medical services with laser-like focus on their mission to care for soldiers, retirees and their families.
When I had the chance to interact directly with the Center commanding officers, I quickly noted the sense of pride and appreciation for caring for not just any patient population, but one who had already made a significant sacrifice in caring for others.
Whether those patients are active duty soldiers, families of deployed soldiers, or those who have returned from the front lines (referred to as “Warriors in Transition”), all are treated with utmost respect and gratitude. “I love the opportunity to come and take care of our war veterans and give back to them in a small way what they have given me and my family,” says Randy Lundell, DO, CPT-P, Family Medicine Physician at Raymond W. Bliss Army Health Center. “Our freedom and way of life are due to their sacrifices.”
Enlisting not mandatory to be a physician with the Army
While the pride observed might have been a selling point in itself, I learned there are also many other professional and personal advantages to being a physician with the Army.
One of the most significant misconceptions of mine, which has now been corrected, was learning physicians do not need to be commissioned officers to work with the Army, and they need not deploy into dangerous combat operations. Even better, civilian physicians receive many of the same benefits, work schedules, and practice environments as an active-duty physician.
For example, physicians with the Army get a minimum of 23 days off each year, not including extra time needed for illness or clinical medical education. Every civilian physician has medical liability coverage under the Federal Tort Claims Act. While some of these attributes might be comparable to what salaried physicians receive in large group practices, it certainly does not mirror the solo practice or small group experience.
Civilian physicians are also attracted to the lifetime compensation plans afforded by the Federal Employee Retirement System (FERS) and Thrift Savings Plan (TSP), with even greater benefits if they have prior military or other federal service experience.
And while comparable benefit packages are extended, Army civilian physicians are free from the obligations of active duty requiring them to follow prescribed career progression pathways into leadership or to move every two or three years to new assignments. A commissioned Army physician must practice where directed via their specific orders, including many who are now overseas due to wartime conditions.
A civilian physician, on the other hand, can select a preferred practice location based on personal or professional desires to practice in a larger urban tertiary care facility, such as the Walter Reed Army Medical Center, or in a outpatient-based community setting in a less populated area, such as the Raymond A. Bliss Army lth Center. And beyond the tangible benefits of compensation and retirement plans, there are intangible rewards as well.
Becoming a civilian physician in the military
For physicians who have just completed training, the Army provides the security of structure and organization that supports the ongoing maturation of a clinician. Many new residents find a larger group practice appealing so they can ask patient care opinions of more experienced colleagues and benefit from practice management systems already in place. That same experience can be gained in the Army with seasoned physicians, in both active duty and civilian positions, there to guide and mentor new doctors. And with the Army offering practice opportunities in 41 specialties, the variety of military medical practice is much like that found in civilian practice.
For those who desire outpatient practice only, many Army medical facilities are like the Raymond W. Bliss Army Health Center, which focuses on preventive, episodic, and disease management care with in-house diagnostic and pharmacy services. Acute hospital care is provided by the local community hospital and its medical staff to meet inpatient care needs. The patient population is generally healthy, compliant and appreciative of the access to comprehensive care provided by the government.
Satisfying Army practice
Findings from the recent Physicians’ Foundation survey noted that the “most unsatisfying” aspects of medical practice reported were as follows:
- Reimbursement (54 percent)
- Managed care (52 percent)
- Malpractice issues (50 percent)
- Long hours/lack of personal time (35 percent)
For mid-career physicians who are experiencing these frustrations, an Army practice opportunity might just be the right next professional step. According to Col. William T. Humphrey, MD, a career family medicine physician and the commander of the Raymond W. Bliss Army Health Center, “Army medical practice is as close to pure medicine as you can get. We enjoy relationships with patients in an environment that allows us to provide the best care possible. We don’t have to worry about the patients’ insurance, logistics or practice economics, we just have to deliver the care. It is great coming to work every day with a predictable schedule, minimal call coverage, and a high quality of life that allows us to pursue family or other life passions.”
Good transitional practice
And for mature physicians facing retirement in several years, an Army position can supply a more gradual transition. “The Army can provide the opportunity to leave the business obligations of a practice behind while still continuing to enjoy the clinical aspects of medicine through the golden years,” suggests LTC Timothy O’Haver, the Deputy Commander for Administration. “Then when the physician is finally ready to leave medicine behind, it really is about leaving clinical medicine rather than trying to escape the business aspects of medicine.”
The United States Armed Forces operate hospitals and clinics in areas of major troop and fleet concentrations throughout the United States, including Hawaii, and at many locations overseas including Japan, Korea, and Germany. Clinical care is provided by a mix of board certified/ board eligible primary care physicians, board-certified specialists and supplemented by non-physician care providers including nurse practitioners and physician assistants. Care is provided to active duty soldiers, their family members, and retirees and their families.
Many military healthcare positions available stateside
The current conflicts in both Iraq and Afghanistan have put considerable pressure on the existing military healthcare system. Many of the active duty physicians have been deployed to overseas facilities, leaving United States installations in tremendous need for physician support. And with numerous practice opportunities available, many are offering flexible packages to be more attractive to the civilian medical marketplace.
In Col. Humphrey’s opinion, “There has never been a better time for physicians, be they active duty or civilian, to take advantage of what Army medicine offers. Army healthcare gives today’s doctors what they are increasingly seeking: long-term income stability, great quality of life, minimal administrative burden and the fulfillment of giving back to the service members and families who have given so much to us.”
While some choose to serve in uniform and others do not, Army physicians see it as a rewarding opportunity to do what they have always wanted to do, serve as a physician practicing medicine. So isn’t it worth some consideration, or at least a shift in perception?
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June 1, 2009
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