Posted on Jul 31, 2019
Are Members of the 70 Series MOS being Utilized Effectively?
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As a personal observation -- that may or may not be true in all cases -- Medical Units place individuals (Doctors or Nurses) in leadership roles who have no idea how to manage outside a team-size element or outside a hospital. The 70 Series individuals should be in those command positions due to extensive experience in administrative policies, procedures, and a full understanding of many nuances of "real Army". Physicians should advise, but not be the primary officer in charge, especially as TPU personnel. Currently, the 70 Series are being under-utilized in this aspect and being overworked in other areas of operations outside of their intended specialization. If individuals higher recognized this, they would understand this is why many medical units are dysfunctional and must rely on the full time AGR staff to correct deficiencies that could be avoided by having a 70 Series MOS in the Commander position. The Commander needs to understand the strategic level versus the mere operational level of missions. Additionally, the Commander should be an AGR position NOT TPU. The Army needs to recognize this and make it a priority in the near future. Does anyone have thoughts on this subject matter?
Posted in these groups: 
LeadershipMEDCOMTRADOC
70B: Health Services Administration
70A: Health Care Administration
LeadershipMEDCOMTRADOC 70B: Health Services Administration 70A: Health Care Administration
Posted >1 y ago
Responses: 4
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Intriguing conversation starter CPT (Join to see)! On the surface, you seem to have a great idea. In the human resource management, we would look at the role of the 70 series in the command to gain a better picture of their functional area:
HEALTH SERVICES SYSTEM MANAGEMENT (70D): health care information management, evelopment, implementation, operation, and evaluation of clinical/patient oriented information systems and the administration of support for medical information systems,
HEALTH CARE ADMINISTRATOR (70A): health care delivery and the management of health care facilities,
HEALTH SERVICES ADMINISTRATION (70B): Plan, coordinate and monitor the treatment of our patients, practice preventive medicine, organize administration, supply equipment, train staff and maintain equipment
PATIENT ADMINISTRATION (70E): Plans, organizes, directs, and controls patient administration in a variety of health care agencies, Assists medical staff in evaluating quality of patient care and in developing criteria and methods for such an evaluation
The rest of the 70 series seem to be medical specialists, so I will lump them together in the broad category of technical specialists.
In civilian medical systems, the Chief Medical Officer has many administrative responsibilities, that the 70 series officers are well versed in, but they (CMOs) have additional roles such as:
1. ensuring that physicians take steps to decrease variation in practice, leading to compliance with best practice guidelines
2. ensuring and improving clinical quality, patient safety, and the coordination of inpatient and outpatient services programs
3. development, implementation and evaluation of care programs
CMOs in the military can have similar functions. The 62 series is responsible for "Commanding and controlling medical units during emergency and nonemergency medical situations and coordinating employment of medical officers and personnel at all levels of command in U.S. and multinational operations". When combined with the civilian expectations of a CMO and the job duties of a Medical Corps Officer (62), it seems that the 70 series can be expected to perform many of the administrative tasks, but the functions that sticks out to me is developing compliance and best practice for other doctors and the development of care programs. Which the 70 series may not have extensive experience or full understanding. The Commander is not an administrative position.
This is akin to the age old debate about 2LT's being in command of a platoon is you have a 15+ year PSG. The PSG should know how to run the platoon, and the 2LT has no command experience, yet is expected to take command of 30 or so Soldiers. Or, to your point, a TPU Company Commander is is charge, but has perhaps a more involved AGR XO or FTUS. Perhaps if the CMO was AGR, it might relieve some of the frustrations with medical units, but the responsibilities of being in Command of a healthcare unit would be the same. The medical corps is a unique beast, in that it tries to mirror the professional aspects of civilian counterparts. Doctors are in charge. However, I see your point the in the military, any officer, regardless of branch, should be able to take a command.
HEALTH SERVICES SYSTEM MANAGEMENT (70D): health care information management, evelopment, implementation, operation, and evaluation of clinical/patient oriented information systems and the administration of support for medical information systems,
HEALTH CARE ADMINISTRATOR (70A): health care delivery and the management of health care facilities,
HEALTH SERVICES ADMINISTRATION (70B): Plan, coordinate and monitor the treatment of our patients, practice preventive medicine, organize administration, supply equipment, train staff and maintain equipment
PATIENT ADMINISTRATION (70E): Plans, organizes, directs, and controls patient administration in a variety of health care agencies, Assists medical staff in evaluating quality of patient care and in developing criteria and methods for such an evaluation
The rest of the 70 series seem to be medical specialists, so I will lump them together in the broad category of technical specialists.
In civilian medical systems, the Chief Medical Officer has many administrative responsibilities, that the 70 series officers are well versed in, but they (CMOs) have additional roles such as:
1. ensuring that physicians take steps to decrease variation in practice, leading to compliance with best practice guidelines
2. ensuring and improving clinical quality, patient safety, and the coordination of inpatient and outpatient services programs
3. development, implementation and evaluation of care programs
CMOs in the military can have similar functions. The 62 series is responsible for "Commanding and controlling medical units during emergency and nonemergency medical situations and coordinating employment of medical officers and personnel at all levels of command in U.S. and multinational operations". When combined with the civilian expectations of a CMO and the job duties of a Medical Corps Officer (62), it seems that the 70 series can be expected to perform many of the administrative tasks, but the functions that sticks out to me is developing compliance and best practice for other doctors and the development of care programs. Which the 70 series may not have extensive experience or full understanding. The Commander is not an administrative position.
This is akin to the age old debate about 2LT's being in command of a platoon is you have a 15+ year PSG. The PSG should know how to run the platoon, and the 2LT has no command experience, yet is expected to take command of 30 or so Soldiers. Or, to your point, a TPU Company Commander is is charge, but has perhaps a more involved AGR XO or FTUS. Perhaps if the CMO was AGR, it might relieve some of the frustrations with medical units, but the responsibilities of being in Command of a healthcare unit would be the same. The medical corps is a unique beast, in that it tries to mirror the professional aspects of civilian counterparts. Doctors are in charge. However, I see your point the in the military, any officer, regardless of branch, should be able to take a command.
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"Medical Units place individuals (Doctors or Nurses) in leadership roles who have no idea how to manage..."
Leaders and managers are not synonymous terms.
IME, administrators can't see the forest for the trees. What is just another line item to them critically impacts the mission of the surgeon.
Looking at the train wreck both civilian and military medical care has become over the past few decades, have the leadership roles been filled increasingly by admin types or physicians?
Yeah, a great admin guy is an indescribable blessing when you need expertise in "administrative policies, procedures, and a full understanding of many nuances of "real Army". But when mission requires the commander to pull a rabbit out of his hat to squeeze out just one more surgery from an exhausted team, treat just one more casualty, or improvise around an poor re-supply issue, I'll put my money on a physician, especially a surgeon, commander more often than not.
Leaders and managers are not synonymous terms.
IME, administrators can't see the forest for the trees. What is just another line item to them critically impacts the mission of the surgeon.
Looking at the train wreck both civilian and military medical care has become over the past few decades, have the leadership roles been filled increasingly by admin types or physicians?
Yeah, a great admin guy is an indescribable blessing when you need expertise in "administrative policies, procedures, and a full understanding of many nuances of "real Army". But when mission requires the commander to pull a rabbit out of his hat to squeeze out just one more surgery from an exhausted team, treat just one more casualty, or improvise around an poor re-supply issue, I'll put my money on a physician, especially a surgeon, commander more often than not.
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CPT (Join to see)
Sir,
I concur with your assessment from this aspect, but as far as professional growth, a physician is going to get promoted regardless of their experience in a leadership role. The Army is incredibly short-handed with several MOS types and incentivizes these individuals to stay in the military. Medical professionals make a lucrative amount of money in the civilian sector. Physicians join the military out of passion, not necessity. As such, it is a blessing that these individuals choose to serve. That being said, each time a Command position is filled with a physician or nurse, a 70 Series MOS individual is losing valuable experience that is required to promote. How would a doctor like it if a medical administrator decided to step in their operating room and try to perform what the doctor has studied for years. This would not end well for the patient or the hospital. When someone who is trained on the administrative side is stripped of their abilities to provide logical guidance on how things best function, chaos ensues and the unit looks like a joke. The doctors and nurses have a very limited focus. As such, they drive their training objectives towards those areas in which they are familiar and hinder the progress of everyone else. Additionally, these individuals are usually TPU and do not focus on the unit and their needs on a regular basis. This falls to the full time staff to fix all inconsistencies and issues that could be avoided if the Commander would listen to those individuals familiar with policies and understand the big picture. It makes it that much more difficult when said physician or nurse fails to communicate except for once or twice a month. As stated, I do not disagree that I would much rather have a physician that pushes themselves to save one more patient when a commander advises that they have accomplished their mission. What I am suggesting is that the Commander be a full time individual that has a broad scope and understanding of strategic operations, and not be placed in a position just because they are physician in a medical unit. Thanks again Sir for your valuable contribution to this discussion.
Very Respectfully,
CPT Edward Krohn
I concur with your assessment from this aspect, but as far as professional growth, a physician is going to get promoted regardless of their experience in a leadership role. The Army is incredibly short-handed with several MOS types and incentivizes these individuals to stay in the military. Medical professionals make a lucrative amount of money in the civilian sector. Physicians join the military out of passion, not necessity. As such, it is a blessing that these individuals choose to serve. That being said, each time a Command position is filled with a physician or nurse, a 70 Series MOS individual is losing valuable experience that is required to promote. How would a doctor like it if a medical administrator decided to step in their operating room and try to perform what the doctor has studied for years. This would not end well for the patient or the hospital. When someone who is trained on the administrative side is stripped of their abilities to provide logical guidance on how things best function, chaos ensues and the unit looks like a joke. The doctors and nurses have a very limited focus. As such, they drive their training objectives towards those areas in which they are familiar and hinder the progress of everyone else. Additionally, these individuals are usually TPU and do not focus on the unit and their needs on a regular basis. This falls to the full time staff to fix all inconsistencies and issues that could be avoided if the Commander would listen to those individuals familiar with policies and understand the big picture. It makes it that much more difficult when said physician or nurse fails to communicate except for once or twice a month. As stated, I do not disagree that I would much rather have a physician that pushes themselves to save one more patient when a commander advises that they have accomplished their mission. What I am suggesting is that the Commander be a full time individual that has a broad scope and understanding of strategic operations, and not be placed in a position just because they are physician in a medical unit. Thanks again Sir for your valuable contribution to this discussion.
Very Respectfully,
CPT Edward Krohn
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In 1973 on the DMZ Korea, the doctor in charge a Captain was a foot doctor, when asked why he volunteered to be stationed on the DMZ, he said, Because I heard you can get promoted faster in a hostel fire zone.
Lucky for us on the DMZ, there were two E-6 medics, veterans of Vietnam there who did everything right, expressly in the field on the wounded men.
Lucky for us on the DMZ, there were two E-6 medics, veterans of Vietnam there who did everything right, expressly in the field on the wounded men.
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