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March: Surgeon General's Corner
Vice Adm. Adam M. Robinson, Jr.
U.S. Navy Surgeon General

Surgeon General's Corner: Navy Medicine: “Achieving Success Through Total Force”  

By Vice Adm. Adam M. Robinson, Jr., Navy Surgeon General

Essential to building the future force of Navy Medicine is correctly setting a total force framework. This means that we must remain flexible and agile in how we fulfill our operational requirements. We must provide consistent training for our forces throughout their careers. We must also maintain continuity of care for our beneficiaries throughout the care continuum. Crucial to our total force efforts is our ability to correctly determine the macro requirements like force size and specialty type, while assessing the unique micro requirements from the deckplates. 

Our total force analysis strives to apply a better understanding of: 1) the correct mix of Active Duty, Reserve, Federal Civilians, and Contractors; 2) the placement of Active Duty billets in locations where civilian turnover is high and recruiting is low; and 3) the placement of Active Duty personnel in locations where the workload volume and type is sufficient to maintain the skills required for operational missions.

The Active Duty component of our total force composition is the backbone of our support to operational missions. BUMED recently participated in a Medical Recruiting Stakeholders Conference with Navy Recruiting Command (CNRC) to provide efficiencies in the recruiting process and to ensure that we keep focused on the quality of personnel that we recruit. While it is good news that retention has increased slightly over the past five years, we must continuously evaluate our training and education programs in order to hone and sustain optimal skill sets.

Most of our Reservists are prior Active Duty. For those who choose to leave Active Duty, Reserve affiliation is  a rewarding option that allows members to still serve their country while maintaining current rank, and also affords them the opportunity to transfer years of service towards reserve duty points and educational benefits such as the Training in Medical Subspecialties program. It is vital that operational support offices at military treatment facilities (MTFs) level engage personnel who are leaving Active Duty to work with CNRC’s Career Transition Office and inform them of Reserve opportunities.

Our federal civilian personnel are unique in that they provide much needed stability in the care we provide to our uniformed members, family, and beneficiary populations. Civilians are also the link to providing continuity in our training programs for both officer and enlisted members. Their influence is felt in our Graduate Medical Education (GME) programs, especially with respect to the guidance they provide our Corpsmen rotating through various departments. Retention of civilian personnel remains high. This is reflected in Department of Defense (DoD) implementation of a physician and dentist pay plan and the DoD Healthcare Occupations Sustainment Project that offer greater flexibility to adjust to local market pay. 

Lastly, our contractors fulfill significant roles in local healthcare markets while providing continuity of care and support for our beneficiaries. They also prevent Navy Medicine from costly network referrals by providing care at the most economic level, our local MTFs.

Our medical support mission spans the globe. Our unique operational requirements drive our Total Force structure. As our requirements evolve, a Total Force framework of Active Duty, Reserve, civilian, and contract personnel provides the flexibility we need to meet our multi-faceted mission. We are measuring and analyzing how best to allocate our Total Force through tools like MedMACRE, the Demand Based Staffing Model, and Fit-to-Fill Assessments. These tools will facilitate the  optimal mix, size and distribution of our workforce at the macro and micro levels. It is my honor to represent you as your Surgeon General. Thank you for everything you do, but most of all, thank you for your service.

-USN-