Posted on Apr 5, 2014
SSG Genaro Negrete
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I am new to the MEDCEN world. I've had the opportunity to interact with a multitude of civilian professionals that staff most of the positions in the hospital. Along with most being prior service, they have been working at the same jobs for 10-15 years. That type of longevity is hard to come by when we have PCS moves and deployments to balance.

Why not move towards making army medical centers staffed by civilians? Then push the soldiers out to the undermanned BCT's.

Civilian employees don't need to take an APFT biannually, don't have to qualify with an assigned weapon, etc.

There are probably a lot of holes in my theory. Leaders, what are your thoughts?
Posted in these groups: Combatmedicmemorialnew01copy Medics
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Responses: 10
SSG Robert Burns
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Edited >1 y ago
Nope. &nbsp;I've been managing civilians in hospitals for quite a while. &nbsp;Without going into too much depth I'll make a bullet list for you.<div>1. &nbsp;Calling out-its an endemic. &nbsp;Nothing like waiting for your 7pm nurse to show up and she calls at 650 saying she's not gonna make it tonight. &nbsp;Then either a military member gets called in (for free) or a civilian works super expensive over time.</div><div>2. &nbsp;Salaries- the gs and contract positions cost/pay more than our military salaries do. &nbsp;You can work me an extra 12 hour shift/wk at no cost. &nbsp;You work a civilian like that and you will lose your job as a manager because you will bankrupt the department.</div><div>3. &nbsp;Training-I see you saying send the military to the BCT's. &nbsp;The problem is, there's no patients in the BCT's. &nbsp;You can't send a nurse to ICU in Iraq and they haven't seen an ICU patient since they've joined the Army. &nbsp;At the hospital is where you learn to be a nurse. &nbsp;At the BCT is where you learn about equipment and paper work, and flu shots.</div><div>4. &nbsp;Government shutdowns/sequestration- so during this last shutdown when all civilians got sent home without pay, do you think the hospital got shut down? &nbsp;Nope. &nbsp;Completely staffed with military, paid or not.</div><div>5. &nbsp;Quit- civilians can and do quite at their leisure. &nbsp;Find a better job somewhere else and they'll bounce in a heartbeat. &nbsp;We don't have that luxury.</div><div>All that to say this....No.</div><div>Oh and what BCT is undermanned? &nbsp;They are number 1 priority in strength/readiness.</div>
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SSG Robert Burns
SSG Robert Burns
>1 y
What I have seen frequently in BCT's is that the slots are filled but the people are elsewhere working in sometimes made up positions.
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SSG Genaro Negrete
SSG Genaro Negrete
>1 y
That is very true. I've seen training room NCO's actually slotted almost anywhere because the MTOE didn't provide the slot on MTOE. <br>
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SGT Suraj Dave
SGT Suraj Dave
6 y
We should just have salaried civilians. I spent my whole military career as a medic within a BCT. Never did any hospital time. I see the need for military Doctors and Nurses, but I don't think we need as many Army Medics working in base hospitals.
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MAJ Ronnie Reams
MAJ Ronnie Reams
>1 y
Used to be and may still be that most military in the PCS hospitals are troops from the Medical units assigned and they work there to keep their skill sup and to avoid just hanging around the barracks. Your Surges, Evacs, Fields, etc do not have much of anything to do when not deployed. At Bragg, we also sent our Bn Surgeons to Womack to work after Sick Call.
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LTC Critical Care Nurse
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<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; First of all you need to keep doctors, nurses, PT/OT, and medics, etc in the hospital in garrison.&nbsp;&nbsp; This is their downtime location between mobilizations and wars.&nbsp;&nbsp; In the clinics and hospitals they learn the skills needed for deployments and their war time missions.&nbsp;&nbsp; While state side they should be attending training, military school, conferences becoming better at their profession and skills.&nbsp;&nbsp; Their deployment readiness should be top notch.&nbsp;&nbsp; </p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; That being said, they tend to be the first to go, and when they do a reservist comes in and fills/holds their position.&nbsp; Army Medical has a 20% Active/80% Reserve mix, which means most of your strength is in your ability to backfill, which is pretty much how the situation is now.&nbsp;&nbsp; I just started my third backfill mission this last month.&nbsp;&nbsp;&nbsp; </p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I agree with SSG Burns assessment of the staffing situations.&nbsp;&nbsp; My civilian job, the staff would be fired on the spot if they tried half the stuff I've seen at Govt hospitals.&nbsp;&nbsp;The number one mission of the Military hosptals is to TAKE CARE OF THE SOLDIER and their FAMILIES.&nbsp;&nbsp;&nbsp; &nbsp;&nbsp; </p>
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CPT Assistant Operations Officer (S3)
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I have been a contractor in a healthcare facility. I can tell you, I know what the company was paid and I know what I was getting paid. My problem with GS employees is that too often the laws allow them to become complacent and not care. It is too difficult to fire them. Some of the military members don't want to bother with the hassle of documenting things. I am in favor of individual contracts. Each person gets a contract directly from the government, renewed annually. This allows for a contract to not be renewed if there are problems. It also reduces the overhead of the large company behind them. The company I worked for made $20-30/hour/position. The individual contractors could be paid a couple dollars more an hour and both the government and the contractors will be happy.

At the end of the day, though, active duty provide the most bang for the buck. Privatizing things sets limits on what you can make someone do. Military members can be worked 16 hours a day and you pay no overtime. I'm not advocating for that, but it can be done if needed.
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