Reserve physician bonus? Gone!

[armytrainingsir]

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Thankful that they are honoring the signed multiyear contracts, as long as they were in place before FY 2020.

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[DeadCactus]

Will be curious to see something about this in official communication. I've been thinking about taking a break, maybe now is the time...

 

[pgg]

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Thankful that they are honoring the signed multiyear contracts, as long as they were in place before FY 2020.

They don't hate you or love you. You're a widget in a billet, and apparently they think they have too many of you. Bonuses are intended to be force shaping tools, nothing more. Don't take it personally.

 

[HighPriest]

They don't hate you or love you. You're a widget in a billet, and apparently they think they have too many of you. Bonuses are intended to be force shaping tools, nothing more. Don't take it personally.

Unless they mention you by name in the reg. That’s probably a sign.

 

[armytrainingsir]

They don't hate you or love you.....Don't take it personally.

Oh, I know that. Just a bit of hyperbole.

 

[Gastrapathy]

@pgg the bonuses being tied more directly to force shaping is another turn for the worse for the MC. This was always true for the line but our bonuses were also designed to reduce the disparity between .mil and civilian pay. The reserve bonuses served the same purpose and the liberal interpretation of critical specialties goes back 20 years. This is a major change in philosophy for the MC and you see it in the AD pay situation as well

 

[militaryPHYS]

"Bonuses" being accession, retention, etc. have always been force shaping whether you are a Doc, Nuke, Corpsman, Cook. They aren't written to supplement the deficit of pay gap. Only special PAY or Incentive PAY does this in the literal sense.

Do physicians perceive bonuses as a pay gap bridge? Of course. But that's just a perception they use to help justify their decision at that time. Bonuses come and go as the military needs you. The military thinks they need less AD and less reserve physicians. The consolidation and attrition will continue until the numbers match current high level expectation.

 

[pgg]

@pgg the bonuses being tied more directly to force shaping is another turn for the worse for the MC. This was always true for the line but our bonuses were also designed to reduce the disparity between .mil and civilian pay. The reserve bonuses served the same purpose and the liberal interpretation of critical specialties goes back 20 years. This is a major change in philosophy for the MC and you see it in the AD pay situation as well

I don't really agree. I would contend the main course has always been mostly force shaping, with a side order of pay gap narrowing. Else we wouldn't see similar bonuses for fields like, say, anesthesia and cat 1 surgical specialties where civilian pay can differ by a factor of 2. Else we would have seen these bonuses get adjusted for civilian pay changes over the years, or at least inflation. As you know, the $ amounts haven't changed in 30 years (except for IM and FP ISP getting a modest bump about 10 years ago).

I'm not saying it's great, but everyone's paycheck - civilian or military, medicine or not - is much more about market forces than some sense of fairness. I mean, CRNAs make an hourly wage comparable to anesthesiologists in many places.

We can choose to have hurt feelings about it, and derive our sense of self-worth and self-esteem from paycheck volume, or not. One choice brings a lifetime of heartburn.

 

[Gastrapathy]

An old corps chief told me that the reason the bonuses were stagnant was that trying to get new ones through was impossible but at least they could keep the old ones regardless of “need.” I mean by the force shaping logic, why pay a USUHS grad anything more than officer pay until the end of the obligation. You’d have no trouble still filling the med school.

 

[Gastrapathy]

Also, basically saying suck it up buttercup when the govt arbitrarily cuts their pay at the same time yours has gone up recently is a little harsh.

Saying we can “choose to be unhappy” absolves the leadership of responsibility for their behavior. It’s not unhealthy to be unhappy when you are mistreated. It’s unhealthy to stay in that situation by choice.

 

[notdeadyet]

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Is this for Special Pay or HPLRP? I haven’t heard any of this from the Guard side, but us finding out late would be pretty true to form.

I remember from an oooold briefing once that around 50% of all MC deployments were reserve/guard docs. With attrition of RC and DHA, how much do they think active docs love rapid cycles of deployment?

 

[Chonal Atresia]

I hope more docs (both reserve and active duty) will speak with their feet and leave. Those indentured servants (long obligations) and those who cannot keep up with the fast-paced civilian practice model will, of course, stay in. But,sooner or later, cutting bonuses will decimate this sinking ship. Patriotism only goes so far when you treat your people like s$&”! Who in their right mind would willingly take a 2x-3x pay cut (some cases even more) when you can cross the street to make fair market value, be treated way better and have stability for your family?

 

[Perrotfish]

I hope more docs (both reserve and active duty) will speak with their feet and leave. Those indentured servants (long obligations) and those who cannot keep up with the fast-paced civilian practice model will, of course, stay in. But,sooner or later, cutting bonuses will decimate this sinking ship. Patriotism only goes so far when you treat your people like s$&”! Who in their right mind would willingly take a 2x-3x pay cut (some cases even more) when you can cross the neet to make fair market value, be treated way better and have stability for your family?

Civilian practice isn't even faster paced at this point, at least for the non procedural specialties. For the last decade civilian medicine has been slowing down: smaller panels, shorter work weeks, and better EMRs that allow for drastically faster charting. Meanwhile military medicine has been cutting both providers and support staff, and the EMR has remained nonfunctional even on those days when it is technically in working order, all while the total number of patients has stayed constant or increased.

I am working full time in the civilian world and I am working much less than I did in the military.

 

[militaryPHYS]

Don’t we all know they are consolidating and don’t want people to stick around? Why then would we be surprised by them taking away bonuses for recruitment/retention? They are just doing what they told us they would do.

Let’s get past this point. There is no pay cut. Pay is base pay plus your specialty (incentive) pay. If you joined or stayed in and justified it by using bonuses (not pay) in your calculations for your budget then I don’t feel sorry for you. Plus any changes to bonuses are for future ones, not ones people already signed. So again. No pay cut. If you think removing a recruitment/retention bonus is unfair then I would agree you should leave as soon as your obligation is up because you don’t understand the system completely.

With my wife being internal med and with everything currently going on she is now more likely to get out than stay in. That doesn’t mean she is surprised/shocked/appalled at her leadership. She is just planning for the next step. When your time is up your time is up.

Most people choose to receive less pay for being a physician because they wanted to serve/volunteer/mission or practice for the underserved. Nobody forced them to. If their priorities change they should leave after the obligated time they volunteered for.

 

[Gastrapathy]

You get less money but it’s no pay cut.
But I’m an orthopod so my moneys up.
No one should complain
You should just suck it up

You gotta fight for your right to gripe(ee)

 

[militaryPHYS]

How is my money up? I owe time. I have no bonuses. I have ortho pay and board cert pay. My pay has nothing to do with accession or retention bonuses.

It’s very simple. If you are upset there is no retention bonus... Get out! If you are upset there is no accession bonus, Don’t sign up!

You guys love the civilian world so much I don’t understand what the problem is. We are talking about people who haven’t joined yet or are at the end of their commitment. Isn’t this a good thing? It is dissuading people from coming in to MilMed and encouraging people to get out. Isn’t this what you all want?

 

[Chonal Atresia]

How is my money up? I owe time. I have no bonuses. I have ortho pay and board cert pay. My pay has nothing to do with accession or retention bonuses.

It’s very simple. If you are upset there is no retention bonus... Get out! If you are upset there is no accession bonus, Don’t sign up!

You guys love the civilian world so much I don’t understand what the problem is. We are talking about people who haven’t joined yet or are at the end of their commitment. Isn’t this a good thing? It is dissuading people from coming in to MilMed and encouraging people to get out. Isn’t this what you all want?


I actually agree with you on this point. I hope military medicine accomplishes their goal and completely decimates recruitment and retention. Then (when the next big conflict breaks out) they will be completely f$&@ed up s$&@ creek without a paddle!

Bust out the popcorn at that point.
BTW, by “consolidating” the military is creating patient abandonment. I see it in my practice with Tricare. Patients have had recent surgery but come to see me because the MTF no longer has “capacity.” In the civilian world you can’t get away with abandonment but the military does whatever it pleases.

Pathetic.

 

[armytrainingsir]

How is my money up? I owe time. I have no bonuses. I have ortho pay and board cert pay. My pay has nothing to do with accession or retention bonuses.

I would argue that any pay you receive above and beyond your grade and time in uniform is a retention bonus, regardless of what it is called. And the promise of getting additional pay while you are contractually obligated is a form of accession bonus. How many physicians would join if their outlook for future pay was just as a CPT over 4 or MAJ over 6 as a board certified orthopedic surgeon? (Keeping in mind the average PGY5 makes about 60k per year, while a CPT over 4 makes 71k).

 

[armytrainingsir]

"I hope military medicine accomplishes their goal and completely decimates recruitment and retention. Then (when the next big conflict breaks out) they will be completely f$&@ed up s$&@ creek without a paddle!"



They have a plan for that. Actually three off the top of my head.

First is IRR. Not sure about now, but in the past, you had to take active steps to get out of IRR. How many know that process now? I would guess the extent of the IRR roles is a pretty healthy secret for AMEDD. For example, an old acquaintance that ETS'ed from the NG in 2006 or so was amazed when he received a letter years later that he had been promoted to 05. He had no idea he was still 'in'. And activating a few hundred physicians would be a mere blip in the 24/7 news cycle.

Recall retirees. Plenty of military retired physicians in their lates 40s,50s and 60s still active in civilian practice to be called up as needed.

And finally

Return to the Draft | Selective Service System

www.sss.gov

 

[Chonal Atresia]

"I hope military medicine accomplishes their goal and completely decimates recruitment and retention. Then (when the next big conflict breaks out) they will be completely f$&@ed up s$&@ creek without a paddle!"



They have a plan for that. Actually three off the top of my head.

First is IRR. Not sure about now, but in the past, you had to take active steps to get out of IRR. How many know that process now? I would guess the extent of the IRR roles is a pretty healthy secret for AMEDD. For example, an old acquaintance that ETS'ed from the NG in 2006 or so was amazed when he received a letter years later that he had been promoted to 05. He had no idea he was still 'in'. And activating a few hundred physicians would be a mere blip in the 24/7 news cycle.

Recall retirees. Plenty of military retired physicians in their lates 40s,50s and 60s still active in civilian practice to be called up as needed.

And finally

Return to the Draft | Selective Service System

www.sss.gov

Interesting points.

Obviously, the draft CAN happen but hasn’t in over 45 years. This country is VERY different from the one in the early ‘70s so I personally don’t see it ever being instituted again unless Armageddon truly happens.

But, as I said above, the military does what it wants when it wants. It has no problem abandoning its’ patient population justified by reaching “capacity.” I’m sure it wouldn’t bat an eye forcing doctors back on active duty after they have honorably upheld their side of signed contracts.

Whether congress would grant them this authority is another question. One would hope not.

 

[militaryPHYS]

I would argue that any pay you receive above and beyond your grade and time in uniform is a retention bonus

I understand where you are coming from and I agree to some extent, but it isn’t how the pay/bonus system is structured. They are kept separate.

If your OP was discussing specialty (physician) pay and not just bonuses then we would be having a whole different conversation. If this is the case please send the reference to the new instruction for all of us to review.

 

[ProwlerturnGas]

I am a navy reservist. I haven’t seen an instruction, notice or even a rumor...yet

 

[militaryPHYS]

Yeah. We are still waiting on FY20 special pay guidance

 

[backrow]

Let’s get past this point. There is no pay cut. Pay is base pay plus your specialty (incentive) pay.

These mental gymnastics are impressive. Would make a DHA Director proud.

Sure, it’s potentially unrealized, but if I wanted to keep my current pay rate for the rest of my career that is likely not possible. That’s a pay cut at some point. Now, if they want to grandfather people similar to how they do BAH then I’d agree with you.


Sent from my iPhone using SDN

 

[militaryPHYS]

One of my first slides in military personal finance 101 I give is don’t plan/count/rely on bonuses. That money goes in to savings. Live, plan and decide based on everything else.

Uncle Sam can add or remove them at any time and without warning. Right or wrong it is how the pay structure works.

 

[Cooperd0g]

milPHYS is right on this one. It is just rare that it actually used as a force shaping tool. Frequently the military is so far behind on using bonuses as a force shaping tool, the landscape has changed enough to not go through with a bonus change.

Several years ago the Navy significantly cut the department head bonus for NFOs while raising the pilot one. They had previously been identical for over a decade. People were pissed. They were expecting that money. So while I think milPHYS is correct, that isn't how people see it. They see everyone else before them getting a certain amount of money for the same job. Not getting it is seen as a pay cut.

 

[pgg]

Also, basically saying suck it up buttercup when the govt arbitrarily cuts their pay at the same time yours has gone up recently is a little harsh.

Saying we can “choose to be unhappy” absolves the leadership of responsibility for their behavior. It’s not unhealthy to be unhappy when you are mistreated. It’s unhealthy to stay in that situation by choice.

I usually agree with you on just about everything here, but you're wrong on this. No one is being mistreated. No one is getting their contracts retroactively changed. No one is being involuntarily extended.

We're talking about retention and accession bonuses, not specialty pay. By definition, this money goes to people without ADSOs who sign new contracts or extensions. It's a simple choice, if you don't like the terms, leave. I could see the argument if specialty pay was changing, if that is something a would-be careerist might have factored into their decision to join or extend, but only a fool would fail to acknowledge that there is a risk that it will change.


A civilian hospital where I do locums shifts sent me an email a few months ago saying they had a new PRN contract for me to sign and return. The rate quoted in the contract was almost 40% less than what I'd previously contracted for. After a moment of incredulous exasperation, I emailed them back asking what was up, and the reply was simply "that's what we pay for PRN shifts in this specialty now". And I said OK, I won't work there any more.

I could've signed the contract and chosen to work on those terms, and tried to be happy about being lowballed by their idiot accountants who can't connect the dots between $ and their eternal ongoing recruiting problems ... but I walked. Maybe they've got someone else lined up to take those days. That's what I mean about people who "choose to be unhappy" ...

 

[Gastrapathy]

@pgg the golden handcuffs mean that it’s not as simple as just find the next locums job. This was part of their comp for decades and now it’s not. It increases the pay gap and for many, it’s not quite bad enough to give up the $1M retirement. But just because they are stuck, doesn’t mean they can’t resent the change.

What would you do if they suddenly cut BAH by 50%? You’d stay to 20 anyway but it would sting. These changes are the second wave that was always coming with the innocent consolidation of bonuses a couple years ago. I predicted it then.

 

[pgg]

@pgg the golden handcuffs mean that it’s not as simple as just find the next locums job. This was part of their comp for decades and now it’s not. It increases the pay gap and for many, it’s not quite bad enough to give up the $1M retirement. But just because they are stuck, doesn’t mean they can’t resent the change.

What would you do if they suddenly cut BAH by 50%? You’d stay to 20 anyway but it would sting. These changes are the second wave that was always coming with the innocent consolidation of bonuses a couple years ago. I predicted it then.

Fair enough, I see your point.

 

[militaryPHYS]

@pgg the golden handcuffs mean that it’s not as simple as just find the next locums job.

I'm sorry but I don't see your point. Isn't the longstanding trend of opinions supplied on this forum centered around how it is so much better on the outside and worth the stress of finding a practice or locums gig? "Grass is so much greener" we say. Or, "don't sign up" in the first place! This has been told to so many on here for so long. But now that MilMed makes the decision easier to NOT join in the first place or to leave when commitment is up we should be upset that we don't want to stay in anymore? It all just seems a bit contradictory.

If you choose to join or stay in past your commitment then you better own it. The military didn't "get you" or sucker you in to anything. You chose under your own free will to accept the pay gap, possible losses or gains and thousands of unknowns of military medical service. Did we really expect the government to hold our hands to tax-free money/benefits for the rest of our lives? Nope. The sooner people understand and accept this the quicker they might find peace and happiness in MilMed. Can't understand or accept it? Don't join; Get out.

 

[Tccanc]

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Thankful that they are honoring the signed multiyear contracts, as long as they were in place before FY 2020.

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Thankful that they are honoring the signed multiyear contracts, as long as they were in place before FY 2020.

I was selected awhile ago by the board and awaiting scroll. I am a family med physician (prior active duty Navy physician) joining the Army Reserve. I haven’t heard of this, my recruiter had said fam med still has a 25,000 accession bonus but he is likely wrong. Hoping I can find out more information on this. Any idea when the changes of reserve bonuses will be official?

 

[Tccanc]

A friend of mine forwarded an email from his reserve consultant. Due to budget constraints, reserve physician bonuses are a thing of the past. The only exceptions are general surgery, orthopedics, emergency medicine, and thoracic surgery. And that’s it. No retention bonuses, no accession bonuses, even for critical wartime specialties.
And y’all thought the DOD just hated active duty physicians, ha ha. They hate all of us.

Thankful that they are honoring the signed multiyear contracts, as long as they were in place before FY 2020.


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[Tccanc]

Here is the FY 20 Reserve bonuses. Looks like rather than a bonus, there may be a monthly stipend equivalent to HPSP amount? Not sure though.

 

[Tccanc]

Here is the FY 20 Reserve bonuses. Looks like rather than a bonus, there may be a monthly stipend equivalent to HPSP amount? Not sure though.
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[cgk]

Does anyone know if Active Duty Retention Bonus for FY2020 is out yet, or if any specialties have been cut?