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There are recent conflicting opinions surfacing within the Navy Medicine community regarding Independent Duty Corpsmen (IDC) patient care duties while assigned to a Military Treatment Facility. IDCs are being assigned as Primary Care Managers at their clinics just like PAs but are responsible for seeing half the number of patients. Many IDCs believe they should spend more time in leadership duties and less time seeing patients. Many senior leadership disagree arguing readiness. On deployment, IDCs are often the sole medical provider with no physician or other practitioner nearby to consult. What is your take?
Posted 11 y ago
Responses: 26
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As a retired IDC that finished his time up on shore I do think IDC's should be seeing patients while on shore duty. You can't expect a person to do two or three years ashore and not get rusty in their medical skills at the same time. That said they are leaders. Onboard ship they fill a huge role in leadership. So the answer is to have them fill do both. If your patient pool for a regular provider is 1200 then your department head or division officer usually has a smaller number like 800. It shouldn't be an issue to give the IDC a pool of Active Duty only patients around that size and block off appointment slots for their admin and leadership time. To not use the the medical abilities and the leadership value that your IDCs bring to the table is just wrong.
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PO1 Aaron Baltosser
As non-IDC FMF types three of us saw 1,800-2,000 patients monthly. The load from what you are describing is a bit heavier, but not much. Seeing patients regularly also keeps you up to date on treatment techniques, and their skills sharp. The Navy after training someone for as long as it takes to earn the IDC designation is going to want to see a permanent return on investment.
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PO1 J R Foster
With people's health and lives depending on the skills of an IDC, I think it is imperative that they stay working in what they were trained to do. That involves their medical profession as well as their leadership role. I do agree that they should primarily see active duty patients only. To have them shy completely away from the medical field they were trained for, takes away a vital resource the Navy needs. To completely remove them from leadership roles and duties, does the same. I think Petty Officer Cousins and Petty Officer Baltosser make very good points.
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LT Aaron Pease
Good points all. (1) I wonder if manpower is at issue. Seems the number of MOs is dwindling (consistent with military manpower across the board); therefore, huge opportunity for IDCs to fill the gap. (2) Standard of care differences are not tolerable as we all know -- our patients deserve our best. (3) Agree with leadership comments if and only if care is taken in developing IDCs as POs and leaders. USN petty officer first, IDC second! Push-button crow(s) do not (always) equal good deck-plate leader!
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Does the level of care change when an IDC treats and AD member afloat compared to an AD member ashore? Should the IDC not see patients on ships and operational units with a Medical Officer? How about an operational unit that is not deployed, should the IDC not see patients and defer the Sailors and Marines to the MO? For units that are deployed, without an MO, and with today's technology, if there is an issue that an IDC can not resolve, they are able to communicate with a medical officer. An IDC on shore duty should be assigned as a medical provider for the AD population at that command. Often, they are assigned to the Acute Care Facility where they are able to keep up on their provider skills. YES, IDCs should see patients on shore duty.
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I think they are quite capable of handling a full load of patients. Look at the number they see when deployed.
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Depends on the current other requirements they have to meet to promote, which could be a reason for wanting to lean towards leadership, training and admin duties. On the other hand, why let your skills diminish?
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I think I can see both sides of this discussion. The IDCs want to work on their leadership duties, and I am thinking it is because without leadership roles and development, promotion is not going to happen. I also understand the need for readiness, and getting the job done. It seems there should be some way so that their time spent as clinic managers should be considered as a leadership role, and count for leadership development. Or am I missing something here?
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CMDCM Gene Treants
CPO Curtiss Hill - As well it should be IMHO.They Should be the best of the best.
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Perhaps the better question is whether the Navy should make IDCs Warrant Officers since they are the "technical experts of their rating"
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YES. Their job is to see patients. As a IDC they see patients, unless working out of rate and THAT would be a crime IMHO. With the amount of time and training put into making a good IDC, they need to work as they are trained. Patient care is their primary responsibility, BUT that does not negate their duties as a Petty Officer of whatever pay grade. Leadership and other duties are all still a part of the requirements that need to be done and must be to stay competitive IN THEIR NEC for advancement.
Although I have seen it, I hate to see an IDC assigned as an administrator in a Naval Hospital. Master Chief HM who is IDC still needs to see patients as his/her primary duty IMHO OR go the Command Master Chief Route and Free up that Slot!
Although I have seen it, I hate to see an IDC assigned as an administrator in a Naval Hospital. Master Chief HM who is IDC still needs to see patients as his/her primary duty IMHO OR go the Command Master Chief Route and Free up that Slot!
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PO1 Todd Cousins
Master Chief I witnessed more then a few HMCM IDCs filling a leadership role and still insisting they got their clinical time in. Hell I remember one at the Marine division level that would sneak in to see patients.
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CMDCM Gene Treants
PO1 Todd Cousins - There were times I did spend a little time in the ET Shop, but my primary duty was still to be the CMC, so it was just stolen time that I got to enjoy. Our roots are strong in our basic training, but we cannot fill both billites, as I said put in for the one that is a leadership role and free up the IDC slot for someone who can fill it full time. I made that choice when I put in for the Command Master Chief Program and gave up the ET Shop on USS NASHVILLE, my first CMC assignment.
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Retired LCDR, MSC. Was IDC. Agree with senior leadership. By the time you go to IDC school, you will have proven your leadership skills, which is one trait considered when choosing IDCs for that duty afloat. Those previous comments are spot on!
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IDC's are well trained by the Navy at not an insignificant cost. While they may want to be a more traditional leader on shore duty with more administrative things, the fact is they are often needed due to lack of sufficient providers to see patients. They sy in the Navy choose your rate, choose your fate. An IDC has to understand that once they start down the IDC path, forever will it dominate their destiny. IF they want to take a strong role in Sailorization, then it is up to them to find those roles on shore duty and apply themselves in addition to meeting the expections the Navy has of them.
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I would say that as long as the standard of care is maintained there should be no change in the IDC's responsibilities at sea or ashore.
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