Family life as a PA in the military???

[CAdamsPAC]

I'm in the Army. I'm a battalion PA for a Parachute Infantry Battalion. Military PAs are used wherever the unit they are assigned to is used. While deployed, Air Force PAs predominantly are used in major bases where aircraft would land. They are more secure than most. However, some AF PAs went out with Army units due to our shortage. There may be a couple PAs tied into AFSOF but I doubt they are going out. I won't speak definitively on that. Navy PAs predominantly provide healthcare on vessels which are as secure as big vessels are (not getting shot at pretty much) but they have PAs that support Marine Infantry units. The Coast Guard has a very similar mission for their PAs on vessels but those vessels are typically support vessels and not any vessel engaged in the war. The Army has units that are in the rear with the gear and they have combat arms units. If you are assigned to that combat arms unit, you go where they go. When I was on my most recent deployment to Afghanistan, I would have to put on 40lbs+ of body army with 210 rounds of 5.56mm, a helmet with night vision goggles, knee pads, elbow pads, M4 carbine with red-dot scope, a light, and a night laser all attached. Then I'd have to put on about 40lbs of medical gear, survival gear, and food/water to last me for 2+ days. Do the math. I weigh 185lbs and I stepped on the scale before I walked out the wire and I was just under 320lbs. We would walk for miles, post up a casualty collection point in a covered position while our boys cordon and searched Taliban friendly villages for days on end with distances from 5-20 kilometers. I ended up finding a fatty protein shake to take out instead of food just to cut weight. When I wasn't walking, I was in the back of a steel can truck with one of my battalion's First Sergeants as the truck commander. There are two litters back there and I would listen to the radio traffic and wait on casualties to come to me for stabilization and evac. When I wasn't on mission, I was posted up in a crappy building I used as my trauma bay on the camp of about 80 people in the middle of taliban country. If smaller missions were going on around us and someone got hurt or if we took contact on the camp they would bring their wounded to me and my team of medics to patch up and evac. These camps aren'y necessarily safe. We took 45 days of consecutive rocketing on our camp over the summer of 2012 and one struck the back door of my trauma bay kicking shrapnel into my head resulting in a brief loss of consciousness and an impromptu suturing lesson for my medics. No evac for me and my aching bleeding head to be checked out by TBI though because who's going to take care of the boys when I'm gone. I put bandages over the suture and went back to missions 48 hours later. Don't get me wrong, my experience is neither the norm nor the extreme. There are Army PAs like MAJ John Detro who shot Al Queda in the face at close distance and are running around with shrapnel in his *** from jumping on top of trauma patients when grenades were tossed in the room and there are PAs who's most difficult task of their deployed career was whether or not to get the extra shot at starbucks. The training you get is what training your unit offers you which will be partially limited due to clinic demands, what you chose to educate yourself on, what experience you have, your Non-Commissioned Officer Leadership, and a 1 week course in San Antonio called, "TCMC" that teaches you to stop people from bleeding, keep them breathing, keeping their blood pressure valid, keeping them warm, and handing them off. After 5 deployments I can tell you being away from my family was tough and I missed my wife and kids but the war was an adrenaline rush that I will never regret. What sucks the most is not being at war, going home every night, and still missing your family. This may be specific to the Army but I have an Army friend of mine who was walking around Nellis AFB, he saw one of his Air Force IPAP classmates who works there full time doing primary care. He asked her how she was holding up at her job. She hugged him in uniform in the parking lot and cried on his shoulder about how miserable it was. This guy is an a$$hole too so I consider it a fairly big deal. This whole PCMH thing in the military is tough. To essentially be a social worker for all 20+ of your daily patients and coordinate care with military specialists who get paid the same for "no surgery" as they get paid for "surgery", radiologists who will tell you they aren't running the Brain MRI you requested for your new onset orgasmic headache patient because they're busy and don't believe you, and a health plan (United) who will make basic medications such as minocycline and Duac for acne a "specialist order only" medication to save money even though there are currently no dermatologists in network will suck the life out of you. It's a service. Taking care of service members and training medics are amazing things and the participation in the wars will forever have changed me for the better. Just know being a military PA entails more than being a civilian PA working for the military.

 

BTW, I have 59 safe exits out of aircraft while in flight :D and my most recent patient was a guy who's parachute who collapsed at about 600ft on a drop-zone here stateside. Mid-shaft femur fx, spinal compression fx at T1 and T8, bilat kidney lacs, spleen lac, bilat pulmonary contusions, and a scapular fracture. We treated him out of the back of a WWII style ambulance and evacuated him on a random national guard helicopter that happened to be in the area.

 

Nate you have stated all the GOOD reasons to be an Army PA.......along with why "The Army" sucks, but being with Soldiers is a great thing..........

[uscbigdawg]

[CAdamsPAC]

Geronimo, I have to ask with all due respect...why does the Army send out their PAs like this? This sounds exactly like an FMF Corpsman's duties (attached to a Marine Infantry unit). Wouldn't they want to protect their investment? As a Corpsman, I understood that I was expendable goods to an extent. But a PA with the same description of duties (and battle rattle) that I had, in country, seems absolutely ridiculous. Just curious, not trying to provoke any inter-service rivalry or pissing contest here.

 

Because that's where the Soldiers and fight are.........PA's provide Unit Level Care in Combat Arms units.............

[3GeronimoPA]

Geronimo, I have to ask with all due respect...why does the Army send out their PAs like this? This sounds exactly like an FMF Corpsman's duties (attached to a Marine Infantry unit). Wouldn't they want to protect their investment? As a Corpsman, I understood that I was expendable goods to an extent. But a PA with the same description of duties (and battle rattle) that I had, in country, seems absolutely ridiculous. Just curious, not trying to provoke any inter-service rivalry or pissing contest here.

 

Corpsman, no offense taken. The deal all boils down to our foundations by doctrine. In a linear battlefield, my battalion's left and right flanks would be manned by sister battalions or by a neighboring brigade. The FLOT(forward line of troops) is where our A, B, and C companies are located with light infantry each supported by a platoon of our D company which is comprised of AT platoons (Anti-Tank). We have company(60mm) and battalion(120mm) mortars which are under the control of the respective commanders to support the line units and we can garner additional support from our brigade HQ for fires by way of 105mm artillery (which is as big as our BDE has due to it being a "light airborne" Brigade). The medical concept is, each company has platoon medics with their platoons on the line, a company medic at a casualty collection point that is formed by him and his 1SG. They patch up who they can and turn them over to our battalion evac section who hands over the patient to the Forward Aid Station that is manned by the PA and a team of medics located at the furthest point forward within evacuation distance to all 3 companies and out of direct fire. Once the PA is done, he either returns dudes to the line or hands them off to battalion internal evac assets back to the battalion aid station which is manned by the battalion surgeon (a designation for the unit physician surgeon or not) and a team of medics at the Battalion Aid Station which is safely located with the battalion commander. He has evacuation assets forward staged with him from our Level II which is a BDE level asset with actual surgeons that can be assigned. As the FLOT moves forward, the aid station jumps. The area behind the FLOT is a "secure" area due to our lines being connected platoon to platoon, company to company, battalion to battalion and BDE to BDE as we move forward through an advancement.

 

The above is doctrinal. Remember, the Army isn't designed to hit enemy loaded beach heads. We are designed to move across entire nations. The "PA" is the first "non-medic" management of war trauma in our model.

 

Now apply this to the modern battlefield, we are not sweeping nations because the enemy is not in a uniform and not distinguishable from the local populace. We project into Iraq and Afghanistan in the same manner as the Marines did. We initially moved forward in the above described manner but along the way we occupied bases, secured wires, and hit the same area twice in attempts to filter the enemy out of the population and engage them. Soldiers, Marines, Sailors and some Airmen all fought and shed blood. For the PA to remain on the camp treating snotty noses and allow his medics to function as the sole trauma management for large scale missions (>2 companies) 1- does not meet the doctrinal design of the level of support the Army deems necessary for a 2 company mission and 2- does not offer the most of what a PA is capable of. Don't get me wrong, my medics are excellent out of their aid bags because I made them excellent and I would destroy non-hackers. However, a PA is not a solid asset if they don't offer more than sick call on a camp. If they can bring up the level of trauma stabilization prior to evac and save just one Soldier's life, his presence was validated. Moreover, the only time I even remotely came close to my death was within a secure line.

 

The Army concept is to put the PA as close to the troops under fire while not himself being under fire and provide initial trauma stabilization prior to evac. I wouldn't go out on platoon or small level missions but if half or more of my battalion was doing something together, their PA was there by doctrine and in reality. Plus, when I was out there taping the ankles of dudes who sprained them on foot movements and was carrying more weight then they were, they ponied up and said, "If doc Taylor can do it so can I". I mean, not all Army PA's are willing to answer the call but someone's got to be a pu$$y to make me look like such a bada$$ :D Just kidding, but no seriously, my battalion commander rated me above infantry officers, my medics would lay down in traffic for me, and I know that I was everywhere I possibly could be to protect my guys. My garrison life sucks but when I look in the mirror I have zero regrets.

 

The Navy/Marine system is surely different by doctrine and I won't argue that I am missing some fundamentals of why the Marines function the way they do. I know our system was tailored from the WWII system and made relevant for my unit of 900.

[3GeronimoPA]

Also, I'll have you know I am just one of a multitude of PAs used this way and we have lost only one PA in the middle east and that was due to a roadside bomb. Shrapnel in our a$$es, heads, or wherever, we have figured out a way to project our most capable point of injury practitioners to the front lines and keep them safe. With well over 2000 PAs deployed, I'd call it a success.

[Corpsman2PA]

Geronimo, thanks for the great response! I knew it had to be a medical doctrine issue, and I thank you for laying it out. Makes perfect sense, and you're right, a success indeed. It would seem that we could use some more PAs like you amongst the ranks (or officers in general). I've always had a gripe with the Marine Corps (okay, a few) but one of them is that for every 1 squared away, follow-through-the-gates-of-hell genuine leader in the Corps that chose to re-up, there's 3 that re-up because "they have nothing better to do." Trust me, I've witnessed it. It was a big reason that I chose to pursue civilian PA school...I couldn't see myself functioning in the beurocracy any longer. Of course, you feel guilty for your choices, but at the same time like you said, you can look in the mirror with no regrets of service. Thanks again for giving me insight into the Army PA model. Appreciated greatly.

[3GeronimoPA]

Geronimo, thanks for the great response! I knew it had to be a medical doctrine issue, and I thank you for laying it out. Makes perfect sense, and you're right, a success indeed. It would seem that we could use some more PAs like you amongst the ranks (or officers in general). I've always had a gripe with the Marine Corps (okay, a few) but one of them is that for every 1 squared away, follow-through-the-gates-of-hell genuine leader in the Corps that chose to re-up, there's 3 that re-up because "they have nothing better to do." Trust me, I've witnessed it. It was a big reason that I chose to pursue civilian PA school...I couldn't see myself functioning in the beurocracy any longer. Of course, you feel guilty for your choices, but at the same time like you said, you can look in the mirror with no regrets of service. Thanks again for giving me insight into the Army PA model. Appreciated greatly.

 

For as much as we have different, we sure do share a lot in common.

 

-Geronimo!

[ventana]

I'm in the Army. I'm a battalion PA for a Parachute Infantry Battalion. Military PAs are used wherever the unit they are assigned to is used. While deployed, Air Force PAs predominantly are used in major bases where aircraft would land. They are more secure than most. However, some AF PAs went out with Army units due to our shortage. There may be a couple PAs tied into AFSOF but I doubt they are going out. I won't speak definitively on that. Navy PAs predominantly provide healthcare on vessels which are as secure as big vessels are (not getting shot at pretty much) but they have PAs that support Marine Infantry units. The Coast Guard has a very similar mission for their PAs on vessels but those vessels are typically support vessels and not any vessel engaged in the war. The Army has units that are in the rear with the gear and they have combat arms units. If you are assigned to that combat arms unit, you go where they go. When I was on my most recent deployment to Afghanistan, I would have to put on 40lbs+ of body army with 210 rounds of 5.56mm, a helmet with night vision goggles, knee pads, elbow pads, M4 carbine with red-dot scope, a light, and a night laser all attached. Then I'd have to put on about 40lbs of medical gear, survival gear, and food/water to last me for 2+ days. Do the math. I weigh 185lbs and I stepped on the scale before I walked out the wire and I was just under 320lbs. We would walk for miles, post up a casualty collection point in a covered position while our boys cordon and searched Taliban friendly villages for days on end with distances from 5-20 kilometers. I ended up finding a fatty protein shake to take out instead of food just to cut weight. When I wasn't walking, I was in the back of a steel can truck with one of my battalion's First Sergeants as the truck commander. There are two litters back there and I would listen to the radio traffic and wait on casualties to come to me for stabilization and evac. When I wasn't on mission, I was posted up in a crappy building I used as my trauma bay on the camp of about 80 people in the middle of taliban country. If smaller missions were going on around us and someone got hurt or if we took contact on the camp they would bring their wounded to me and my team of medics to patch up and evac. These camps aren'y necessarily safe. We took 45 days of consecutive rocketing on our camp over the summer of 2012 and one struck the back door of my trauma bay kicking shrapnel into my head resulting in a brief loss of consciousness and an impromptu suturing lesson for my medics. No evac for me and my aching bleeding head to be checked out by TBI though because who's going to take care of the boys when I'm gone. I put bandages over the suture and went back to missions 48 hours later. Don't get me wrong, my experience is neither the norm nor the extreme. There are Army PAs like MAJ John Detro who shot Al Queda in the face at close distance and are running around with shrapnel in his *** from jumping on top of trauma patients when grenades were tossed in the room and there are PAs who's most difficult task of their deployed career was whether or not to get the extra shot at starbucks. The training you get is what training your unit offers you which will be partially limited due to clinic demands, what you chose to educate yourself on, what experience you have, your Non-Commissioned Officer Leadership, and a 1 week course in San Antonio called, "TCMC" that teaches you to stop people from bleeding, keep them breathing, keeping their blood pressure valid, keeping them warm, and handing them off. After 5 deployments I can tell you being away from my family was tough and I missed my wife and kids but the war was an adrenaline rush that I will never regret. What sucks the most is not being at war, going home every night, and still missing your family. This may be specific to the Army but I have an Army friend of mine who was walking around Nellis AFB, he saw one of his Air Force IPAP classmates who works there full time doing primary care. He asked her how she was holding up at her job. She hugged him in uniform in the parking lot and cried on his shoulder about how miserable it was. This guy is an a$$hole too so I consider it a fairly big deal. This whole PCMH thing in the military is tough. To essentially be a social worker for all 20+ of your daily patients and coordinate care with military specialists who get paid the same for "no surgery" as they get paid for "surgery", radiologists who will tell you they aren't running the Brain MRI you requested for your new onset orgasmic headache patient because they're busy and don't believe you, and a health plan (United) who will make basic medications such as minocycline and Duac for acne a "specialist order only" medication to save money even though there are currently no dermatologists in network will suck the life out of you. It's a service. Taking care of service members and training medics are amazing things and the participation in the wars will forever have changed me for the better. Just know being a military PA entails more than being a civilian PA working for the military.

 

BTW, I have 59 safe exits out of aircraft while in flight :D and my most recent patient was a guy who's parachute who collapsed at about 600ft on a drop-zone here stateside. Mid-shaft femur fx, spinal compression fx at T1 and T8, bilat kidney lacs, spleen lac, bilat pulmonary contusions, and a scapular fracture. We treated him out of the back of a WWII style ambulance and evacuated him on a random national guard helicopter that happened to be in the area.

 

 

thank you for your amazing service!!

 

spent 4 years at Elmendorf as a crew chief in usaf..... amazing people in the military!

[3GeronimoPA]

thank you for your amazing service!!

 

spent 4 years at Elmendorf as a crew chief in usaf..... amazing people in the military!

 

 

It has been an honor to serve such a great nation with such a great Constitution.

 

Elmendorf and Richardson have now combined to Joint Base Elmendorf-Richardson. There were some growing pains up front but I think we have worked out most of the kinks. I even work a shift once a week in the Emergency Department over there on the Elmendorf side to keep the skills up. Working so close with the AF especially here on their front lines has given me a whole new respect for the way they work. Thank you for your service!

[ventana]

It has been an honor to serve such a great nation with such a great Constitution.

 

Elmendorf and Richardson have now combined to Joint Base Elmendorf-Richardson. There were some growing pains up front but I think we have worked out most of the kinks. I even work a shift once a week in the Emergency Department over there on the Elmendorf side to keep the skills up. Working so close with the AF especially here on their front lines has given me a whole new respect for the way they work. Thank you for your service!

 

 

When I was there they were pretty much open bases between them... I was in the 90th FS so the back way out of our squadron was through Fort Rich, There is a GREAT King Fishing hole back up on te Fort Rich Eagle River area - was my favorite spot to go - -lost more fish then I landed.... suspect they were BIG kings as I was breaking 40lb line repeatedly.... Used to spend my summer nights riding up the the ski area (I was an avid cyclist and there was a Time Trial up the hill) and winter nights sliding down the sledding hill on the same road - that was a totally insane sledding run like 2 miles long! do they still have it? is the ski area still open?

 

 

Someday I am heading back to AK!!!

[3GeronimoPA]

They still have Arctic Valley which is outside the gate and Hillberg Ski Area which is on the Elmendorf side. I'm familiar with that fishing hole. It's out back behind the ammo storage. Some genius got the idea to Fence off the passage so you can't get back there unless you are willing to be dropped off (so the fuzz doesn't see your car) and take the walk which is about a mile or so. Now the only people that get back there are ammo maintainers and jerks like me. Dudes will ask, "how did you get back here?" and I start saying things like, "I've known First Sergeant for about 7 years" or "I waited at the gate until a MP/SF drove by and he gave me the go ahead to come on back". Who knows what may end up happening but I'm fairly confident if I get caught following fish and game laws on base and violating some local policy that I'll be forgiven. The reds and silvers come up that same inlet. I have been gone for 4 King seasons in a row. By the time I got back this season the reds were running and there were, "If you pull a King out of the water we will condemn your soul after we execute you" signs I was only able to watch them swim by and float back down dead.....

[HMtoPA]

 

 

 

He's definitely a naval officer. He's the second one that I've met that works with IHS and/or the Public Health Service.

 

@Corpsman2PA - Geronimo's deployment is not uncommon for PAs that are attached to the BCTs. While most live in aid stations/CSH's going out on rucks is far from uncommon.

 

Sorry, but I really think you're mistaken.  Navy PA's do not outsource to other federal agencies.  I've seen spreadsheets with every single Navy PA billet listed, to include the name and rank of the person filling the billet.  You must be thinking of USPHS Commissioned Corps officers.  They use Naval rank, wear Naval uniforms, and absolutely provide medical staffing to numerous federal agencies (to include the IHS).

[uscbigdawg]

[HMtoPA]

I really don't care that much dude.  I don't even know the Navy ranks half the time.  I was Army and didn't consider ever joining another branch, so take my apathy as sincerity.

 

I don't know how much you care or don't care, and never made a statement supposing to do so.  I just wanted to clear up some misinformation that I perceived you to be spreading.  Mind you, I don't think you were intentionally seeking to misinform anyone, but for someone who now claims to not care so much about the subject, and not know so much about the Navy, you certainly seemed to speak pretty authoritatively about it.  Your POV is informed by the fact that you were in the Army, mine by the fact that I am in the Navy.  These boards are browsed by lots of PA's and potential PA's with an interest in Naval service, and I just don't want any of them to think that some cushy Federal job is in the cards for them should they join up.  Fair enough?