Physician Opportunities to Make a Difference in US

"Physician Opportunities to Make a Difference in US Government” Officer name Recruitment Physician Professional Advisory Subcommittee US Public Health Service

Special Credits to the Following Officers for Contributing to this Presentation n n n LCDR Deborah S. Belsky, MD MPH LCDR Matt Daab, MD CDR Sara E. Luckhaupt, MD MPH CDR Sylvie Cohen, MD, MPH CDR Dorothy Sanderson, MD CAPT Paul Kitsutani, MD CAPT Ha C. Tang, DO

Objectives n n Why consider service in the US Government? Appreciate the wide range of opportunities to impact change in Federal Government Recognize the range of career options What are the professional and personal challenges?

What are reasonable career goals? n n Making an impact on what scale? Reasonable living standard Opportunity for advancement Opportunity for lateral moves

What are reasonable career goals? n n Avoid malpractice Good place to raise a family Retirement benefits Hopefully happiness

What is your primary interest? n n n n Domestic vs global focus Clinical, administrative(policy), Research Underserved populations? Operational medicine Preventive medicine Disaster response Academic?

What are some of the many options in Federal Government? ? n Department of Homeland Security • United States Coast Guard (USCG) • Immigration and Customs Enforcement (ICE)

What are some of the many options in Federal Government? ? n n n Centers for Medicaid and Medicare Services (CMS) Dept of Justice, Bureau of Prisons (BOP) Department of Defense VA Department of State White House

Department of Health and Human Services IHS, FDA, NIH and CDC n Health Resources and Services Administration (HRSA) n Office of the Assistant Secretary for Preparedness and Response(ASPR) n US Public Health Service n

History of U. S. Coast Guard n n n Est. 1790, world’s 12 th largest naval force, one of 5 U. S. armed services, one of 7 uniformed services. Only military branch outside Do. D (falls under US Dept of Homeland Security but can transfer to Navy in times of war). 42, 000 on active duty

USCG Mission n n Ports, waterways, and coastal security Drug interdiction Aids to navigation Search and rescue Living marine resources Defense readiness Migrant interdiction Marine environmental protection Ice operations Other law enforcement

An average Coast Guard day -We save 15 lives -Assist 114 people in distress -Conduct 82 search and rescues -202 law enforcement boardings -Service 40 aids to navigation -23 waterfront facility safety inspections -Interdict 26 illegal migrants at sea -Seize $12. 4 million worth of illegal drugs -Protects $4. 9 million in property, and provides 4 cutters in support of Theatre Security Operations.

PHS role in USCG n n PHS officers wear the CG uniform and are subject to UCMJ regulations Provide primary care and are responsible for ensuring Coast Guardsmen meet required physical standards for military service and rate specific requirements (e. g. , flight status). If PHS officer meets physical requirements, may apply and train to become USCG flight surgeon with special capabilities and requirements (monthly flying in CG aircraft among others). Only 63 PHS physicians are assigned to USCG

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Immigration and Customs Enforcement (ICE) n n n Immigration enforcement Preventing terrorism and Combating the illegal movement of people and trade.

ICE Health Service Corps staff n n n >900 USPHS officers, federal civil servants and contract support staff. Direct care to 15, 000 detainees housed at 21 designated facilities throughout the nation. Oversees medical care provided to an additional 17, 000 detainees housed at non-ICE Health Service Corps staffed detention facilities

Centers for Medicaid and Medicare Services (CMS) n Administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards.

CMS n n n Indirect Medical Education(IME) Partly based upon residents to bed ratio Part of $30 Billion Dollars the US Government pays for residency training in the US.

Census on US Veterans n n 19. 6 millions 1. 6 millions are females 3. 6 millions with service connected disabilities Veterans represent 11% of the adult civilian population, but 26% of the homeless population, according to the Homeless Research Institute (2007).

NYT Report n n Three months ago, Mr. Mc. Donald took control of a demoralized and dysfunctional 330, 000 -employee agency buffeted by crisis, with problems ranging from outdated software to what even the White House described as a “corrosive” and retaliatory culture. Seeks to recruit 28, 000 staff

U. S. Department of State n Mission: • Shape and sustain a peaceful, prosperous, just, and democratic world and • Foster conditions for stability and progress for the benefit of the American people and people everywhere. • This mission is shared with the USAID, ensuring we have a common path forward in partnership as we invest in the shared security and prosperity that will ultimately better prepare us for the challenges of tomorrow. (U. S. Department of State website)

U. S. Department of State Physician Opportunities n Foreign Service Specialist • Provide important healthcare service at one of over 270 posts overseas, in Washington, D. C. , or elsewhere in the U. S. • Access position openings from State Department website or USAJobs