Why do some NCOs feel that they have an MD when dealing with their Troop's Profiles?

<p>I stayed at a Holiday Inn Express last night, so I'm pretty much a doctor.&nbsp; </p><p>&nbsp;</p><p>You are right, NCOs are not doctors but they need to be pretty good at deciphering profiles and determine what exercises a Soldier can and cannot do.&nbsp;&nbsp;Profiles don't indicate every&nbsp;exercise that cannot be done.&nbsp; We do need to be careful though not to further injure Soldiers, as this can cause&nbsp;greater issues!&nbsp; &nbsp;</p>

I think this particular issue comes down to two things: first, knowing your Soldiers. Most issues that most folks end up complaining about would be resolved if leadership would take a minute to pay attention to their Soldiers. If my Soldier came back to me after an accident or something serious and told me that the TMC just told them to essentially drive water and drive on, there would be some issues. ..with that, there are malingerers. Knowing your Soldiers and seeing what they are capable of under normal, healthy circumstances prevents us from throwing that label on folks that it shouldn't be thrown on, and identifying the people that that label truly fits.
The second is that, despite the urging of the most gung-ho NCO, the Army is a marathon, not a sprint. I would much rather a Soldier have the opportunity to get out of the Army on his or her own terms, and not on a medical chapter. I know what I am, and a doctor is not one of them. There is nothing so important that I have to put my Soldier's health in danger, especially for something like morning PT. If a Soldier of mine comes up to me saying he is hurt, he is going to the proper channels to get fixed, and he is going to follow that channel's guidance to the letter.

I was being processed for a medical discharge for a knee injury when the rear D NCOIC decided that the next day was going to be a "road march day." However, my profile specifically forbid road marches, and I was being discharged for that injury. I already knew by this point to carry a copy of my profile around with me at all times, and I had learned to keep back up copies in case the first one was damaged (got wet, torn, etc).
This NCO called my office to let us know that the next day was a road march day and what we were to do. "Show up at 0600 with PT uniform and boots with a rucksack that weighs 35 lbs" or something like that.
I showed up in PT uniform, but because of my profile I knew better than to try a road march so there were no boots and no rucksack. She went off. She told me she was going to see me getting an article 15 because I had disobeyed the direct order of a sergeant. I calmly asked her if I should obey her order or the major's order that gave me the profile. She said I was "full of shit" (her words) and wanted the major's number. I said, "Don't worry. He'll be calling you."

I have a permanent profile for a knee injury and have seen the NCOs that think they have an MD. I think that they see everyone in the same group. For example everyone with a broken arm should heal in the same way and in the same amount of time. What they fail to understand is that everyone's body is different and every injury is different and thus take different amounts of time to heal. Even then they think that some injuries will fully heal because someone else had a similar injury that did. I folded my right knee completely backwards and can tell you that just because you break your knee, it doesn't mean that you will fully heal. There are other factors with my injury that make it different from just simply a broken knee.

With that said, I have seen soldiers that abuse their profile. You will see soldiers that have a minor injury that are given a no run profile only to see them walking the PT track like they are taking a stroll down the beach. The point of PT is to improve (or at least maintain) your physical fitness. Just because soldiers with minor injuries have a no run profile doesn't mean that they can't walk fast to get their heart rate up and work the muscle groups in their legs. I at one point walked at 25:15 for the walk event for a record PT test. I know it is only pass/fail but I was trying to get something out of it. I can say that after 7 years with the no run profile, I was able to get my profile lifted to run at own pace and distance. I still get a lot of crap for not running in formation with the unit but I know that if I do, I will undo all the work I have put in to better myself and heal.

Long story short, only a doctor can tell what the soldier can and cannot do and how long it will take to heal. Don't group all profiles together. Not all of us are shaming or malingering. If you feel your soldier is shaming, have to commander get more information from that soldiers doctor on what the extent of the injury is, what the treatment is, and what the estimated healing time will be.

<p>Chief</p><p>&nbsp;</p><p>As an NCO I have a medical degree, a social working degree,&nbsp;psychologist, marriage counselor, finance advisor, and the list goes on and on</p>

I've seen this happen many times. Often, the NCO in question gets set straight by either the medics, or someone senior to him in a less than friendly conversation.

I've also had many platoon sergeants come to be trying to prove a soldier is malingering. We had a hell of a time trying to establish a pattern of fraudulent visits for medical care. The issue, as explained to me by my PA, is that providers are supposed to treat the pain as described by the patient. There is no empirical way to prove a patient's pain is in fact a 9 out of 10. The provider has to go off that, among other things, to see if the treatment plan is working. So proving malingering in a Soldier would take a long history of ineffective treatment coupled with a fluctuating story regarding his pain scale, events leading up to the injury, or any other details along his treatment plan. It's easier to prove the soldier is violating their treatment plan than it is to say they are malingering.

If the unit is authorized a PA on it's MTOE, then that's usually the first person to go to for clarification. I've had infantry team leaders bring me their soldier's profiles looking for clarification and I pass it by the PA.

If you don't have a PA readily available, a phone call to the profiling physician may be in order. If it becomes an issue about HIPAA, the commanding officer can get involved. They are allowed more leeway due to the command position they are in.

If a soldier has physical limitations put on paper from a civilian physician, then it has to be put on a DA 689 or DA 3349 by a military physician. This ensures the physician (who is supposed follow profiling standards IAW AR 40-501, Standards of Medical Fitness) properly translates the limitations into "Army speak".

Essentially, the profiling process is a recommendation for the solider so that they can get better. There is an allowance for commanders to order soldiers to violate all or part of their profile if it is absolutely necessary to accomplish the mission. This isn't typically enforced because there are few situations (outside of combat) that a commander would take the risk of further physical damage to a soldier and having to explain it to higher (ie, higher command, or MEB members)

As for the regulation saying profiled soldiers must at all times carry a copy of their profile, I know I read it somewhere but can't, for the life of me, find it again. It would still qualify as a lawful order from any level of the NCO support channel or the Chain of Command. Even if I trust my soldier entirely, if he says he's on a profile, I need to read the exact limitations imparted by that profiling officer. It's not something I'm going to take someone's "word" for it.

DAMN, wish you was my chief!!&nbsp;

Even being a medic with a wealth of medical knowledge I would never presume that what a MD had written was wrong. I understand as an instructor that a lot of troops play the system and ride profiles. I think those that have been in longer do it more because they know the system. Some leaders are trying to be so authoritative that they think they are the be all, know all of the army.

As an NCO, you are directly responsible for the performance of your Soldier. There failure is your failure, and physical fitness is a high-vis portion of the measurement of a Soldiers performance. Therefore, when a Soldier is on a profile, you as a leader feel that they are being "sold short." So, as a leader, most feel that unless we help push them through the injury, they will continue to be injured and done an injustice.

Do I agree? Not at all.