Health Professions' Retention-Accession Incentives Study Report to Congress (Phases II & III: Adequacy of Special Pays and Bonuses for Medical Officers and Selected Other Health Care Professionals

Abstract

Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources gathering and maintaining the data needed and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington headquarters Services, Directorate for information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 223024302, and ABSTRACT (Maximum 200 words)(U) The military Health System (MHS) must execute twin missions. The primary mission of the MHS and the three Service medical departments is force health protection. This readiness mission involves providing medical support in combat and other military operations and maintaining the day-to-day health of about 1.5 million men and women who serve in the Army, Air Force, and Marine Corps. The second mission is to provide a health care benefit to nearly 6.6 million other people who are eligible to use the MHS. Because the Department of Defense (DOD) relies on a single force to meet the sometimes disparate missions, it must cultivate a workforce that is dedicated to caring for patients, committed to continuous improvement in performance and productivity, and competent in both wartime and peacetime. This challenge is particularly difficult because uniformed health care professionals are costly to access and train, and they have skills that are in demand in the private sector. Summary IntroductionThe Military Health System (MHS), one of the largest and oldest health care delivery systems in the United States, must execute twin missions. The primary mission of the MHS and the three Service medical departments is force health protection. This readiness mission involves providing medical support in combat and other military operations and maintaining the day-to-day health of about 1.5 million men and women who serve in the Army, Air Force, Navy, and Marines Corps. The second mission is to provide a health care benefit to nearly 6.6 million other people who are eligible to use the MHS.Because the Department of Defense (DoD) relies on a single force to meet these sometimes disparate missions, it must cultivate a workforce that is dedicated to caring for patients, committed to continuous improvement in performance and productivity, and competent in both wartime and peacetime. This challenge is particularly difficult because uniformed health care professionals are costly to access and train, and they have skills that are in demand in the private sector.Congressional awareness of this mandate and competition from the private sector for qualified health care professionals resulted in the following committee language in the National Defense Authorization Act for Fiscal Year 2001:The committee directs the Secretary of Defense to conduct a review and to report to the Committee on Armed Services of the Senate and the House of Represe...

The Cost of Pursuing a Medical Career in the Military: A Tale of Five Specialties

“…In contrast to the civilian sector and its relatively high proportion of specialists, because of a lower level of retention, the military is struggling to maintain the optimal number of specialists for its needs. 18 Our findings suggest that interventionalists are acutely aware of the pay differential between military and civilian careers and may pursue a path that leads to a higher net present value of their educational returns as soon as their military obligations are complete.…”

“…We examined this to determine whether different career choices were more or less likely to remain in the military after training. 18 We examined one measure: the net present value of the educational investment that could be expected by a college graduate contemplating a career in orthopedic surgery, general surgery, gastroenterology, internal medicine, or psychiatry in the civilian or military paths described above. Net present value is the current value of an expected stream of cash flows at a predetermined rate of interest, the discount rate.…”

“…However, on completion of a residency, a military physician's income potential may be more limited, and income levels may vary less across specialties. 17,18 With an eye on the potential impact of physician payment reform in the private sector, we sought to understand how the military payment structure affected physicians' returns on educational investment across medical specialties and how the military payment system was related to retention of physicians of different specialties within the military workforce.…”