Research for Medical Personnel

The purpose of N81's M&P IWAR (Manpower and Personnel Integrated Warfare Architecture) 2000 is to examine the alignment of the Navy's operational capabilities and requirements. The examination focuses on four areas: civilian staffing, medical manpower, reserves, and retention. This study supported that effort by addressing the medical manpower issue. Our specific tasks were: provide a comprehensive profile of all operational medical personnel assets by Navy fleet and Fleet Marine Force (FMF) organizational structure; identify capabilities provided by each medical unit by platform or related organizational entity; identify the medical manpower requirement determination process for both the Navy fleets and FMFs; assess the requirement determination process, examine differences and inconsistencies within and between Navy fleets and FMFs; and, identify opportunities to achieve balance and consistency in the distribution of medical manpower resources.

The Navy Surgeon General has asked CNA to evaluate physicians' job satisfaction and retention within the existing climate to determine if major issues exist. The scope of the study was expanded to include a comparative analysis of compensation for Navy physicians continuing a military career versus leaving for a private-sector track. We find that a substantial current compensation gap exists between military and private-sector physicians, particularly at the end of the 7-year career point, and the disparity in total compensation varies widely by medical specialty. Our finds show, however, that as Navy physicians accrue more military service, it becomes more lucrative for them to complete 20 years, retire, and then pursue a private career. This information memorandum documents the results of these compensation comparisons.

The Navy's Graduate Medical Education (GME) program consists of post-medical school programs to train physicians. These programs have been successful in improving the quality and dependability of sources of medical corps personnel. In recent years, the Navy has downsized GME somewhat. Further reductions in GME may be mandated because of budget constraints, but Medical Operational Support Requirements - which support the Marine Corps, ships afloat, and Navy bases outside the continental United States - may require some specialty programs to enlarge. Therefore, the Surgeon General of the Navy, via the Assistant Chief for Plans, Analysis, and Evaluation, asked CNA to study past medical corps attrition and build a model to assist with the planning of GME program size. This research memorandum addresses how the Navy can set priorities among its GME programs, a subject currently under study by staffs working for the Chief, Medical Corps, the Assistant Chief for Personnel Management, the Assistant Chief for Plans, Analysis, and Evaluation, and the former Health Services Education and Training command. This memorandum is intended to assist the work of these staffs.

CNA developed a method for comparing CHAMPUS and medical treatment facility (MTF) inpatient costs that uses Medical Expense and Performance Reporting System (MEPRS) data to calculate the MTF cost per admission for a category of care. However, a lack of reliable MTF data on cost per admission is a major obstacle to the application of the methodology. This research memorandum provides MTFs with a detailed description of procedures used to identify and correct problems with MEPRS data collection at Naval Hospital, Portsmouth.