Uniform Question Related to the Commissioned Corps of the U.S. Public Health Service

2015-11-03T18:13:13-05:00

So today while pumping gas I noticed a woman wearing what appeared to be a military uniform. My friend asked if she was Navy and I was curious enough to step over and ask.

She replied that she was a [U.S.] Public Health Service officer.

It is hard to explain why but her uniform did not look 'real'. Plus, her ribbons were not individual- each line of ribbons horizontally was one piece. And they were slightly misaligned.

I was inclined to say something about her ribbons being out of alignment but held back.

I also had noticed she had no Blue sticker on her car's windshield. When I asked about that, she said 'they don't do that anymore', adding that 'all you have to do is show your ID'.

When I asked, she said she was a nurse practitioner which of course would have meant she was an R.N.

I did not ask to see her ID and just said goodbye.

1. Was I looking at a civilian dressed in a military uniform?

2. Do you, as Active Military, feel it is inappropriate for a former service person to point out uniform deficiencies?

3. I've obviously not been in a PX for more than a few years- do they make horizontal bars of ribbons in one piece?

Thanks!

Response by SSgt Private RallyPoint Member made Nov 3 at 2015 6:27 PM

2015-11-03T18:27:36-05:00

Seems to me you were likely looking at a US Public Health Services Officer. Thanks to Capt Mark Strobl, who clarified for me that they are commissioned officers. So yes, they wear uniforms and ribbons.

I don't think it's ever inappropriate to point out uniform deficiencies--if done tactfully and respectfully. I would be cautious pointing out deficiencies that I wasn't personally familiar with as with US Public Health Services Officers. I also don't think it would have been appropriate to ask for her ID. It would have been demeaning, in my opinion.

Response by Capt Mark Strobl made Nov 3 at 2015 6:30 PM

2015-11-03T18:30:26-05:00

In my last command (1st MED BN, 1st FSSG), I served with a variety of PHSO's. I'll be delicate: They are their own breed of cat... and military protocol wasn't ever at the top of their list. However if you did catch a poser, at least the "service member" wasn't wearing a Trident, jump wings, or a Bronze Star. Based upon the scenario as presented, 1.) The appearance of a PHSO is consistent, and 2.) to point #1.), it was probably a PHSO.

Response by SSG Paul Forel made Nov 3 at 2015 9:30 PM

2015-11-03T21:30:16-05:00

Thanks very much, SFC Davis!

Response by SPC Private RallyPoint Member made Nov 3 at 2015 10:02 PM

2015-11-03T22:02:44-05:00

The seven uniformed services are, in order of precedence by ceremonial formation:

United States Army
United States Marine Corps
United States Navy
United States Air Force
United States Coast Guard
United States Public Health Service Commissioned Corps
National Oceanic and Atmospheric Administration Commissioned Officer Corps

(Yes, I looked it up)
Basically, it looks like they were created as a sort of active reserve. They can be militarized like the coast guard. The public health service traces their origins to marine hospitals in 1798. The NOAA commissioned corps was created to be covered under the law of land warfare and Geneva convention in case of capture. Just a cursory search on the agency shows they do a lot more then monitor the weather.
Turns out they are real officers, legally. They get paid and hold rank along DOD lines. They seem more akin to medical and JAG officers in that they are specialists who happen to be commissioned and are typically limited to their fields.
In the case of these organizations it seems that the limited contact with the traditional military has resulted in a civilian that wears a uniform, while our JAG/medical officers become lawyers and doctors that happen to be soldiers.
There's an interesting discussion topic...

Response by SGT Jerrold Pesz made Nov 4 at 2015 1:20 AM

2015-11-04T01:20:06-05:00

I researched this years ago when I was wondering why the Surgeon General was wearing an admiral's uniform. Found out that it was because he was the ranking officer in the Public Health Service and as such he was a three star admiral. I also found out that the USPHS is an all officer branch.

Response by PO1 John Miller made Nov 4 at 2015 3:19 AM

2015-11-04T03:19:10-05:00

She is correct in that the military doesn't issue windshield stickers anymore. The Air Force and Army haven't used them in quite some time, and the Navy stopped using them around 2011.

Response by CAPT Kevin B. made Nov 4 at 2015 3:19 AM

2015-11-04T03:19:59-05:00

BTW Nurse Practitioners are not RNs. RNs require an associates degree minimum. Many nursing programs are 4 year. A NP requires a masters degree. They can write prescriptions and do many of the routine medical monitoring of chronic illness that doctors are simply overqualified for but absent NPs, have to do it. Many NPs used to be RNs but then completed their graduate program.

Living rural means you see more NPs. At our small town clinic, they have doctors, Physician Assistants, and RNs. The PA/NP side is masters level education. They didn't exist when I was younger. A NP handled my Express Scripts medication transfer to the new office and gave me a new one. In rural areas you hope you don't have to see the Doc because it would mean something more serious. There's a pretty good protocol that determines which provider you see. Works fine as the next level up is right there if needed.

Response by PO1 Rick Serviss made Nov 4 at 2015 4:35 AM

2015-11-04T04:35:22-05:00

What would you have done if she said yeah I'm a fake? As far as I know they still sell ribbon bars.

Response by PO1 Rick Serviss made Nov 4 at 2015 4:36 AM

2015-11-04T04:36:15-05:00

Oh and she's right, bases don't issue stickers anymore. They scan the ID or CAC.

Response by MAJ Private RallyPoint Member made Nov 4 at 2015 8:21 AM

2015-11-04T08:21:45-05:00

Nurse Practitioners are not RNs.
There are all manner of ways you can have your ribbons done, some better than others.
It is 100% fine to express your curiosity when seeing a uniform. You should feel free to ask about what you think are uniform deficiencies. It is not fine to "confront" someone over those deficiencies until you have asked and are sure you're right.

Response by CDR Terry Boles made Nov 4 at 2015 9:59 AM

2015-11-04T09:59:30-05:00

SSG Paul Forel
PO1 John Miller, CAPT Mark Strobl, SRA Brandon Olsen, SPC Fernando Acevedo, SFC Jerry Couch, MAJ Fred Nace, PO1 Rick Serviss, CAPT Kevin Ball, SGT Jerod Pcsz, SSG James Montgomery

Great question and post to clarify who and what the Public Health Service (PHS) is. I have served in 3 different branches of service; Navy enlisted, Air Force officer, and PHS officer. Indeed the PHS does wear military uniforms shared from the Navy, in fact NOAA also uses this uniform. Both PHS and NOAA make a few changes to the uniforms in the attempt to personalize it service specific, however at first glance one would assume this person is a Naval officer. Since the BDU is no longer a uniform item, both NOAA and PHS adopted the Coast Guard ODU as a replacement uniform. Why you ask? The PHS (6700 on AD) and NOAA (I think 200-330 on AD) are the 2 smallest uniformed services and as such do not have the budget for service specific uniforms, not to mention their respective histories do reflect the sea services. The below may be a bit long but worth the read about just who and what the PHS is.

Who is the US Public Health Service?

https://www.youtube.com/watch?v=lYGLqn0KdCo&index=5&list=PLSDzEhxgwQWXywrplSavjnodDqsrWRCBW (PHS, the little known service)

http://usphs.gov/docs/pdfs/uniform/Uniformed%20Service%20Rank%20Chart.pdf (Rank Chart)

The PHS is one of seven Uniformed Services of the United States and has been around for over 200 years. The origins of the PHS may be traced to the passage of an Act in 1798 signed by President John Adams that provided for the care and relief of sick and injured merchant seamen. The earliest Marine Hospitals created to care for the seamen were located along the East Coast, at the harbors of the major port cities, with Boston being the site of the first such facility, followed later by others including in the Baltimore vicinity at Curtis Bay. Later they were also established during the 1830s and 1840s along inland waterways, the Great Lakes, and the Gulf of Mexico. By the 1850s the Marine Hospitals were established along the Pacific Coasts as the country expanded westward. Funding for the Marine Hospital’s was provided by a mandatory tax of about 1% of the wages of all maritime sailors. The PHS Commissioned Officer Corps was formally established by congressional legislation in 1889, and signed by 22nd/24th President Grover Cleveland. At first open only to physicians, over the course of the 20th Century, the PHS expanded to include veterinarians, dentists, physician assistants, sanitary engineers, pharmacists, nurses, environmental health officers, scientists, physical therapists, and other types of health professionals. The PHS was called upon to assist the military in the Spanish-American War of 1898. All of the PHS Marine Hospitals were made available for the care of the sick and wounded of the Army and Navy. A PHS medical officer was on duty aboard the Revenue Cutter McCullough with the fleet of Commodore Dewy at the battle of Manila Bay.

During World War II, the President was given legislative authority for militarizing the PHS. Congress on November 11, 1943 authorized military benefits for the commissioned officers of the PHS and also gave the President the authority to declare the PHS to be a military service in times of war. The Public Health Service Act of July 1, 1944, which repealed the 1943 Act, contained the same provision for militarization of the PHS. On June 21, 1945, President Truman issued Executive order No. 9575 which declared "the commissioned corps of the Public Health Service to be a military service and a branch of the land and naval forces of the United States during the period of the present war, World War II." The Public Health Service Act of July 1, 1944 was later amended to state that the President might declare the PHS to be a military service not only in time of threatened or actual war, but also in "an emergency involving the national defense proclaimed by the President." In the absence of a declared war in Korea, the PHS reverted back to a Uniformed Service although many PHS officers deployed. The PHS also contributed support to military operations such as in Vietnam and the Persian Gulf. For example, the PHS organized surgical teams in Vietnam, consisting of both active duty officers and civilian personnel. PHS was also involved in efforts to control malaria and other infectious diseases in Vietnam. On July 6, 1988, the Department of Health and Human Services and the Department of Defense signed for the first time a Memorandum of Agreement which established a contingency planning relationship between the departments "for the mobilization and employment of US Public Health Service (PHS) Commissioned Corps Officers in DoD health care activities." The PHS has partnered, very successfully, with the Defense Health Agency of the Department of Defense to augment behavioral health and physical therapy resources for returning Soldiers, Sailors, Airmen, and Marines. PHS officers traditionally can be found in large numbers assigned to the Indian Health Service (IHS), Bureau of Prisons (BOP), CDC, FDA, Coast Guard, NOAA, and a host of many other federal and state agencies.

In 2002 Vice Admiral Richard Carmona was sworn in as the 17th US Surgeon General (SG) of the United States Public Health Service. SG Carmona was a high school dropout who enlisted in the Army in 1967 and subsequently became a combat-decorated Vietnam veteran with the Army’s Special Forces. The years that followed, SG Carmona obtained his medical degree in 1979 and became a Fellow of the American College of Surgeons. Prior to being sworn in as SG, he was the chairman of the State of Arizona Southern Regional Emergency Medical System, a professor of surgery, public health and family and community medicine at the University of Arizona, and the Pima County Sheriff's Department surgeon and deputy sheriff. During SG Carmona’s tenure he is credited with the transformation of the PHS and the initial partnerships with DoD which led to PHS officers deploying in harm’s way for mutual missions and providing more medical providers at military treatment facilities.

Although a small branch of service with 6746 commissioned officers, the PHS deployed nearly 900 officers providing a continuous presence from 2003 to 2014 for ongoing operations in both Afghanistan and Iraq working directly with the Ministries of Public Health to create national programs and services for both countries. PHS officers deployed to Afghanistan delivered and coordinated clinical and public health interventions designed to improve maternal and child health outcomes in a sustainable systems approach. The Afghanistan Health Initiative focused on the Rabia Balkhi Hospital to implement processes and systems designed to strengthen hospital management and leadership; to develop culturally appropriate training programs for physicians, midwives, and other health providers in the hospital; and to improve health outcomes for mothers and newborns. While other PHS officers deployed in support of combat units; one such officer was CAPT Maurice Sheehan (0-6) who deployed for 12-months in 2008 at Forward Operating Base (FOB) Fenty and partook in numerous operations working with Pashtoon refugees, non-governmental organizations (NGOs), and the Department of State in the hotly contested Korengal Valley with 173rd Airborne Brigade Combat Team and then after a Relief in Place/Transfer of Authority (RIP/TOA) with the 1st Infantry Division, known as the “Big Red One”. During one such operation, CAPT Sheehan, while serving at Combat Outpost (COP) Seray in the Chowkay Valley, earned his Army Combat Medical Badge (CMB) as he came under heavy enemy fire while enroute to performing medical interventions on a wounded Afghanistan Army soldier. For his work and similar combat actions and interventions both in the Korengal at COP Vegas, he was subsequently meritoriously awarded the DoD Bronze Star.

PHS officers also deployed to backfill medical needs at Landstuhl Regional Medical Center in Germany and Tripler Army Medical Center in Hawaii to provide care to wounded warriors. PHS officers are currently assigned to the Pentagon, USNORTHCOM/NORAD, TRICARE, Secret Service, Department of Homeland Security, and Army and Air Force medical treatment facilities (MTFs) providing care to wounded warriors with traumatic brain injuries. PHS officers also provide direct health care services to service members of the US Coast Guard and the commissioned officers of NOAA at their bases and aboard ship.

https://www.youtube.com/watch?v=D9_bYzJoR2E&list=PLSDzEhxgwQWXywrplSavjnodDqsrWRCBW&index=2 (Womack Army Medical Center at Fort Bragg)

https://www.youtube.com/watch?v=xft5Z2eNlLk&index=4&list=PLSDzEhxgwQWXywrplSavjnodDqsrWRCBW (Brooke Army Medical Center)

https://www.youtube.com/watch?v=oruuk2ztoQ0&list=PLSDzEhxgwQWXywrplSavjnodDqsrWRCBW&index=3 (Naval Medical Center Portsmouth)

PHS officers are involved in health care delivery to underserved and vulnerable populations, disease control and prevention, biomedical research, food and drug regulation, mental health and drug abuse services, and response efforts for natural and man-made disasters as an essential component of the largest public health program in the world. The PHS were once again called upon in 2014 when President Barack Obama pledged the nation’s resources in the fight against the Ebola virus in West Africa. A team of specialized PHS officers deployed to Monrovia, Liberia, to manage and staff a 25-bed hospital (MMU) constructed by the DoD to treat health care workers stricken with the virus. The PHS was the only branch of service that provided direct patient care. More than 300 PHS officers deployed to Monrovia for the MMU mission, while an additional 300 PHS officers deployed to West Africa in support of Centers for Disease and Prevention Control (CDC) missions. In September, 2015, President Obama presented the PHS with the Presidential Unit Citation for the MMU Ebola mission in Monrovia.

https://www.youtube.com/watch?v=2zDEt96R2F4&index=1&list=PLSDzEhxgwQWXywrplSavjnodDqsrWRCBW (MMU Monrovia)

https://www.youtube.com/watch?v=N9DgryQAe84 (MMU Monrovia walk through)

The PHS is well known throughout its history for their deployments during disasters. Some examples are when the PHS deployed to Ground Zero, more than 1000 PHS officers deployed to New York City. During hurricanes Katrina, Rita, and Wilma the PHS deployed more than 2000 officers to standup and manage field hospitals. In the aftermath of the Hattian earthquake the PHS deployed officers to provide medical care, and with the Gulf oil spill the PHS was there providing environmental expertise. During the 2014 unaccompanied minor children immigration crisis the PHS deployed and managed the initial medical triage and medical care, and provided case management services.

In addition to disaster response, the PHS has partnered with the US Navy on their health diplomacy missions. PHS officers have been part of the Navy's Pacific Partnership (in the Pacific basin) and Continuing Promise (in the Caribbean/west Atlantic) since 2007. Such missions are often carried out on either the USNS Mercy (T-AH-19) or USNS Comfort (T-AH-20), though other ships, such as the USS Bataan (LHD-5) have also been used.

Today, the PHS has and continues to serve this Nation in time of peace and war. Although a small Uniformed Service of 6746 commissioned officers, the PHS stands ready to meet the global and domestic health challenges of the 21st century through partnerships with DoD/NOAA/Coast Guard providing health care to service members of all branches of service, as Liaison Officers in foreign countries, providing research and health care to some of the most vulnerable populations, duty assignments within multiple federal and state agencies, and as the only Uniformed Service in the world that focuses exclusively on the public’s health through “Protecting, Promoting, and Advancing the Health and Safety of the Nation”.

US Public Health Service: little known but important

The PHS Commissioned Officers Foundation for the Advancement of Public Health commissioned this video highlighting the little known but important work of the...

Response by CDR Private RallyPoint Member made Jul 27 at 2016 10:41 PM

2016-07-27T22:41:27-04:00

First you should familiarize yourself with the seven uniformed services. Once you do that all of your other questions will be answered. And yes there are seven. Just go to Wikipedia and type in uniformed services.

Response by COL Private RallyPoint Member made Mar 24 at 2018 9:18 AM

2018-03-24T09:18:22-04:00

My spouse, USPHS CAPT, always gets confused as navy because they were the same uniform. She was the XO and Chief of Staff at the Defense Health Agency (Tricare) so of course everyone just assumed she was Navy. Happens all the time. Except when she was confused with a pilot at the airport and they sent her to the crew entrance. She had Army flight crew wings from her flight nurse days. Lol.

Response by CH (LTC) Robert Leroe made Mar 24 at 2018 7:57 PM

2018-03-24T19:57:45-04:00

A nurse practitioner is more than an RN; they can prescribe some medicines. Some bases don't have car stickers; you have to show your ID...so 2 things are valid. I'm wondering if this is something like the Surgeon General?