usphs physicians professional advisory committee john maynard woodworth, first surgeon general...

John Maynard Woodworth, First Surgeon GeneralMarine Hospital Service 1871

US Public Health Service 1912RADM Rupert Blue

Fourth Surgeon General

Since 1991, the number of medical officers in the Corps has been steadily declining at the rate of 50 per year

Source: PPAC Consolidated Pay White Paper, June 2011.

Number of Officers in Medical, Dental, Nurse and Pharmacy Categories, 2001 - 2011

0

200

400

600

800

1000

1200

1400

1600

1800

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Year

Nu

mb

er o

f o

ffic

ers

Dental

Medical

Nurse

Pharmacy

Background on Loss of Medical OfficersBackground on Loss of Medical Officers

Declines have been seen in the 3 agencies employing the majority of medical officers

Source: OCCFM, October 2011.

Number of medical officers by agency, 2001-2010

0

50

100

150

200

250

300

350

400

450

500

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

Nu

mb

er o

f m

ed

ica

l o

ffic

ers

AHCPR ATSDR BOP CDC CMS

DHS DOC DOD TMA EPA FDA

HRSA IHS INTERIOR JUSTICE NIH

OS PSC SAMHSA USAMRMC USCG

USDA


The loss has been greater for males than females.


Number of medical officers by sex, 2001 - 2010

0

200

400

600

800

1000

1200

1400

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

Nu

mb

er o

f m

edic

al o

ffic

ers

Female

Male

Total


In 2010, 39.8% of medical officers were female.


Medical Officers by Gender2010

Males

Females


In 2010, 28.6% of medical officers were eligible for retirement


0

50

100

150

200

Medical Officers

0–4 5–9 10–14 15–19 20–24 25–29 30+

Years of Retirement Credit

Distribution of Retirement Credit for Medical Officers

Number 28.6%


Another 19.7% will have become eligible by 2015


0

50

100

150

200

Medical Officers

0–4 5–9 10–14 15–19 20–24 25–29 30+

Years of Retirement Credit

Distribution of Retirement Credit for Medical Officers

Number 28.6%

19.7%


Project HistoryProject History

PPAC/OCCFM collaborationThe Office of Commissioned Corps Force Management (OCCFM)and the PPAC begin collaborative effort to address the issue.

PPAC Retention Subcommittee created in 2009Retention Subcommittee created to identify and respond toissues causing medical officers to separate from the Corps.

Focus groups held in Spring 20107 focus groups with 32 randomly selected officers.Results used to formulate the survey.

Web-based survey June - August 2011554 (61%) medical officers responded to the survey.

Focus Group Phase

• Guide for the Focus groups was developed by OCCFM in conjunction with the PPAC Retention subcommittee

• OCCFM generated a random list of medical officers and separated these into 3 groups based on years of retirement credit:

<5 yrs, 5 – 15 years, and >15 years

• 7 focus groups were formed with 32 officers total participating

• membership was reviewed to ensure officer diversityagency, sex, ethnicity, and role (clinical/research/applied health)

• focused groups were convened in March and April of 2010 conducted via teleconference

Development of the SurveyDevelopment of the Survey


Web-Based Survey Phase

• A small group, distinct from the officers who facilitated the Focus groups and collected their comments, analyzed the focus group data

• Focus group comments were distilled into succinct statements reflecting the issues of concern

• Statements were grouped into categories and ordered

• A 5-point Likert response scale was provided for each statement (1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree)

• Demographic questions and general questions relating to retention were added along with opportunities for comment

• A draft Web-Based survey was prepared using Survey Monkey® • Initial draft survey was tested online by the Subcommittee members and a revised draft was presented to the PPAC leadership and the Chief Professional Officer (CPO) for review

Final Version of the Survey

• 37 scaled response items grouped into 7 categories:- Uniformed Service- Job Environment- Career Advancement and Promotion- Personal/Family Issues- General Administrative Requirements and Support- Financial Issues- Overall Satisfaction

• 3 multiple choice service obligation and retirement-oriented items

• 2 items with options for free text entry

• 4 optional, multiple choice demographic items


Administration of the SurveyAdministration of the Survey

Survey Administration

• Distributed to all medical officers via a link embedded into an email sent out 16 JUN 2011 to 2 different distribution lists (OSG, PPAC)

• 4 email reminders were sent out by the PPAC Chair and the CPO during the period the Survey was active

• The survey was discussed and participation encouraged at PPAC Forums and other Medical category meetings as well

• Survey remained active until 5 AUG 2011

Quantitative Analysis• Data was downloaded from Survey Monkey into a Microsoft Excel file and imported into SAS version 9.2

• Strongly agree/agree responses were grouped for analysis, as were strongly disagree/disagree responses; neutral and not applicable responses were excluded from analysis

• Responses were compared using chi-square and Fisher’s exact tests; two-sided p-values of < 0.05 were considered statistically significant

• Care was taken throughout the analysis to avoid presentation of any data that might allow identification of any individual officer

Analysis of the SurveyAnalysis of the Survey

Free Text Analysis• Officers were able to enter free text into 2 open fields:

- other factors that may lead to early separation

- issues positively or negatively affecting retention

• A small group of officers categorized the participants’ responses transformation readiness deploymentuniforms financial retirementbenefits medical job opportunitiestraining promotions awardsmentorship administrative miscellaneous

• Responses within a category were examined to identify patterns

• Key themes were identified and described

• Representative comments were selected and presented

Analysis of the SurveyAnalysis of the Survey

Survey Respondents DemographicsSurvey Respondents Demographics

Here are a few sample characteristics…

The demographics of the Survey Respondents were similar to those of the Medical Corps as a whole

Total Respondents = 554 (61%)No. of Medical Officers at the time of the Survey = 902

Factor

No. (%) Resp

No. (%) Corps

MaleOfficer

337 (61%)

551 (60%)

15+ years Service

270 (49%)

441 (48%)

Assigned to CDC

259 (47%)

403 (44%)

Comparison of Respondents with All Medical Officers

0%

10%

20%

30%

40%

50%

60%

70%

Per

cent

Respondents

All Medical Officers

Male 15+ yrs CDC

ResultsResults

Overall Positive Aspects of the Corps

Aspects of a career in the Corps about which a majority ( > 60% )of officers responded positively.

• the adequacy of medical care for officers and their families (80%)

• supervisor support for Corps officer needs

• time for personal needs

• coverage for medical malpractice via the Federal Tort Claims Act

• a clear understanding of what it takes to be promoted

• opportunities to serve on deployments

• opportunities for work in a variety of locations and settings

Corps leadership should make efforts to preserve and highlight these strengths in recruitment efforts with medical officers. However, there is still room for improvement in many of these areas.

Overall Negative Aspects of the Corps

Aspects of a career in the Corps for which a small number ( < 1/3 )of officers responded positively.

• the awards process is easy to navigate (9%)

• adequate formal mentoring (14%)

• competitive one year special pay contract (14%)

• positive impact of mobility on family life (15%)

• Corps headquarters support for officers (28%)

• adequacy of Corps communications (31%)

• manageability of administrative requirements (32%)

• promotion requirements (33%)

Corps leadership should make efforts to lessen the burden of concerns raised in order to improve retention of medical officers.

ResultsResults

Do the positives outweigh the negatives?

Nearly 1/4 of medical officers

— and 64% of officers with <5 yrs retirement credit —

indicated they are...

neutral about remaining in the Corps

or do not plan to remain in the Corps until retirement

ResultsResults

Top ResponsesTop Responses

Top five factors that may lead a medical officer to consider early separation from the Commissioned Corps (N=554).

Factor * No. (%)

Conflict between Corps and agency responsibilities

190 (34%)

Promotion issues 177 (32%)

Pay not comparable to positions outside the Corps

179 (32%)

Uniformed Services issue 162 (29%)

Lack of job opportunities that interest me 135 (24%)

* Officers could select multiple factors.

Other Factors (see text responses) 188 (34%)

Differences noted for Female Medical Officers

Female officers were less positive about their Corps experience than male officers.

• Women were significantly less likely than men to respond positively about the military aspects of the Corps, such as…

attractiveness of deployments

daily uniform wear

transformation

•. Women were also less likely than their male counterparts to report feeling…

respected by the Corps

that they participated in activities valued in the awards process

protected by the Federal Tort Claims Act (FTCA)

that the Corps allowed for time to meet personal needs • Significantly more female officers than male officers indicated that uniformed services issues were reasons for considering separation (38% vs. 24%, p=0.0007)

• Female officers were less likely than male officers to indicate that they planned to stay in the Corps until retirement (73% of female officers vs 80% of male officers, p=0.05)

ResultsResults

Differences by Years of Retirement Credit

Officers with fewer years of retirement credit were less certain of their plans to remain in the Corps than officers with more years of service.

For officers with <5 years of retirement credit…

36% planned to stay in the Corps until retirement

35% planned to extend their service when their current contract or obligation ends

41% indicated they didn’t know what their plans were with regard to continued service

ResultsResults

Survey Questions on plans for continued service

38. What are your plans for your contracted or obligated service?

Separate before my current contract or obligated service ends

Separate when my current contract or obligated service ends

Extend my contract beyond its current end date

Don't know

39. What are your plans for staying in the Commissioned Corps?

Separate before 20 years of service

Retire at 20 years

Retire after 21-25 years

Retire after 26-30 years

Stay over 30 years if possible

Retire before 20 years due to a disability

Don't know

ResultsResults


Issues identified by officers with <5 years of retirement credit as potentially leading to early separation…

promotion (41%)

uniformed services issues (41%)

pay (38%)

lack of interesting job opportunities (35%)

Officers with fewer years of retirement credit were less likely to…

- agree with daily uniform requirements

- indicate that the Officer Basic Course (OBC) was a positive experience

- have difficulty managing Corps administrative requirements

- feel that communications were inadequate

- not feel supported by Corps headquarters

- find deployment opportunities attractive

ResultsResults


Issues identified by officers with 5-15 years of retirement credit as potentially leading to early separation…

promotion (42%)

conflict between agency and Corps responsibilities (41%)

pay (40%)

lack of interesting job opportunities (29%)

uniformed services issues (25%)

Officers with more years of retirement credit were more likely to indicate that…

they felt respected by the Corps

they participated in activities valued in the awards process

they knew how to navigate the promotions process

promotion benchmarks were valid

ResultsResults

Differences by Duty Station

There were NO significant differences in officers’ plans to stay in the Corps until retirement based on whether respondents were stationed in…

isolation/hardship (ISOHAR) U.S.non-ISOHAR U.S.overseas locations

Factors potentially leading to early separation were also not significantly different between these groups

ResultsResults

Differences by Agency

NIH and USCG respondents were more likely to indicate plans to remain in the Corps…

NIH: 90% vs. 77% of other officers

Reasons cited included…-- pay not being comparable to positions outside the Corps (48% vs. 30%, p=0.008)

USCG: 90% vs. 77% of other officers (p=0.03)

Reasons cited included…-- ineligibility for medical special pays during training (23% vs. 8%, p=0.004)

Reason less cited…-- being in Uniformed Service (19% vs. 32%,p=0.0002)

-- billet downgrading (7% vs.19%, p=0.04)

ResultsResults

Differences by Agency

CDC respondents were less likely to plan to stay in the Corps until retirement than respondents working in other agencies (72% vs. 84%, p=0.001).

Reasons cited included… -- being in uniformed service (42% vs. 18%, p<0.0001)

-- the OBC experience (12% vs. <5%, p<0.0001)

Reason less cited…-- low pay (26% vs. 37%, p=0.007)

IHS respondents were as likely to indicate plans to remain in the Corps as officers in other agencies (85% vs. 76% of other officers, p=0.08)

Reason less cited…-- being in Uniformed Service (19% vs. 32%, p=0.01)

ResultsResults

Transformation, Readiness, Deployment and Uniforms

Overall, issues with being in uniformed service were the fourth most common issue identified by medical officers as a factor that may lead them to consider early separation, and was the top most important issue for female officers and officers at CDC.

In both the quantitative and the qualitative survey, medical officers responded negatively to a cluster of issues that in the qualitative survey were described as "militarization" of the Corps; these also had low agreement from female and CDC officers:

• OBC being a positive experience• deployment service is attractive• mobility having a positive impact on family• transformation is positive• agree with daily uniform wear

There was no consistent difference by years of service in support for the various statements related to uniformed services issues, though few junior officers found OBC a positive experience or viewed transformation as positive, and few senior officers found deployment attractive.

Uniformed Service IssuesUniformed Service Issues

Pay, retirement, benefits, and medical

Pay not comparable to positions outside the Corps was the second most cited reason in the quantitative survey for considering early separation.

• Only a few officers felt that a one-year special pay contract was competitive with positions outside the Corps, and even a four-year contract was felt to be competitive by only slightly over half of medical officers.

• Several officers noted difficulties or fear of signing 4 year contracts for family reasons. This study did not ask about the medical specialty of respondents, so it is not possible to say whether comments on pay varied between primary-care and specialist physicians.

• Qualitative comments by senior officers suggested that changes to the pay structure between 20 and 30 years of retirement credit could have a great impact in retaining officers in this group

• Over half of all medical officers felt that a medical school loan repayment program would be attractive, a statement with which nearly two thirds of junior medical officers agreed

• Other benefits that would assist in retention of medical officers included same-sex partner benefits and improved policies for maternity/paternity/adoption leave.

Pay & Benefits IssuesPay & Benefits Issues

Job opportunities, training, promotions, awards, and mentorship - support for career advancement

Promotion issues were the third most important factor to lead officers to consider early separation. Survey findings suggest that medical officers did not feel adequate support for…• an adequate formal mentoring program• promotion requirements being valid indicators for promotion• an easily navigable awards process• full-time training opportunities (even if ineligible for special pays)

These issues were especially important to junior (<5 years) and mid-career officers (5-15 years of service)

There were not many differences between female and male officers in this area

Career IssuesCareer Issues

Administration - providing communication, respect, and support

Large numbers of medical officers expressed several areas of concern related to communication by the Corps:• feeling respected by the Corps• feeling adequate support from Corps headquarters• feeling informed about Corps policies, procedures, and requirements• feeling that the administrative requirements are manageable

Agency liaisons, clearly an important link between officers and Corps administration, were felt to be supportive by less than half of all medical officers.

The qualitative comments offered a glimpse of how strongly a perceived lack of respect can affect medical officers.

Though important issues for all officers, the quantitative survey suggested that many of these concerning sentiments may be of even greater importance for female and junior medical officers.

Administrative IssuesAdministrative Issues

Conflict with agency responsibilities

The leading factor noted by medical officers as leading them to consider early separation was conflict between Corps and agency responsibilities. This was particularly striking for mid-career and senior officers.

Qualitative survey responses suggested that some officers felt that Corps duties interfered with their mission to provide public health.

Over 3/4 felt that some agency duties should be considered deployments.

Agency IssuesAgency Issues

Work/life balance - conflict with personal needs

Overall, the Corps emphasis on officer mobility was viewed negatively by the majority of medical officers.

Female medical officers were significantly less likely than males to feel that mission requirements of the Corps allowed sufficient time to meet personal needs.

Qualitative comments highlighted frustration with a lack of flexibility of the Corps in allowing telecommuting or a temporarily reduced work schedule, as compared to civil service.

There were no obvious differences in these perceptions by year of service or agency.

Work/life IssuesWork/life Issues

ConclusionConclusion

NEXT STEPSPPAC sees the following next steps as being important to improve the quality of service for medical officers in the Corps:

• Present the key findings to Corps leadership and identify action steps to address the issues identified in this report; identify issues that require more in-depth assessment

• Circulate the final report to all medical officers as well as post the final report on the PPAC website

• Host a series of discussion telephone/internet forums on recommendations and next steps, open to all interested officers

• Review structure of PPAC sub-committees to ensure that PPAC subcommittees exist to cover each of the key areas of recommendations

• Encourage PPAC sub-committees to flesh out a short term and a long term action plan for their area -- initially based on the retention survey findings, but also incorporating additional ideas generated through ongoing work

• Work with Corps leadership to establish a system for routine exit interviews of officers retiring or separating early, conducted by a neutral third party

Back up SlidesBack up Slides

BACK UP SLIDES

Table 1. Demographic characteristics of Commissioned Corps medical officers in survey compared to CCMIS statistics for all medical officers in 2010.

Characteristic Survey Respondents (N=554) a No. (%)

All Medical Officers in 2010 (N=915) No. %

Sex b Male Female

322 (61%)202 (39%)

551 (60%)364 (40%)

Retirement Credit Years <5 5–15 >15

74 (14%)198 (37%)257 (49%)

149 (16%)325 (36%)441 (48%)

Duty Station US US Isolated/Hardship Overseas

464 (88%)39 (7%)26 (5%)

Not availableNot availableNot available

Current Agency CDC IHS NIH USCG/ICE (DHS) FDA HRSA OS-HHS (including ASPR) BOP DoD Other

240 (47%)96 (19%)54 (11%)48 (9%)17 (3%)15 (3%)17 (3%)9 (2%)8 (2%)7 (1%)

403 (44%)171 (19%)107 (12%)77 (8%)48 (5%)32 (4%)23 (3%)17 (2%)14 (2%)18 (2%)

a Some officers declined to respond to demographic survey items. Percentages exclude missing responses and may not sum to 100 due to rounding. Numerator for medical officers by sex = 887.

Survey Respondents DemographicsSurvey Respondents Demographics

Table 5. Summary of statements with which more than 60% of respondents agreed or strongly agreed

Statement Total No. Respondents

Agree/Strongly AgreeNo. (%)

I have adequate access to affordable, high-quality medical and dental care. 552 451 (82)

My family has adequate access to affordable, high-quality medical and dental care. 489 381 (78)

Certain of my agency duties should be considered equivalent to a deployment, and credited as such.

554 423 (78)

I plan to stay in the Commissioned Corps until I am eligible for retirement. 523 404 (77)

My supervisor adequately supports my Commissioned Corps needs. 549 374 (68)

I understand what I need to do to be promoted in the Commissioned Corps. 546 342 (63)

Working in a variety of locations and settings is attractive to me. 552 338 (61)

The opportunity to serve on deployments is attractive to me. 552 334 (61)

I am adequately covered by the Federal Tort Claims Act (FTCA) in the event that I am sued for medical malpractice.

489 292 (60)

Mission requirements of the Commissioned Corps allow me time to meet personal needs.

550 331 (60)

Agree or Strongly AgreeAgree or Strongly Agree

Table 6. Summary of statements with which fewer than 40% of respondents agreed or strongly agreed

Statement Total No. Respondents

Agree/Strongly AgreeNo. (%)

The awards process is easy to navigate. 547 50 (9)

The Medical Category has an adequate formal mentoring program. 527 75 (14)

Medical officer pay with a 1-year special pay contract is competitive with positions outside the Corps.

514 71 (14)

The Corps’ emphasis on officer mobility has had a positive impact on my family. 499 75 (15)

Commissioned Corps headquarters personnel offices adequately support officers and their needs.

549 156 (28)

Communication on Commissioned Corps policies, procedures, and requirements is adequate.

553 169 (31)

Commissioned Corps administrative requirements are manageable. 553 176 (32)

Current promotion requirements and benchmarks are valid indicators of officers deserving of promotion.

552 180 (33)

I am willing to pursue full-time training opportunities even if I am ineligible for special pays during the training.

523 196 (37)

I feel respected by the Commissioned Corps. 551 204 (37)

Agree or Strongly AgreeAgree or Strongly Agree

Table 7. Medical officer agreement with statements pertaining to specified features of Commissioned Corps service, stratified by sex

Item Strongly Disagree/Disagree,

No. (%)*

Neutral, No. (%)

Agree/ Strongly Agree, No. (%)

p-value

Male Female Male Female Male Female

OVERALL SATISFACTION

Plan to stay in Corps till retirement

23 (8) 25 (13) 37 (12) 29 (15) 245 (80) 144 (73) 0.09

UNIFORMED SERVICE

Variety of locations is attractive 77 (24) 44 (22) 44 (14) 34 (17) 201 (62) 123 (61) 0.57

Deployment service is attractive 63 (20) 59 (29) 46 (14) 38 (19) 212 (66) 105 (52) 0.005

Deployment training adequate 75 (24) 65 (33) 71 (22) 53 (27) 172 (54) 82 (41) 0.01

OBC positive experience 60 (26) 42 (30) 64 (28) 45 (32) 106 (46) 55 (39) 0.38

Agree with daily uniform wear 85 (26) 92 (46) 47 (15) 38 (19) 189 (59) 72 (36) <0.0001

Transformation is positive 93 (30) 86 (44) 68 (21) 58 (29) 157 (49) 53 (27) <0.0001

I feel respected by the Corps 85 (27) 79 (39) 99 (31) 57 (28) 136 (43) 66 (33) 0.008

Stratified by SexStratified by Sex

Item SD/D SD/D Neutral Neutral SA/A SA/A p-value


JOB ENVIRONMENT

Can balance Corps requirements and agency work

88 (28) 72 (36) 72 (23) 40 (20) 160 (50) 88 (44) 0.12

Supervisor supports Corps needs 41 (13) 30 (15) 53 (17) 31 (16) 227 (71) 138 (69) 0.75

No resistance to deployment from duty station

70 (27) 41 (28) 48 (19) 29 (20) 138 (54) 78 (53) 0.97

Adequate formal mentoring 146 (48) 99 (51) 112 (37) 67 (35) 46 (15) 28 (14) 0.81

Senior officers available for informal mentoring

72 (24) 54 (28) 102 (34) 61 (32) 128 (42) 78 (40) 0.59

Adequate coverage from FTCA 32 (11) 16 (9) 72 (25) 63 (37) 187 (64) 91 (54) 0.02

CAREER ADVANCEMENT AND PROMOTION

Know how to get promoted 61 (19) 50 (25) 49 (16) 28 (14) 206 (65) 123 (61) 0.31

Benchmarks are valid 127 (39) 89 (44) 76 (24) 57 (28) 119 (37) 55 (27) 0.07

Some agency duties should be considered deployments

32 (10) 11 (6) 46 (15) 18 (9) 234 (75) 169 (85) 0.02

Training opportunities are accessible 51 (16) 42 (21) 78 (24) 46 (23) 193 (60) 111 (56) 0.31

I’m willing to pursue long term training without MSP eligibility

131 (42) 69 (37) 64 (21) 41 (22) 114 (37) 77 (41) 0.47

I participate in activities that are valued in awards process

83 (26) 69 (35) 90 (28) 61 (31) 146 (46) 70 (35) 0.04

Awards process easy to navigate 224 (70) 157 (79) 64 (20) 25 (13) 31 (10) 18 (9) 0.07

Table 7 Cont’d: Stratified by SexTable 7 Cont’d: Stratified by Sex



PERSONAL/FAMILY ISSUES

Mission requirements allow time for personal needs

37 (12) 38 (19) 66 (21) 61 (30) 217 (68) 102 (51) 0.0005

Mobility has positive impact on family 147 (49) 94 (53) 99 (33) 61 (35) 52 (17) 21 (12) 0.27

Officers have good medical care 26 (8) 26 (13) 29 (9) 15 (7) 266 (83) 161 (80) 0.19

Families have good medical care 27 (9) 16 (10) 35 (12) 23 (14) 233 (79) 129 (77) 0.83

GENERAL ADMINISTRATIVE REQUIREMENTS

Headquarters personnel are supportive 142 (44) 91 (46) 84 (26) 49 (25) 94 (29) 60 (30) 0.91

Commissioned Corps communications are adequate

119 (37) 97 (48) 94 (26) 48 (24) 109 (34) 57 (28) 0.04

I receive adequate notice of job opportunities

72 (23) 44 (22) 59 (19) 39 (20) 180 (58) 116 (58) 0.96

My agency liaison is supportive 78 (24) 65 (32) 93 (29) 53 (26) 150 (47) 84 (42) 0.14

Corps administrative requirements are manageable

120 (37) 88 (44) 90 (28) 57 (28) 112 (35) 57 (28) 0.23

Basic readiness is easy to maintain 72 (22) 45 (22) 64 (20) 48 (24) 186 (58) 108 (54) 0.53




FINANCIAL ISSUES

Adequate administrative support for pay issues

76 (24) 64 (33) 85 (27) 42 (22) 156 (49) 89 (46) 0.08

MSP paid promptly 91 (29) 53 (27) 42 (13) 32 (16) 182 (58) 115 (58) 0.65

MSP 1 yr contract competitive 191 (63) 114 (62) 67 (22) 45 (25) 45 (15) 24 (13) 0.76

MSP 4 yr contract competitive 80 (25) 38 (20) 57 (18) 43 (22) 177 (56) 111 (58) 0.25

Retirement pay is fair 61 (19) 31 (16) 69 (22) 54 (29) 188 (59) 103 (55) 0.20

Med school loan repayment program would be attractive

62 (27) 30 (21) 42 (18) 32 (23) 124 (54) 79 (56) 0.36

*Percents represent proportions of those who responded to the individual statements; missing and “not applicable” responses are excluded.


Table 8: Factors leading to consideration of early separation stratified by sex

Factor Male, No. (%) Female, No. (%)

p-value

Conflict between Corps and agency responsibilities 119 (37) 164 (32) 0.22

Pay not comparable to positions outside Corps 106 (33) 67 (33) 0.95

Promotion issues 104 (32) 65 (32) 0.98

Uniformed services issues 78 (24) 77 (38) 0.0007

Lack of job opportunities that interest me 75 (23) 55 (27) 0.31

Billet downgraded in new billet structure 53 (16) 43 (21) 0.16

Unable to commit to multiyear special pay contract 33 (10) 29 (14) 0.16

Ineligibility for special pays during training 35 (11) 19 (9) 0.59

Experience at OBC 19 (6) 13 (6) 0.80

Lack of domestic partner benefits 20 (6) 8 (4) 0.26

Inability to meet fitness requirements 10 (3) 7 (3) 0.82

Early Separation Stratified by SexEarly Separation Stratified by Sex

Table 10. Factors leading medical officers to consider early separation from the Corps, comparing officers with <5 years of retirement credit to officers with >15 years.

Factor Officers with <5 Years Retirement Credit (N=74), No. (%)

Officers with >15 Years Retirement

Credit (N=257), No. %

p-value


20 (27) 81 (32) 0.57


Billet downgraded in new billet structure

7 (9) 44 (17) 0.14


28 (38) 66 (26) 0.06

Ineligibility for special pays during training

11 (15) 13 (5) 0.009



Experience at OBC 21 (28) 5 (2) <0.0001

Inability to meet fitness requirements 0 13 (5) 0.08

Unable to commit to a multiyear special pay contract

10 (14) 36 (14) >0.99

Lack of job opportunities that interest me

26 (35) 48 (19) 0.004

Years of Retirement CreditYears of Retirement Credit

Table 11. Factors leading medical officers to consider early separation from the Corps, comparing officers with 5-15 years of retirement credit to officers with >15 years.

Factor Officers with 5-15 Years Retirement

Credit (N=198), No. (%)

Officers with >15 Years Retirement

Credit (N=257), No. %

p-value


82 (41) 81 (32) 0.03

Promotion issues 84 (42) 59 (23) <0.0001


46 (23) 44 (17) 0.12


80 (40) 66 (26) 0.001


30 (15) 13 (5) 0.0003

Uniformed services issues 54 (27) 71 (28) >0.99


Experience at OBC 6 (3) 5 (2) 0.54



16 (8) 36 (14) 0.05


58 (29) 48 (19) 0.01


Table 12. Factors leading medical officers to consider early separation from the Corps, comparing officers uncertain of their plans to remain in the Corps to other officers who responded to these survey items.

Factor Officers Uncertain of Plans to Remain in

the Corps (N=81), No. (%)

Other Officers (N=461), No. %

p-value


35 (43) 155 (34) 0.10



15 (19) 85 (18) >0.99


33 (41) 145 (31) 0.12


9 (11) 45 (10) 0.69



Experience at OBC 14 (17) 19 (4) <0.0001



16 (20) 47 (10) 0.02


23 (28) 111 (24) 0.40


Transformation

• 59 officers commented on issues related to transformation -- 51 made comments against transformation -- 2 made comments in support of transformation -- 6 made other comments about transformation

• 38 officers commented on the militarization of the Commissioned Corps in negative terms; 25 indicated that they felt that the transformations are at odds with the public health mission of the Corps. Quite a few officers indicated that …

-- differences between the Corps and other uniformed services should be maintained and even celebrated

-- if they had wanted to join the military, they would have done so

-- efforts to bring the Corps in line with the Navy or other uniformed services have resulted in too much paperwork and too many requirements.

Qualitative AnalysisQualitative Analysis

Readiness

• 19 officers commented on issues related to readiness

• The majority of these officers indicated that readiness requirements were overemphasized and/or that they were difficult to attain • Some officers stated that readiness requirements were unrelated to their job and that the time spent maintaining readiness detracted from their public health work or mission

• A few officers indicated that this is particularly difficult for officers in remote or overseas locations

• A number of officers indicated that maintaining readiness is challenging for administrative reasons. For example…

no centralized location to enter readiness informationRockville staff unresponsive to officers, etc.


Deployment• 52 officers commented on issues related to deployment

• 14 officers indicated that they were dissatisfied with the threat of forced deployment or were in situations that made it difficult to deploy (either because of family obligations or because they were stationed internationally)

• 18 officers indicated that deployments were either poorly organized or made poor use of officers’ skills

• 18 officers indicated that they felt a tension between deployments and their agency dutiesfor some, tension arose primarily from their supervisorswhile for others, the tension stemmed from their own sense of obligation... -- to perform their clinical or other duties or the lack of anyone to backfill -- while the officer was deployed.

• Several officers mentioned that, even when not an official CCRF deployment, other work should be recognized as deployments

-- coordinating responses from headquarters -- or deploying with one’s host agency


Uniforms• 42 officers commented on issues related to uniforms -- 30 made negative comments about uniforms -- 3 made comments that were neutral or positive about uniforms -- 8 made other comments about uniforms

• Most officers indicated that they disagreed with the requirement for daily uniform wear -- Many indicated that this would affect their decision to stay in the Corps -- 12 indicated that the focus on the uniform attempted to make the Corps look like a military service and indicated that they felt it was important to distinguish the Corps from the military -- Several officers felt that it was inappropriate for public health officials to wear BDUs, as these are associated with battle rather than health -- 8 indicated that wearing the uniform can interfere with the mission or with their work -- Some officers felt that the wear of the uniform can lead to distrust and negatively affect relationships -- Others indicated that they did not see a need to wear the uniform when they are working at their desk or not interacting with the public.

• Many officers disagreed with the move toward aligning uniforms with the Navy -- Some felt it is important for the Corps to have a uniform that reflects its distinct mission -- 6 officers indicated that they were not happy with the recent changes in the uniforms, including removal of uniforms like the “Salt and Peppers” -- 6 officers indicated that the current uniforms were not comfortable

• 3 officers indicated that leadership should be required to follow and enforce uniform code


Pay• 65 officers commented on issues related to financial concerns -- 56 made negative comments about financial issues -- 9 made comments that were neutral or positive about financial issues

• Common statements on Pay issues: -- 37 remarked on the lack of equivalent pay in comparison to the civilian sector -- 5 commented on the lack of special pays at the flag level -- several commented on poor retirement pay at the base pay rate -- 6 cited administrative problems with receiving their special pays as a negative -- 2 suggested increasing the MRB for a 2 yr contract to the value of a current 4 yr contract

• 8 of the favorable or neutral financial comments stated that the PHS pay system, including special pays, was similar in total pay to civilian counterparts


Retirement• 29 officers commented on issues related to retirement -- 24 made negative comments about retirement -- 5 made comments that were positive about retirement

• 12 commented negatively about retirement pay. The largest reason was that it was not as financially attractive as the civilian sector

• 4 stated that a percentage of the special pays should be included in the retirement pay

• 5 raised concerns over retirement benefits and suggested possible changes to make them more attractive

• 2 suggested allowing officers with over 30 years to stay longer if they wanted and met the requirements to do so


Benefits

• 33 officers commented on issues related to benefits -- 29 made negative comments about benefits -- 4 made comments that were neutral or positive about benefits

• Issues raised included…lack of loan repayment (11)GI bill transferability (6)domestic partner benefits (4)adoption time off (2)continuation of TSP and matching pay (2)oversees benefits (1)on-call extra pay (1)VA educational benefits (1)yearly paid continuing medical education (1)

The positive comments addressed the overseas benefits, and benefits for federal employees.


Medical

• 13 officers commented on medical issues -- 9 made negative comments about medical issues -- 4 made comments that were positive about medical issues

• Issues raised included…quality of care (2)administrative TRICARE issues (2)ease of use (2)access to care (2)choice (1)

The positive responses discussed high-quality healthcare, and free healthcare for life.


Job Opportunities

• 92 officers commented on job opportunties -- 88 made negative comments about job opportunties -- 4 made comments that were neutral or positive about job opportunties

• Issues raised included lack of job opportunities…lack of clinical jobs (26)lack of jobs in specific locationsbetter opportunities outside PHSlack of non-clinical jobs (3)lack of O-6 jobs or jobs that promote career progression (5)lack of laboratory opportunities (2)lack of academic positions (3)lack of interesting and meaningful work in the PHS (6)disagreed with term limited positions (4)

• Issues raised included mobility…lack of options in certain geographic areas (25)lack of international opportunitieslack of stability, forced geographic mobilityinability to move due to familyinability to transfer between agencies

• Positive/neutral responses…cited mobility as a plus and that it should be further touted (1)cited career choices as a bonus (2)


Training

• 31 officers commented on issues related to training -- 30 made negative comments about training -- 1 made a positive comment about training

• Common comments included…lack of access to training (10)|lack of funding for training opportunities (8)lack of response/deployment preparation (4)OBC as a negative experience (8)


Promotion

• 79 officers commented on promotions -- 75 made negative comments about promotions and 9 indicated it as a cause for separation -- 4 made comments that were neutral about promotion

• Common comments on activities required for promotion included…need for self-promotion (13)not tied to excellent work performance (10)deployments and PHS activities are given excess weight (13)unfair to officers in field assignmentsunfair to those in clinical billets (8)

• Comments about paperwork associated with the promotion process included…documentation required is excessiveforms often lost with negative impactsneed to FAX as opposed to emailing as an attachment

• Comments about unfair emphasis of activities in the promotion process included…mobility should not be a requirement for promotion (3)lack of clarity in the requirements for promotionfeedback process flawed and not helpfulsupervisors don’t understand the promotion process with negative consequences (4)inability to transfer between agencies

• Comments about the promotion process itself included…separation of permanent and temporary promotion should be abolished (5)need for more flag billets, especially in the field (2)rates of promotion are too low (3)promotion is based on personal relationships (2)


Awards

• 41 officers commented on issues related to awards – all were negative5 listed it as a cause for separation

• Comments regarding the dependence on the individual officer of the awards process included…need for self-promotion (7)overly difficult and time-consuming (6)favors less effective officers with more time on their handsneed to write one’s award

• Comments regarding the unfairness of the process because of a bias towards officers with greater opportunities based on their position included…

difficulty based on which center the officer is assigned (3)harder for clinicians and those out in the field (2)certain jobs or opportunities are favored (5)lack of criteria for awards (1)difficult to attain recognition for individual awards (1)

• Comments on the awards process itself included…not understood by or requires too much effort from supervisors (6)dependent on the officer’s contact (1)time to process applications takes too long (2)


Mentorship

• 12 officers commented on issues related to mentorship, 2 listed it as a cause for separation -- 10 were negative comments about mentorship -- 2 were positive comments about mentorship

• Most comments pertained to a lack of available mentors…lack of mentors (6)need to have one assigned to every officer (1)mentors not motivated to be good mentors (2)no response to attempts to contact potential mentors (1)


Administration

• 100 officers commented on administrative issues -- 91 made negative comments about administrative issues and 26 indicated it as a cause for separation -- 8 made comments that were neutral about administrative issues -- 4 made comments that were positive about administrative issues

• Common comments on lack of officer support from OCCO/headquarters included…unhelpful or unresponsive (30)failure to respond to communications (phone calls/emails/messages) (8)disrespectful to officers (9)Compensation Branch failed to correct errors or were unresponsive (11)lack of liaison support (6), but there were several positive comments about liaison support as welllack of support form DHHS (3)

• Comments about paperwork required and online support included…online support is inadequate (5)CCMIS or Direct Access are difficult/burdensome to use (5)paperwork/administrative requirements are too burdensome/time-consuming (20)communication on administrative policies is insufficient forms often lost with negative impactsneed to FAX as opposed to emailing as an attachment

• Comments about unfair emphasis of activities in the promotion process included…mobility should not be a requirement for promotion (3)lack of clarity in the requirements for promotionfeedback process flawed and not helpfulsupervisors don’t understand the promotion process with negative consequences (4)inability to transfer between agencies

• Comments about the promotion process itself included…separation of permanent and temporary promotion should be abolished (5)need for more flag billets, especially in the field (2)rates of promotion are too low (3)promotion is based on personal relationships (2)


Support for and Viability of the Corps

• 51 officers commented on issues related to high-level administrative support for the Corps ro problems with leadership in the Corps

• 31 indicated that they felt that there was not enough support in HHS or OSG for the Corps or that they had concerns about the future viability or stability of the Corps

• 16 commented on problems with Corps or agency leadership

• 6 commented on the fact that the Surgeon General is a political appointee rather than a career Corps officer

• 15 were unhappy with the furlough plan developed in the case of a government shutdown

• 6 commented on the pause in new hires


Respect for and valuing of Medical Officers

17 commented that officers (often specifically medical officers) are not respected or valued by Corps leadership


Conflict with Agency Responsibilities

15 cited conflict between Corps and Agency responsibilities

6 indicated that they have had problems with civilian supervisors


The Role of the Corps

8 indicated that the Corps in its current structure does not align with its stated mission, indicating that the goal of serving public health does not seem to be foremost


The Indian Health Service (IHS)

12 officers commented on issues specific to Indian Health Service, most of which related to poor treatment of officers in IHS


Work/Life Balance Issues

45 commented on issues related to work/life balance and family

• 22 officers commented on issues related to working part-time, telework, and flexible schedules

• 17 commented on the impact of geographic mobility expectations on their family.


Transformation, Readiness, Deployment and Uniforms

Overall, issues with being in uniformed service were the fourth most common issue identified by medical officers as a factor that may lead them to consider early separation, and was the top most important issue for female officers and officers at CDC.

In both the quantitative and the qualitative survey, medical officers responded negatively to a cluster of issues that in the qualitative survey were described as "militarization" of the Corps; these also had low agreement from female and CDC officers:

• OBC being a positive experience• deployment service is attractive• mobility having a positive impact on family• transformation is positive• agree with daily uniform wear

There was no consistent difference by years of service in support for the various statements related to uniformed services issues, though few junior officers found OBC a positive experience or viewed transformation as positive, and few senior officers found deployment attractive.

Uniformed Service IssuesUniformed Service Issues


Pay not comparable to positions outside the Corps was the second most cited reason in the quantitative survey for considering early separation.

• Only a few officers felt that a one-year special pay contract was competitive with positions outside the Corps, and even a four-year contract was felt to be competitive by only slightly over half of medical officers.

• Several officers noted difficulties or fear of signing 4 year contracts for family reasons. This study did not ask about the medical specialty of respondents, so it is not possible to say whether comments on pay varied between primary-care and specialist physicians.

• Qualitative comments by senior officers suggested that changes to the pay structure between 20 and 30 years of retirement credit could have a great impact in retaining officers in this group

• Over half of all medical officers felt that a medical school loan repayment program would be attractive, a statement with which nearly two thirds of junior medical officers agreed

• Other benefits that would assist in retention of medical officers included same-sex partner benefits and improved policies for maternity/paternity/adoption leave.

Pay & Benefits IssuesPay & Benefits Issues

Job opportunities, training, promotions, awards, and mentorship - support for career advancement

Promotion issues were the third most important factor to lead officers to consider early separation. Survey findings suggest that medical officers did not feel adequate support for…• an adequate formal mentoring program• promotion requirements being valid indicators for promotion• an easily navigable awards process• full-time training opportunities (even if ineligible for special pays)

These issues were especially important to junior (<5 years) and mid-career officers (5-15 years of service)

There were not many differences between female and male officers in this area

Career IssuesCareer Issues


Large numbers of medical officers expressed several areas of concern related to communication by the Corps:• feeling respected by the Corps• feeling adequate support from Corps headquarters• feeling informed about Corps policies, procedures, and requirements• feeling that the administrative requirements are manageable

Agency liaisons, clearly an important link between officers and Corps administration, were felt to be supportive by less than half of all medical officers.

The qualitative comments offered a glimpse of how strongly a perceived lack of respect can affect medical officers.

Though important issues for all officers, the quantitative survey suggested that many of these concerning sentiments may be of even greater importance for female and junior medical officers.

Administrative IssuesAdministrative Issues


The leading factor noted by medical officers as leading them to consider early separation was conflict between Corps and agency responsibilities. This was particularly striking for mid-career and senior officers.

Qualitative survey responses suggested that some officers felt that Corps duties interfered with their mission to provide public health.

Over 3/4 felt that some agency duties should be considered deployments.

Agency IssuesAgency Issues


Overall, the Corps emphasis on officer mobility was viewed negatively by the majority of medical officers.

Female medical officers were significantly less likely than males to feel that mission requirements of the Corps allowed sufficient time to meet personal needs.

Qualitative comments highlighted frustration with a lack of flexibility of the Corps in allowing telecommuting or a temporarily reduced work schedule, as compared to civil service.

There were no obvious differences in these perceptions by year of service or agency.

Work/life IssuesWork/life Issues

Uniformed service issues: transformation, readiness, deployment and uniforms

• Conduct discussions on aspects of uniformed service that resonate with Corps officers and identify acceptable ways to retain our unique USPHS identity while also embracing core Uniformed Services values • Review Officer Basic Course (OBC) course evaluations & engage in ongoing dialogue with DCCPR and the Training Branch • Brainstorming with Medical officers to elicit ideas on how to better support and introduce officers to the Corps and uniformed service

• Better utilize officers’ deployment expertise, recognize some agency deployments and offer improved deployment preparation training

• Work with OASH and OSG to enhance visibility of the Corps & recruitment

• Communicate with other uniformed services about efforts or initiatives to make a career in a uniformed service attractive to women

Potential InterventionsPotential Interventions


• Work closely with the Compensation Policy Advisory Board to make recommendations to changes in Medical Officer pay • Restructure pay so that 4-year contracts are not required to achieve a salary equivalent to what one might earn outside the Corps

• Review retirement benefits to assess how retention of officers with >25 years of service can be improved

• Establish a medical school loan repayment program

• Provide benefits to same-sex partners of officers

• Review maternity/paternity/adoption leave policies


Job opportunities, training, promotions, awards, and mentorship- support for career advancement

• Improve and encourage routine use of PHS mentors by medical officers • Offer online and internet-based training sessions to mentors to ensure consistency and quality

• Ensure mentors routinely receive awards or letters of appreciation

• Explore how promotion requirements can be improved to accommodate medical officers with widely varying functions

• Conduct systematic reviews and routinely monitor agency awards processes to streamline the process and improve consistency between agencies

• Continue special pays for officers who pursue long-term training

• Identify mechanisms to facilitate awards for high performing officers– training of federal supervisors– tasking mentors to play the role of “award advocate”



• Engage in projects with Corps headquarters to improve communication with officers

• Establish a task force to work collaboratively with DCCPR to improve customer service through a rigorous quality improvement initiative

• Improve understanding of how Corps administration functions– for example through use of internet video-conferencing and social media tools

• Improve visibility of agency liaison by encouraging proactive outreach to officers in a systematic manner for routine administrative functions

• Identify dedicated staff members at headquarters or agencies that are knowledgeable in issues specific and of importance to medical officers

– for example special pays, licensure, long term training, retirement



• Ensure officers know how to address concerns if they feel their billet description does not accurately describe their role within an agency

• Encourage routine communication between agency and Corps leadership to ensure that being in the Corps is viewed as "added value“

• Identify a formal mechanism for allowing deployment credit for some agency duties

• Minimize Corps non-public health duties– for example streamline admin requirements through use of electronic/scanned documents



• Increase medical officers’ awareness of programs that allow and support teleworking

– for example streamline administrative requirements

• Identify a mechanism to allow officers with special family needs to reduce their work schedule for an extended period of time

• Identify career tracks for medical officers that do not make promotion dependent on mobility.


Limitations, Possible Bias and Assumptions

Because this was an anonymous survey, it is possible that some officers took the survey more than once. In addition, although the listserv used to distribute the survey is the most accurate listserv of medical officers available, it is possible that not all medical officers received the survey by email.

A total of 619 complete/partial survey responses were received; 608 (98%) were responses from individuals who identified themselves as medical officers. We did not verify they were medical officers.

These 608 responses were sent from 271 unique Internet Protocol (IP) addresses. Multiple responses were received from some IP addresses because:1) agency firewalls -- multiple unique computers may appear to have the same IP address2) multiple officers may have used the same computer (e.g., a clinic computer) to respond to the survey.

Of the 608 respondents, 554 officers (91%) completed most of the required portions of the survey, and 536 (88%) completed all required portions of the survey. We analyzed the subset of these 554 surveys with the assumption that each was completed by a unique respondent.

There may be a response bias either towards excessive satisfaction in that the officers who are most unhappy with the Corps may be less likely to complete a Corps survey, or towards excessive dissatisfaction in that disgruntled officers may have been more likely to respond.

This survey only included officers who have remained in the Corps – a survey of those who had recently separated would likely demonstrate even less satisfaction. The optimal mechanism to overcome such a response bias would be to conduct exit interviews of all medical officers who apply for retirement or early separation.

Study LimitationsStudy Limitations

The Way Forward

The findings from this survey should be used not only to improve medical officer retention, but also to try to enhance medical officer career satisfaction. Improving medical officer career satisfaction will likely not only improve retention but also improve recruitment of new medical officers.

The findings from this survey should be combined with information from other sources such as agency surveys to identify key areas of intervention where discrete actions can be taken to improve the likelihood of medical officers completing a full and satisfying career in the Corps.

Although some issues identified by this survey may take years of sustained effort and dedicated resources to improve, many of the issues identified by this survey can be addressed immediately without need for significant financial resources or massive structural changes. Providing ample opportunities for career advancement is a critical way to encourage bright and ambitious medical officers to dedicate their lives to the Corps.

Given the importance of good communication and a sense of respect in feeling satisfied with one's work, it is clear that the Corps should take immediate action to improve these areas and create more positive relationships among Corps headquarters staff, agency liaisons an and medical officers. There is a need to examine agency and Corps relationships.

Addressing the work/life balance is clearly an important issue for officers, but especially for female officers.

RecommendationsRecommendations

PPAC Action PlansPPAC Action Plans

PPAC Plans: Corps vs. Agency Conflict Issues• Ensure officers know what to do if billets do not accurately

describe their role within an agency

• Encourage routine communication between Agency and Corps leadership to share Corps successes, improve recruitment, and advance new issues of importance such that the Corps is considered "added value"

• Identify a formal mechanism for allowing deployment credit for some agency duties

• Minimize Corps administrative burden (e.g., allow transmission of electronically scanned administrative documents)


PPAC Plans: Promotion & Career Issues• Encourage routine use of PHS mentors, especially for those in

overseas or remote duty stations

• Train and reward mentors to ensure consistency and quality

• Improve promotion requirements to accommodate medical officers with widely varying functions

• Conduct systematic review of Agency awards processes to streamline processes and improve consistency

• Routinely monitor award processes & identify mechanisms to facilitate awards for high performing officers (e.g., training of federal supervisors, creating "award advocates")

• Continue special pays for officers in long-term training


PPAC Plans: Pay & Benefits Issues• Work closely with the Corps Compensation Policy Advisory

Board to make recommendations to change pay

• Restructure special pay so that <4-year contracts can achieve a salary equivalent to outside the Corps

• Review retirement benefits to assess how retention of officers with >25 years of service can be improved

• Establish a medical school loan repayment program

• Provide benefits to same-sex partners of officers

• Create maternity/paternity/adoption leave policies*


PPAC Plans: Uniformed Service Issues• Conduct Corps-wide discussions of what aspects of

uniformed service resonates with USPHS officers

• Identify ways that USPHS can retain our unique identity while embracing core values of the Uniformed Services

• Improve the Officer Basic Course (OBC)

• Conduct brainstorming sessions with Medical Officers to elicit ideas on how to better support and introduce officers to the Corps as a uniformed service


PPAC Plans: Uniformed Service Issues (cont.)• Continue efforts with other uniformed services to make

uniformed service career attractive to women*

• Improve deployment by better utilizing officer expertise on deployments, recognizing some agency deployments, and offering improved deployment preparation training

• Work with OASH and OSG to enhance visibility of the Corps and recruitment


PPAC Plans: Admin. & Communication Issues• Engage in projects with Corps headquarters to improve

communication with officers

• Establish a task force to work collaboratively with DCCPR to improve customer service

• Improve understanding of how Corps administration works

• Improve visibility of Agency liaisons by encouraging proactive outreach to officers in a systematic manner for routine administrative functions

• Identify dedicated staff members at headquarters or agencies that are knowledgeable in issues specific and of importance to medical officers (e.g., retirement)


PPAC Plans: Work-Life Balance Issues• Increase medical officers’ awareness of programs that

allow and support teleworking

• Allow officers with special family needs to reduce their work schedule for an extended period of time

• Identify and increase awareness of career tracks that do not require mobility for promotion

PPAC Plans: Exit Interviews• Work with Corps leadership to establish routine exit

interviews of officers retiring or separating early – conducted by a neutral third party

PPAC Next StepsPPAC Next Steps

Next Steps for PPAC – How you can be involved:

1.Present key findings to Corps leadership and identify action steps

2.Circulate final report to all medical officers

3.Host regular “Open Forum” calls to identify additional issues that can be addressed by PPAC

4.Re-structure PPAC subcommittees to ensure that PPAC will cover the key areas of recommendations

5.Establish PPAC subcommittee mission statements and specific goals, initially based on Retention Survey findings, to guide future work

6.Produce annual PPAC reports to document accomplishments based on subcommittee goals and assess PPAC effectiveness

usphs physicians professional advisory committee john maynard woodworth, first surgeon general...

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