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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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I have not been active duty for over 20 years. But I had an opinion then and I still have it today. I believe IDC's can easily be faced with a medical issue above their capabilities and I believe that any unit ashore or afloat needs a Medical officer assigned. Corpsmen have their place in a military unit just like EMTs and Paramedics have their place in a civilian community. But there needs to be a doctor available to back those individuals up.
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CPO Patricia Waddell
I am a retired HMC never an IDC, but as a civilian I see a lot of PA's and CNP's and they do NOT work completely independently but have a Doctor that they consult with if there is an issue above their expertise. IDC's have proven their ability to handle most issues and have saved many lives over the years. I would have no problem seeing an IDC for my medical care and they need to keep up their skills while ashore.
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CPO (Join to see)
So, here is where I disagree with you. Let's look at the logistics with this. How many operational platforms do we operate on a regular basis?? More then we can support with Medical Officers that's how many. Now let's take the Submarine IDC into account. Take any given waterfront with how many boats we have and the number of UMOs we have. Ratio is about 8:1, with OPTEMPS being what they are we could never get boats underway doing what needs to be done. Let's also not forget the other things that the Sub IDC has to do along with medical care, they are running a Radiation Health Program, preventive Medicine, Gas Free Engineering, and everything else that the Medical Department is responsible for, and oh, don't forget, they are the ONLY Corpsman assigned on board. We put a lot of responsibility on these individuals and expect them to carry out their orders and maintain any skills needed to take care of their crew. Here on shore duty I do feel like some of my skills are decreasing and I hate that. How do I expect to take care of young Seaman Timmy with what ever it is that he needs help with if I don't take care of keeping my skills up? By comparing a corpsman to an EMT is kind of disrespectful when people forget about those higher trained people along with all of our Techs that are the best in supporting our AD crews and their families. That's about all I have to say.
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it seems to me that this is kind of a perishable skill and seeing patients while on shore duty is a good way to keep in practice. I'm not sure I'd feel very comfortable if my doc had just got off shore duty and had not seen patients regularly since their last sea tour.
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As a non-IDC corpsman I would have to say that IDC's are a must in shore duty. In many cases I preferred to be seen as a patient by and IDC than a doctor and as for working with them, they helped teach me more than I did in corps school in my first command. They also need to be able to stay on top of the game while on shore duty to ensure their next fleet tour is going to keep our shipmates healthy.
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As long as care remains the same yes they should as someone who is retired from the US Navy I understand the importance of staying proficient in your career. Things change even more so in the medical field.
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Retired HMC (non-IDC; retired 15 years ago) here, working as the risk manager for a Level 1 Trauma/Academic medical center and dozens of clinics, I continue to hear that when IDCs retire, there is no certification of sorts that would make their vast and intense clinical experience (no LPN, and such) marketable and compensable commensurate to such level of experience. I would assume that part of it is the type of patient population that IDCs see in the service; more likely than not, the lack of political will to fight for the civilian certification "equivalency"- and funds generated when IDCs have to take "a few more courses" to get that LPN or RN or PA degree. Unless the status quo changes, the IDCs, for whatever it's worth, should be permitted to spend 50% in clinical practice and 50% administrative. This would reinforce their resumes and give them a good fighting chance at landing administrative/management-type employment upon retirement- and meet operational needs. I would even argue that the closer retirement comes, the administrative percentage should go up higher. Another approach could be enhancing the IDC curriculum to as close as possible, approximate civilian curricula (LPN, RN, PA) to reinforce the argument for equivalency certification.
As an Adjunct Professor for an undergraduate Health Care Management program as well, I advise all my students to take their Master degrees- which has become the minimum to be competitive in the civilian world. I hope this helps.
As an Adjunct Professor for an undergraduate Health Care Management program as well, I advise all my students to take their Master degrees- which has become the minimum to be competitive in the civilian world. I hope this helps.
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Susan Doss Jara
Very good point, their isn't a certification. Perhaps IDCs training should be a prerequisite to a PA program or NP program with national certification. This could make them more marketable for promotion and the civilian sector.
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PO1 Todd Cousins
The only problem with this is to get an IDC to a civilian equivalent type of 'cert' would require them to have at least a bachelors degree and in most cases a masters. But I do like your work around in the experience area and I believe my last clinic in Bel Chase did an excellent job of getting the admin stuff done. As an example I was the primary care LPO and could have been the clinic as well if I was staying in longer. The Chief IDCs all ran sections of the clinic as well as seeing patients. This is an ideal setup and I really wish it was the norm for shore duty.
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CPO Paul Acedera
Precisely, Todd- what we want is a balance of full service to the nation and to the Navy while we are in....while being mindful at the same time, that the rest of our lives will be spent out of the Navy uniform. Thank you- great thoughts there, shipmate.
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Update since this was originally posted. BUMED instruction now requires that IDCs be empaneled for 500 patients on shore duty. That is about 50% of the expected empanelment of full time licensed providers.
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The problem with shore duty clinics is that there are never enough providers to begin with. Patient care should be top priority. Teaching HM3 Deepneedle how to give an eval input is secondary.
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PO1 Todd Cousins
You are right here but not completely. Patient care is the number one mission but insuring a sailor under your command is properly trained both medically and militarily is just as important for HM's on shore duty as for any other rate.
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PO1 Chris Crawley
PO1 Todd Cousins - The clinics have plenty of on duty time every week to do training outside of patient service time, including at least 1 half day per week.
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PO1 Todd Cousins
But as a leader I always felt it was important to teach all the time. medically I found a lot of patients that where ok with me showing young sailors things while taking care of the patient. The problem is finding time to mentor in the right way, don't get me started on the BS navy mentor check list junk, when you are seeing patients every ten or fifteen minutes all day. The half a day you are referring to is when we have to do all those stupid classes you get to do in a stand down. We don't get those. After all you all would go crazy if the clinic shut down for a day a month and wouldn't provide medicine to you or your families. by the way you should go nuts if we did. The answer to me is give them an hour or two a day to do the LPO or Chief job that is also part of their duties.
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Worst medical care I've ever received was from an IDC. And I was told to suck it up because it was free. Unethical malpractice. I'll never trust another one. If I walked in on an IDC as my PCM I would about face the hell outta the room and never look back.
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As a retired IDC, when I was on shore duty my time was balanced with managing a clinic and seeing patients and having duty in the ER. An IDC onboard ship has many duties and shore duty never carried the same work load as it did being forward deployed. The IDC needs to see patients and train junior corpsman in clinical skills. In regards to leadership, being a professional that is able to balance duties, responsibilities and problem solve setting an example for junior sailors will be recognized by Navy leadership and a contributor to upper mobility in promotion and assigned responsibilities.
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It all depends upon the "Needs of the service" coupled with the experience and training qualifications of the (IDC). You always take into consideration the needs of the service. If the service doesnt need you seeing patients then it's OK to spend time developing your leadership role where and when applicable. While all members need leadership training, patient care should not lack. If the unit in which the IDC is serving is flush with medical personnel, it is also OK to try other leadership roles, the IDC Primary function is to provide medical services "Just stick to the playbook"!
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