Col Max Lee shares the opportunities that come at crossroads in your military career.
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Episode Transcript
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Laura Tilley (00:00):
I'm looking forward to this next discussion,
(00:16):
Dr. Max Lee, retired Air Forcecolonel, who's going to talk
about those career transitionsand opportunities that you all
will have in your future. Sowith that, Dr. Lee.
Max Lee (00:32):
Okay, well, as Dr.
Tilly has announced that I'll behere to hopefully entertain and
provide some of my perspectivesduring my time. And as I'm
continuing to learn from myexperience as a relatively
recently retired member, butthere's more to the story. So
you'll see that it getsconvoluted and a little bit
(00:54):
weird, but that's okay. That'semergency medicine. So, I don't
know. And I won't even try tomatch the quality and the, you
know, the genuine, genuineemotion and caring that we saw
with the various other panelsbefore I have. So the only thing
I can do is to try to entertainyou. So here we go as a dressing
(01:18):
monkey of sorts. All right, Ihave no financial disclosures to
make the information presentedare those of my own. And they're
from my own experiences andopinions. And by no means am I
an expert, but rather arecontinuously learning students
(01:40):
and of the presented topics. Sowith that, a mentor of mine told
me medicine is staged theaterfor Ugly people. So the only
thing that I'm eminentlyqualified for is maybe
presenting from my from my lackof looks. So I'll ask the
audience, do we have anystudents in medical students,
(02:05):
undergrads who are interested inin emergency medicine and or the
military in our audience today?
Raise your hand, please. Allright. So please, help them
understand what they're gettinginto and to interface with them
because some of the leaders atGSA CEP were the ones who
brought me into emergencymedicine and 20 some odd years
(02:27):
later, here I am Here I amtalking. So please, I would
appreciate if you can extendthat opportunity. Army folks who
do have either previousexperience in the army or
currently in the army, raiseyour hand please. Okay, so we
got a little cluster here. Navy.
All right, excellent. Air Force.
Okay, so we got to kind of thewings of the Air Force, the
(02:49):
senator Corps and the Navy side.
Excellent. Do we have any folkswho are either retired or in the
reserve or guard currently?
Yeah, great. So we have a greatswath of experience and a range
of time in the military and inemergency medicine. So please
take advantage of ouropportunities here, guys, thank
(03:12):
you very much.
So my background is not going tobe the same as yours. And as you
can see from some of theseuniforms, is dated. And you'll
see like, why is this guywearing an army uniform? Well,
you know, why is he wearing aKevlar vest inside an aircraft.
So it's to say my experiencewill not necessarily necessarily
(03:33):
be the same as yours. However, Iin that, in that journey, I had
an opportunity to get to meetand work with just tremendous
people. And if I can help in anyway to help you understand some
of the opportunities that areavailable or connect you with
somebody with more knowledge inthat field, and I have, that is
what I see as my role movingforward. So just a brief
(03:56):
background, I started mymilitary life as an Air Force
Academy cadet, went to U shoes,then went to the EM residency at
Wright Patterson, then taught atSasha and San Antonio emergency
program for four years and thenwent to my operational and
command tours. Some people say Idropped off the face of the
earth. And if there's oneregret, I wish I wouldn't have
(04:17):
used that time, in the otherside of the operational world as
a excuse to not stay connected.
Alright, so that's kind of onelife lesson I'd like to pass
along. Second, then I then Ineeded to understand what I
wanted to do when I grew up andthe field of healthcare, the
business of medicine, and a lotof things were changing. So I
(04:37):
got lucky enough to go to an MPHcompleted at Ann Arbor,
Michigan, then completed a AirForce aerospace medicine
residency to understand some ofthe public health implications
of what we're doing and to leadpopulations to better health
rather than just individual orsmall group of people, or
whatever to one The people inthe emergency department but how
(05:00):
can we translate that intobetter care throughout the
system. Then I went to a commandat RAF Lakenheath speaking, you
know, going to almost adifferent. Even though they say
the same things, the words aredifferent, like napkins are
completely different than whatwe think of napkins they think
(05:21):
of as diapers. So it was achallenge and learning some of
the English as they say. Andthen I finished my time into
active duty Air Force as a chiefof aerospace medicine FSOC
headquarters. I currently am theaerospace medicine consultant at
the United States Air ForceSchool of aerospace medicine,
where I do a lot of policy workrelated to aviation waivers and
(05:42):
policies regarding who, who andwhat medical conditions are safe
to fly and maybe not safe tofly. And then I also have time
carved out to practice emergencymedicine. So I have an amazing,
amazing opportunity to translatesome of my practical and
clinical work, excuse me, to, topolicy that affects our
(06:05):
warfighters. And to admiralspoint, I know, we don't
necessarily talk aboutlethality. But really what we
are here to do, whether we are acorpsman or a medic, or
emergency physician, or nurse,all of that really is to provide
confidence in our leadership toexecute mission. Right? That's
(06:26):
really the bottom line, in myopinion. And with that
confidence, there's two ways Iknow how to support that
confidence and that we're goingto be able to provide the very
best care in whatever settingthat we are in thrusted upon
whether it's in the field,whether it's in a submarine, or
on top of the burning aircraftcarrier, we have to provide that
expert level of medical care.
(06:50):
The second is human performance.
How do we enable our soldiers,sailors airmen to fight in these
challenging conditions andenvironment to exceed their
normal capacity and really winthat battle? Because as we
learned in T, Triple C, the bestbattlefield care is overwhelming
superior firepower. Right? Okay.
(07:15):
So, I'm kind of hard headed. Andit took me a long time to
understand some of theseconcepts. And I'm very good at
binary thinking, yes, no blackand white. But that doesn't
really translate in real world.
And sometimes it doesn'ttranslate in medicine as well.
So let me highlight some of theexamples. Instead of yes, no. Is
your best possibility for maybeor if certain parameters are
(07:37):
met? You may have heard theterm? Not no, because but yes,
if right, so that's probablyimportant concept in talking to
your commanders and leaders onwhat is possible? Not know,
because but yes, if theseparameters are met, what about
admit or discharge, right?
Sometimes this is a clinicalone.
(07:59):
But how about different aspectsof how we practice medicine, it
could be close follow up, ormaybe there's home care
available? Maybe they go homewith a PICC line, or they have
IDI follow up? How crazy isthat? Hey, I'm going to be on
the shift next day. Come onback. And I'll check out your
wound to see you know, if weneed to do anything different or
pack it or get more advancedcare, observation stays right.
(08:22):
There's plenty for our Rob'sunits and some advanced EDS have
smaller, shorter stays thatsomebody let's say a kiddo with
croup in the middle of thenight, can stay till the morning
and see how they do. So and thenthere are either other step down
care facilities availableinstead of being a fallen
impatient for months on end,there might be a step down care
available. So I think how wepractice medicine can be applied
(08:42):
to a lot of aspects in not onlyour clinical practice, but in
daily life. Other commondiscussion is, is it medical or
surgical, but why not? Both?
Right? There's interventionalradiology, who is not either
medical or surgical, but cancertainly help stage procedures,
like try to stop the bleeding inthe liver. And then because the
patient is on the or table forso long, that you know they
(09:06):
expire, right? And maybe westaged the procedure. How about
new adjuvant therapy? Can wehack out the whole cancer? Well,
maybe we shrink it down whenmedications or radiation and
then go after the cancersurgically. And then minimally
invasive, and othernanotechnology that is available
to us. So both medicine andsurgery is advancing at a very
(09:26):
rapid rate. And then instead ofthinking about now or never
think about, well, is this theoptimal time? Should we do this
now? Or can this wait a littlebit? We love making decisions
with what information we havebecause we're emergency medicine
physicians that that's what wedo best. However, sometimes it's
better to delay that decisionand make it when it's necessary,
(09:49):
especially in let's saysomething like business or
policy right now versus later orwhen the resources are
available. And when it isrequired, all right?
So how do we prioritize andthink about what is important to
(10:14):
us, and that self reflection, Iwould argue, is the most
important thing to allow you tothink clearly about clearly
about what might be yourdecisions and, and decision
points in the future. So I'llhighlight a couple of them that,
you know, we may have thoughtabout, or you may see other
people will reflect on. Butfirst is kind of like
(10:36):
popularity, right? You know,that little burst of dopamine
you get when somebody hits alight button, or you get a
positive feedback, you know,that's, that's something that's
real. And then maybe some peopleare driven by money. And, and
opportunity to make money as anemergency physician, both as a
within the military, butcertainly outside as well. What
(10:58):
about rank? How do you put $1cost to the rank? Now there are
certainly $1 figure that you getfrom whatever your service,
years of service and what rankyou are, but there are other
intangibles that just money fromthe rank? What about power, your
ability to change or stop changein something from happening?
(11:21):
Right. So that is, at least inmy mind, from a person and
leadership perspective, isdefinition of power? Or is it
for experience, I love thispicture of this kid looking at a
butterfly. And there's justgenuine surprise and wonderment
and excitement and engagement.
And, you know, maybe that's you,when you teach residents in DC a
(11:42):
new way to insert a centralline, or new way to approach a
patient disease process when thewhen that light bulb comes on,
that's a powerful thing. And inthat might be something that you
value, is it for legacy of whatyou're leaving behind whether
it's written words, or whetherit's the number of people you've
trained, or interacted with, orhelped along the way, that can
(12:04):
be a certainly a powerful force.
But what I have to say that'scommon to everyone here in this
audience is service, you'vesigned up to serve the nation's
call. But not only that, toserve those who fight for our
nation's causes. So I think thatcould be one of those unifying
things, and something that weneed to consistently think about
(12:27):
whether we're in the uniform ornot as we move forward. All
right. So I sometimes see thecareer decisions as a midlife
crisis, not from a you know,should I buy a sports car? Or do
I run a, you know, run off andget married to somebody else.
Not in that sense, but in asense that some doors open and
(12:51):
certain doors close. There wereopportunities to maybe for me to
stay more operational or utilizesome of my aerospace medicine
training to go to the astronautcorps or other things, but those
open and close certainopportunities and avenues. So
you have to really carefullythink through that those
(13:13):
decision points, and it'sstressful. But it's okay, it's
stressful. And I feel that thisis us stress, because this
really is a first world problem,isn't it, you're having an
opportunity to do amazing thingsand affect people's lives. And
doing it in a positive,altruistic, hopefully, and in a
socially acceptable way. Soalthough it is a challenging and
(13:36):
sometimes stressful situation,take advantage of it. Because
with each openings, there mightbe closings, and with each doors
closing, there might be newopportunities that open, it may
lead you down to a new path. Andsometimes it can be a very
circuitous route, maybe you doan operational tour, and then
you come back to teaching, andthen teach your residents the
value of understanding how todeal with the line and the
(13:58):
leadership. Maybe you do an MBAafter you know or an online MBA,
you will utilize those skills toaffect the healthcare system to
help out the very people whoyou're serving. So these are
some challenges and then thereare pitfalls, right? If you are
not clear on what you havethought through and what are
(14:18):
your values, and orient yourlife goals and future with those
values. I would posit that therewill be future challenges and
second guessing that comes aboutand cause more stress. So that
self reflection I think iscritical piece of understanding
where you might want to gookay, so how do you find your
(14:40):
passion? And these are some ofthe questions that I pondered
and loved and none of these arenew ideas under the sun. I'm
sure you've seen this at youknow, the 12 o'clock Saturday
infomercials. So I'm not sayinganything new here. But these are
kind of important questions thatI felt helpful in May making my
decisions. One is what am I goodat? Or what can I excel at?
(15:04):
Right? So I may want to playprofessional basketball, but I
know I'm not going to excel inthat field, I haven't had the
training, I probably don't havethe size and speed to do that.
So okay, but are there thingsthat I am uniquely able to do
because of my talents andexperiences? Alright, so next
(15:24):
is, Am I on the path towardseudaimonia. So this was a taken
from a speech that JFK deliveredin the 60s, and the meaning of
eudaimonia, it really isprobably best translated to
human flowering, right, humanflourishing, and your ability to
really understand and reach yourfull maximal potential. So is
(15:48):
what I'm pursuing or about topursue in the next five to 10
years, what will bring meeudaimonia. And to the Greeks,
that was the true definition ofhappiness, in pursuit of
happiness, knowing that you'reon the path to really fully
realizing your capabilities. Andeudaemonia, I think is a
(16:09):
wonderful word to illustratethat. And then third, do I have
to do this? Or do I want to dothis? That perspective is
amazingly powerful on when yougo to work, or when you are
making your living, both duringmilitary career and afterwards,
right? If you have a passion todo it, you know, as a retiree,
(16:31):
many people would say, Well, whyare you working? Now? Why do you
work as hard as you do? Or whyare you involved with certain
groups in organization? Well,because it brings me happiness.
And because I want to do it, notbecause I have to do it. And
because I enjoy the company andthe people that I've worked
(16:51):
with. And I also feel that Ihave to give back to the
community that has helped me somuch. So again, looking through
this, and deeply thinking aboutwhat you're passionate about,
will help you find that answer.
So I'm sorry, I don't have acanned answer in saying you
should do this, this, this andthen this, because everyone's
experience, interests, passionsare going to be different. But
(17:14):
I'm what I'm trying to lay outis a general principle in
general idea where I found mostuseful in making my journey, but
also, as I discussed openly withother people on how I made that
decision. Okay, so as that timecame nearer, and nearer and
(17:35):
nearer retirement, how do I makethat and retirement decision?
And for some of our medicalstudents, and someone, some,
some of our folks starting offearly in their career, this
might be a long ways off idea.
You're like, Oh, am I ever gonnasee till retirement? And quite
honestly, I thought verysimilarly at that time. But as
time came closer, some of thesediscussions and thought
(18:00):
processes were clarified. And Iwas able to kind of put it down
into these three ideas. And thenI'll give you my cynical one,
because, you know, I told you atthe start, I can't compete with
other folks here to make it alittle humor, sorry. So
about five years before the endof my active duty time, I
(18:21):
started thinking about what aremy values? And are they aligned
with the values of myorganization, and you see the
core values of our three sisterservices up there. And, and
these are amazing, time testedand true values that will help
you not only in the military,but is so sought after outside
(18:42):
of the military, that you have ahuge leg up on a lot of your
other peers, who do not havethese amazing experiences,
though challenging as they maybe. Next is, am I developing and
working towards a goal right? AmI in that pursuit of eudaimonia?
And am or am I just checking thecalendar on the shifts work that
(19:04):
I've done? Or, or you know, justgoing through the motions? Well,
you have to find joy in what youdo. So you have to think deeply
in about what is it that you'reworking towards? And then
lastly, am I holding others ormy organization back? Right? I
mean, I can't speak for anyoneelse but myself. But if there
(19:26):
are other capable subordinateswho should be taking on your
roles, it's part of your job asa leader to help develop them
and get them ready for that nextrole. So that was one of the
things that I looked at. Now. Ihad a chance to discuss this
with one of my close colleaguesand he says, You know what, I
think this can be all turneddown into what we call, don't be
(19:50):
an appendix, Colonel. Anyoneever heard of that term before?
Okay, so don't be an appendixColonel. So let's think about
the anatomy of the appendix.
Right? One, it had a purpose,but now we don't know what it
really is about. Alright,second, if it's removed, there's
no significant harm to theperson or the organization.
(20:10):
Okay. And then third, when it'snoticed, it's usually a problem,
because it's usually full ofstuff. All right, so don't be an
appendix girl. All right. Youknow, when people say I'm going
(20:32):
to retire from active duty, alot of people think about, this
guy is gonna get a boat, movedown to the panhandle of Florida
and fish and you know, chill outin the water. But you know, a
lot of things occupying eat upyour time. So don't think that
once you get out of the activeduty military that you're gonna
have any more time, thecumulative trauma, both mentally
(20:53):
and physically over the courseof your career is going to have
an effect. And you're going toprobably need some time to get
some things that are fixed thatyou have neglected because of
career deployments, etc,including your family. So
personal health needs of theimmediate family. And what I've
recently discovered and havinghad been working through is
(21:18):
aging parents, I never thoughtI'd have to think about wills,
power of attorney. You know,anytime there's a illness or a
challenge, medically, guess whogets the call, right. And it's
even too extended, of course,all two cousins, sometimes
friends. So it's a true, I callit a, it's a honor to be able to
(21:43):
advise and help in thosecritical moments of somebody's
life, not only for my parents,but to my extended family and
their friends. So I appreciatethat. But it will certainly eat
up some of your time.
And then whatever your new roleis, or new job is, or maybe you
have a serious hobby that youwant to turn into a business. So
(22:07):
that'll certainly may be able toeat up quite a significant chunk
of your time. And thenopportunities to enrich yourself
and others through social andcommunity volunteer involvement.
And part of what I do is to tryto improve what we do as GSA CEP
and I find that very rewarding,and then I've been able to
(22:29):
connect and work with my churchbecause, you know, I found peace
and, and solace during some ofthe more challenging times in my
life. So it's, again, anopportunity to get back, but
whatever it is, that drives youand your passion. Being
emergency medicine, doctors andbeing physicians, you it will
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consume your time. So don'tthink that just because retire
life is gonna get necessarilymore relaxed or easier. Or other
things I wish I knew beforeretirement. Separation doesn't
mean you give up all the creditsof your service. Did you know
that you could buy back some ofyour time if you go into the GS
(23:10):
system as a retire it towards aGS retirement? Interesting,
right. So there areopportunities there. And I'll
have links in the talks. Andhopefully, these talks will be
available to download for ourparticipants. And those links
will take you to the sites thatgives you kind of the source
document and where you can findthese things. So I hope you guys
(23:31):
use it in the future too. For asa reference. Military service
buyback time towards first timeI mentioned that anyone heard
the rumor that like serviceacademy time kind of counts
towards your retirement. Anyoneheard of that? Okay, so some
some folks who may be serviceacademy grads, but there is it's
(23:52):
not towards your militaryretirement. But if you do the
government service retirement,it will pay back we will add to
that government service. So forexample, if you retire at 16
years with government service,you'll get credit for 20. So
there's interesting things thatcan happen with your service
academy time. And thoseprocesses and and source
(24:15):
documents are listed here foryour reference. A couple of
other things. Anyone heard thekind of the thing about if your
Uniformed Services Universitythat you'll get time added
towards your retirement, right,we've probably heard that and
seen maybe the documentsfloating around so there's a
source document in that link,it'll take you directly to that
PDF that was signed in 2003. Ibelieve that gives you that
(24:39):
extra time at the end. So youhave to hit 20 and then you get
credit for roughly for it's likethree years and nine months
afterwards. And and theimportant thing here is it's not
20 Let's say you go to 22 yearsand you add four years of you
shoes, you multiply that by thebase pay at 22 years highlighted
(25:00):
In the red circles, rather than26 years, right, so even though
the difference is relativelysmall, their math is a little
bit nuanced, you know, that'sthe personnel system doing its
thing. So I would consider thatcarefully if you want to fully
fully retire, and you want toutilize your monetary retirement
benefits appropriately. Okay.
(25:24):
Okay, I'll cover these in theslides. But I put this year as a
reference for different websitesthat you can go to look at, look
into some of these things. Andthis is kind of near and dear to
my heart now, because my oldestson is about to go off to
college. So the 911 GI Billbenefits are just amazing. And
(25:47):
if you are looking intoretirements, and if you are
within maybe four or five yearsof getting out, I would highly
encourage you to look at how youcan be eligible to transfer
those benefits that benefitstransfer will, will open so many
opportunities if you havechildren, or dependents. And
(26:07):
what that allows you to do aftersix years, you're eligible for
buying into that transfer, andthen you sign up for for more.
So if you're at the 10 yearcareer mark, that's usually
early majors mid majortimelines, if you are make
thinking about that decisionfour to five years before
whether you separate or retire,making that decision to look
(26:30):
into the benefits are awesome.
And let me tell you why. First,you can transfer the benefits to
multiple kids, or spouses. Andin many colleges, if you apply
for one year, it translates overto the rest of the three years
while they're in college. So youcan so I have four children, I'm
going to divide each of thosebenefits, nine months each to my
(26:50):
children, because you get 36months. And during that time,
they'll get paid for the instate tuition rate plus the five
base rate for their food androom and boarding. What an
amazing, amazing benefit. Butwait, there's more. The Yellow
Ribbon programs, the lot of theuniversities have recognized the
(27:14):
benefits of and the sacrificesthat military families have made
in their service along withtheir active duty member. So
they have a matching program forso you might be in a private
school or a private institution.
And they have matching programstowards a Yellow Ribbon Program.
Oh, and by the way, some yellowprograms extend out to graduate
(27:39):
school. So if you're able tosave some portion of your post
911 GI Bill, and then they canmatch the Yellow Ribbon Program
for the graduate programs, whichare typically much more costly
than you would have a hugebenefit. So look at the options,
and carefully consider when youmight want to use that gi
(28:00):
benefit or Yellow Ribbon Programmatching. Right. So it doesn't
always have to be for undergrad,I think the limit is up to age
26. So they have some time anddepending on what their long
term interests are, there mightbe a very strategic advantage of
waiting a little bit more. Andin the talk, you'll see this
link there. But there's thisthing called the GI comparison
(28:21):
tool put out by the VA. And ifyou go there, you can search the
school by names and locationsand compare what they offer,
what G What Yellow Ribbonprograms they have, what gi
programs they have 911 GI Billprograms they have matching. So
this is like one of the coolestsites I've seen in helping plan
my family for further educationand future.
(28:45):
And then, as a service member,amazing, amazing scholarship
opportunities. I'm not at allaffiliated with this
organization, but it's Folds ofHonor. And if you have honorably
served in the military, yourfamily and children are eligible
for significant scholarshipopportunities. And the cool
(29:07):
thing about scholarships anddepending on whether it's a
scholarship or a stipend, it mayallow you to save some of the
911 bills and then use that forroom and board. So sometimes you
can't use sometimes if some ofthese scholarships take away
from the total amount paid outfrom your 911, post 911 GI Bill,
(29:31):
some of them add on to it. Soit's a careful it's something to
consider as you look carefully.
But the great thing is there'sthis amazing thing called
Facebook that allows you to lookat these things and there's
Facebook families within thatuniversity or college that
they're very helpful in reachingout and helping you navigate
through those challengingwaters. I'm not a big Facebook
(29:53):
user, but my wife convinced methat hey, there are some
redeemable and really made Needstuff that's available when use
well and appropriately? Okay?
Maybe you guys are interested ininterested in opening a
business, or maybe you'reinterested in developing a new
device that's going to not onlybe able to help pediatric
(30:16):
patients, but OB patients andyou know, various other, you
know, sized folks and you'relike, hey, I have this idea. And
I'm going to start this, thereare Veterans Assistance programs
to help you get started on thesebusiness ideas. Because you are
a veteran, and if you have aservice connected disability, so
how many people are flightsurgeons or have a flight
(30:37):
surgeon billet, okay? Did youknow that as a flight surgeon,
because you're exposed to a lotaircraft noises, you're going to
have some hearing loss. Now,whether that's just through
normal aging or through exposureto loud aircraft, hard to say.
But that's a service relateddisability. And you get in you
(30:58):
have an automatic competitiveadvantage and bidding for
government contracts and insmall business business
initiative. So understand thoseroles. And the links hopefully
in that system will guide you tosome of the resources that are
available. So it's reallyamazing to see that all these
benefits are within our easygrasp only if we ask or only if
(31:21):
we seek out rather than I don'tI, it would be very tough for
Let's see our veterans returningfrom the Vietnam War, right, a
very different picture. And avery different situation that
we're in today. So what what agreat time to be military
service member. Okay, my chair,Dr. Glenn Hamilton and right
(31:46):
Wright Patterson, er right stateprogram, said during residency,
he said, you know, you get threethings in the job. One is job
satisfaction, second is pay. Andthird is how great the location
is just pick two out of thethree, because you're not going
to get all three of them. Andthat kind of happens also with
pay. So your gross earnings mayincrease as a civilian, whether
(32:10):
you're a civilian or contractor,or even if you're out in the
community working in theemergency department, or your
gross pay will definitely go up.
But I think most of us havefound out that Florida,
California and Texas provide thebest tax shelter for a while or
serving active duty, right, alot of that goes away. So
sometimes there's state taxes orcity taxes in such that take
(32:33):
away from your overall take homeor net pay. So however, the
disability pay is not taxable.
Right. So just to be clear, thatyou guys understand, and some
states allow a reduced rate ornon tax for retirement purposes.
(32:54):
So I think there are 33 statesthat offer that. So whatever you
wherever you settle down, kindof look at that aspect. Because
when you when you're making realmoney and outside, then then it
may make a little bit more of adifference on where you settle.
Okay,spouse and children Survivor
Benefit Program. So there is anopportunity, if you're a retiree
(33:15):
to pay a certain amount ofmoney, in that in case you die,
your survivors get about 55% ofyour retirement pay for the rest
of their life. So it's pay upearlier, it's almost like a
disability income or disabilityinsurance, right, you're paying
up earlier to protect them, ifyou were to pass away earlier.
(33:37):
So there's a calculator outthere that's available to do
that. And if you get intocontact with me, I'll make sure
that you get that calculator tomake that discussion. Because
even though the average agemight be 78, for males in the
United States, currently in aalmost ad for females, if you've
lived to 45, or 50, that numberis much different. It's maybe
(34:00):
85, or 88. So it'll allow you tohave a mathematical inflection
point on whether to do thesurvivor benefits or not. Right.
So it's a pretty cool tool, andI'll be happy to share that with
you. Now, going specific intothe general schedule, we call g
s, sometimes government service,but in the parlance of the
(34:21):
personnel list, and payroll, g sis general schedule. And then
there's a grading system fromgrade one early, you know,
younger, less experienced tograde 15, which is the highest
GS grade before you go into theSES grade, which is kind of the
geo equivalent or flag rank orequivalent. But within the GS
(34:43):
system, you have steps steps onethrough 10 Depending on your
seniority and experience. Soalthough you may think that uh,
hey, I'm an experiencedemergency department, physician,
I'm going to work in a residencywhere I'm What was you know,
supervising residents workingwith, you know, complex issues,
I should be Gs 15, grade 10,there may be some advantages to
(35:08):
going, you know, Gs 15, and thengrade one because it allows for
increases in your salary downthe road. But where that is made
up is the next line, there'sthis thing called a locality
pay. So if you look at the GStable on any DoD resource, you
will see that it's maybe half ofwhat a em physician might make.
(35:31):
But if you look at the localitypay, it's different for each
geographic area and for thespecialty, so they try to get
you to market value in thatarea, right. So that locality
pay is the real negotiationpoint, in my opinion, rather
than what your step grade is GS,because it's going to go up to
(35:53):
understand understanding some ofthe areas where you can argue or
not argue, but discuss what theright concepts are, right GS
position is, will help you bethat, that much more employable
with that process and program,annual leave, this isn't
negotiable as well, who wouldhave thought and leave would be
negotiable. But depending onnumber of years of service, if
you've had 15 years of servicein that career field that you're
(36:16):
working for, you're allottedeight hours of paid leave for
annual leave per pay period,which is about two weeks, versus
if you only have like, you know,if you don't have much
experience at all, then you onlyget like four hours per that two
weeks. So it's almost a double.
So with your experience as amilitary physician, especially
(36:38):
if you're going to join on as anemergency physician,
highlighting your experiences,that career field can help
significantly and how muchleave, you accrue. Sick leave a
standard at four hours per payperiod, which is amazing,
because you know, now you havetime and, you know, time
allotted to take sick leave. Andwhen used correctly, I think
(37:02):
it's a real boon becausesometimes I don't, you know, if
I have a kid who needs to gofollow up for an appointment,
that I might use only two hours,right, and you can take leave in
smaller increments. And you cando it almost by half day or
sometimes even by the hour. So,you know, your 40 hours of leave
may be much longer than yourtraditional military leave of
(37:24):
five days versus seven days,right? Because when you're on
leave with the civilian system,you're not, you know, count the
weekends, you know, becauseyou're not expected on that
time. The Federal EmployeeRetirement System, again, with a
military retirement and theFederal Employee Retirement
System, it's one of the fewpension programs that are
(37:45):
available anywhere in the UnitedStates. Right. So
I think this is a amazingopportunity. And there's math
and calculation that goes withit. And then most of all, you
know, if Congress votes forsomething as a savings program,
you know, it's a pretty gooddeal. The TSP is an amazing
process. And you should, Ithink, as an active duty member
(38:07):
take full advantage of that. Butespecially as a retiree here, or
if you're going into thegovernment service, because
they'll match your TSP as wellup to 5%. So great resource.
Okay. And so I said I'd bring,I'd have a little twist at the
end. There is this thing calleda retired individual mobility or
(38:32):
mobilization, Augmentee, orretired ima. So I'm currently
going through a process to be aretiree who also serves as an
ima. Now, how does that work?
Right? So one, you have to getthrough this indispensability
clause. So somebody's gonnareally want you to be there,
because you have some experienceand knowledge that they want
from you. Usually, flag officerhas just kind of helped sponsor
(38:55):
that. And then but during yourcareer, you might, you may get
an opportunity to work with somepeople that really want want you
and want to work with you, evenafter your careers done. retiree
status, you stay and you stillget your retiree pay, but when
you're activated, you get paidas the reservists but the cool
thing is that time when you'reactivated, counts towards your
(39:17):
added retirement time. So if youretire with 26, you work towards
maybe a 30 year retirement, butyou also get to serve your
country and be involved with themission. So those are some
interesting opportunities. Andif you have any questions, I'd
love to talk about it with you.
(39:38):
All right, homestretch here. Sowhat are my three takeaways,
first scheduled time to selfreflect right? You can call it
journaling, meditation, prayer,mindfulness, single tasking,
whatever it is. Take time andschedule time to self reflect.
Know yourself and know yourenemy and you will need not fear
the result of 100 battles SunsooWe don't learn from experiences
(40:02):
we learn from reflecting on theexperiences of John Dewey. And
if I had an hour to solve theproblem, I'd spend 55 minutes
thinking about the problem, andfive minutes thinking about
solutions, Albert Einstein, Ithink those are some wise words
and important as you set thatfactor on where you want to end
up in the future. Second, planto win the long game. We love
(40:27):
rushing to decisions, becausewe're emergency medicine, we got
it, we have the abilities, we'regoing to do it right. But life
is maybe a little bit differentthan emergency medicine. So I
think transitioning and thinkingabout the long game is
important. And really isn't thisthe definition of resiliency,
right, as we're all trying toget there and to make ourselves
(40:47):
more resilient. So plan for thelong term and the long game,
life is a marathon, not asprint, the winner of the
marathon has the fastest averagespeed, not necessarily the
fastest top speed. And to win aquick victory at any cost, is
that worth losing the ability tobuild a team of supporters in
(41:08):
the future? Right, this is ateam game, we can't do it alone.
And my last point here isbolster integrity, and build
relationships. During the Romantimes of the Republic, the
soldiers will strike the palm oftheir sword on their caress or
(41:29):
breastplate, and the ringingtone instead of a whack or a
thud would indicate the armorscompleteness and, and unbroken
miss, the soldier would thenshout Integritas. letting their
commanders understand that theyare dressed, but not only that,
they're mentally ready for theduties at hand. This is a
(41:50):
paraphrase from generalCoolatta, the Commandant of the
Marine Corps speech in 1999, hewas our commencement speaker at
you shoes of my graduating year.
So this kind of resonatedwith me, as you know, as I read
about this, so again, thatintegrity is the core value and
the thing that is gonna help setthe right factor on where you
(42:15):
need to go. However, it'simportant to understand that
through low integrity is thecommon courtesy. Respect is a
delivery mechanism. If people donot want to work with you, or if
they fear you, you'll never getthe best answer or full
participation, and integrity andrespect are earned and exchange
with both supervisorysubordinates across across the
(42:37):
way your family. So it's notjust a one way thing up or down,
it goes side to side, up anddown. And everywhere else in
between. Stated differently, theamazing and positive effect of
integrity is lost when practicedwithout the purpose of building
relationships. So mentor, coachand be an advocate for our
(42:57):
future leaders, build teams thatcan solve yet unknown problems
for the future, and pay itforward. And always don't forget
your family, because they'vebeen with you the whole time. So
my last slide here, I'll leaveyou with this. You know, as he
looked back and review some ofthe literature I got, I didn't
(43:20):
really understand what theymeant when I read this play by
William Shakespeare as a highschooler. But as I look back and
think I go, Man, this guy had itright. He understood what was
happening. And I'll just readyou a small snippet. So if you
concentrate on the soldier andthe person with that powdered
wig or the magistrate I'll justread you the excerpt from there.
(43:41):
As he described the differentstages of life. Then a soldier
full of strange oaths andbearded like the part I think
he's talking about a leopardjealous in honor sudden and
quick and coral seeking, seekingthe bubble reputation even in
the canons mouth, and then thejustice and fair round belly
(44:02):
with good Capen line Capen beingfed and fed chicken with ice
severe and beard, a formal cutfull of lies, saws and modern
instances. And so he plays hispart. So with that, I just would
like to say thank you forletting me play a small part in
your your time here at GSA setconference. I'm looking forward
(44:26):
to having the conversations withyou, learning from you, and
conveying any messages orhelpful hints that I might have
to better connect you and haveyou ready for the future. I just
want to thank my amazing familyand my wife who we met at
issues. She is kind of the sheis definitely the wind beneath
my wings and sail as we gothrough our life journey
(44:50):
together. And the QR code willlink you to the GSA CEP or I'm
sorry, Jess s feedback forms.
And I would sincerely appreciateyour feedback on on not only my
talks, but the other talks,because our goal is to improve
the delivery and the value thatwe bring to our organization. So
(45:13):
with that, I know I'm definitelyout of time. I thank you for
your attention. And if there'sany time for a question, I'd be
happy to answer any Laura, arethese two questions I am Allah.
Yes, stepped down.
Unknown (45:36):
As much as a suggestion. If you haven't
looked into the idea ofincorporating yourself and
becoming or treating an LLC foryou or your family, there's
various ways of doing that. fromstate to state. But I would
highly recommend it as a way toprotect your assets, especially
if you step out into thecivilian world practice
(45:56):
medicine. It will help protectyou from adverse events. It's
also a way to shelter yourassets from taxes and things
like that. It's an easy andcheap thing to do, you can do it
at any time. Suppose you'regonna do something unusual in
(46:17):
your military career? That's nota standard, a nine to five?
Max Lee (46:22):
Yeah, why is it advice, and there's some nuances on what
you can and can't do anddifferent advantages of S corp
versus LLC. And I'll be happy todiscuss some of those finer
points if you have questions.
One more question. Yes, sir.
Unknown (46:38):
Madigan, first of all, thank you for your service and
your ongoing service. It'samazing. I have a question about
how long did you actually takewhile you were still? Prepare?
Max Lee (46:51):
Yeah, great question. I think I thought about it after.
Honestly, after my, my fun time,my time with the units and with
the teams were over. I said,What is you know, what am I
really about? What do I want topursue? Do I want to do the
command track? Do I want toclimb the military, you know,
(47:15):
ranking system. And so I had toseriously think about what my,
you know, talents, as well aswhat my interests were, and also
with what my family was willingto support and work together on
and from the onset, I told them,hey, this is a, this is
something I can't do alone. Andwe'll have to work together. So
probably about six years beforeI started thinking about it.
(47:40):
Probably in the start of my lastjob as the F sock aerospace
medicine, the SGP and F sock Imade the decision to retire. And
it took about two years to planall these things. And then COVID
threw everything in a loop, Icouldn't get my VA appointment
(48:03):
to get all my physicals and youknow those things done, but have
faith in the system. The VA doesa really amazing job of
following up I got a call likesix months after I retired. And
then, you know, my pay hadn'tcome in from my disability
retirement stuff. And theyfollow it up and they say, Hey,
we've adjudicated your lettersin the mail. And oh, by the way,
(48:24):
we're going to back pay for allthe months that you weren't paid
for. And then I got a call fromHerbert field at headquarters
FSOC and say, Hey, currently, Iknow you've retired and you did
a partial duty. It's been about10 months, I'm sorry, it took
this long to process, but youwill be deposited this amount
that you're owed, I hadcompletely forgotten about that.
(48:47):
But especially from a retirementperspective, the system and the
VA and the processes are thereto really protect you and work
with you. So have haveconfidence in that and take the
tabs class multiple times if youcan, because you'll you'll learn
a lot about the all theseresources that are available
into much greater than detailsand I have outlined here. So
(49:10):
thank you very much. You guysare amazing group of people. I'm
here to assist or advise in anyway I can. And I look forward to
meeting you and getting to learna little bit about your life
story. Thank you
I'm looking forward to this next discussion,
(00:16):
Dr. Max Lee, retired Air Forcecolonel, who's going to talk
about those career transitionsand opportunities that you all
will have in your future. Sowith that, Dr. Lee.
Max Lee (00:32):
Okay, well, as Dr.
Tilly has announced that I'll behere to hopefully entertain and
provide some of my perspectivesduring my time. And as I'm
continuing to learn from myexperience as a relatively
recently retired member, butthere's more to the story. So
you'll see that it getsconvoluted and a little bit
(00:54):
weird, but that's okay. That'semergency medicine. So, I don't
know. And I won't even try tomatch the quality and the, you
know, the genuine, genuineemotion and caring that we saw
with the various other panelsbefore I have. So the only thing
I can do is to try to entertainyou. So here we go as a dressing
(01:18):
monkey of sorts. All right, Ihave no financial disclosures to
make the information presentedare those of my own. And they're
from my own experiences andopinions. And by no means am I
an expert, but rather arecontinuously learning students
(01:40):
and of the presented topics. Sowith that, a mentor of mine told
me medicine is staged theaterfor Ugly people. So the only
thing that I'm eminentlyqualified for is maybe
presenting from my from my lackof looks. So I'll ask the
audience, do we have anystudents in medical students,
(02:05):
undergrads who are interested inin emergency medicine and or the
military in our audience today?
Raise your hand, please. Allright. So please, help them
understand what they're gettinginto and to interface with them
because some of the leaders atGSA CEP were the ones who
brought me into emergencymedicine and 20 some odd years
(02:27):
later, here I am Here I amtalking. So please, I would
appreciate if you can extendthat opportunity. Army folks who
do have either previousexperience in the army or
currently in the army, raiseyour hand please. Okay, so we
got a little cluster here. Navy.
All right, excellent. Air Force.
Okay, so we got to kind of thewings of the Air Force, the
(02:49):
senator Corps and the Navy side.
Excellent. Do we have any folkswho are either retired or in the
reserve or guard currently?
Yeah, great. So we have a greatswath of experience and a range
of time in the military and inemergency medicine. So please
take advantage of ouropportunities here, guys, thank
(03:12):
you very much.
So my background is not going tobe the same as yours. And as you
can see from some of theseuniforms, is dated. And you'll
see like, why is this guywearing an army uniform? Well,
you know, why is he wearing aKevlar vest inside an aircraft.
So it's to say my experiencewill not necessarily necessarily
(03:33):
be the same as yours. However, Iin that, in that journey, I had
an opportunity to get to meetand work with just tremendous
people. And if I can help in anyway to help you understand some
of the opportunities that areavailable or connect you with
somebody with more knowledge inthat field, and I have, that is
what I see as my role movingforward. So just a brief
(03:56):
background, I started mymilitary life as an Air Force
Academy cadet, went to U shoes,then went to the EM residency at
Wright Patterson, then taught atSasha and San Antonio emergency
program for four years and thenwent to my operational and
command tours. Some people say Idropped off the face of the
earth. And if there's oneregret, I wish I wouldn't have
(04:17):
used that time, in the otherside of the operational world as
a excuse to not stay connected.
Alright, so that's kind of onelife lesson I'd like to pass
along. Second, then I then Ineeded to understand what I
wanted to do when I grew up andthe field of healthcare, the
business of medicine, and a lotof things were changing. So I
(04:37):
got lucky enough to go to an MPHcompleted at Ann Arbor,
Michigan, then completed a AirForce aerospace medicine
residency to understand some ofthe public health implications
of what we're doing and to leadpopulations to better health
rather than just individual orsmall group of people, or
whatever to one The people inthe emergency department but how
(05:00):
can we translate that intobetter care throughout the
system. Then I went to a commandat RAF Lakenheath speaking, you
know, going to almost adifferent. Even though they say
the same things, the words aredifferent, like napkins are
completely different than whatwe think of napkins they think
(05:21):
of as diapers. So it was achallenge and learning some of
the English as they say. Andthen I finished my time into
active duty Air Force as a chiefof aerospace medicine FSOC
headquarters. I currently am theaerospace medicine consultant at
the United States Air ForceSchool of aerospace medicine,
where I do a lot of policy workrelated to aviation waivers and
(05:42):
policies regarding who, who andwhat medical conditions are safe
to fly and maybe not safe tofly. And then I also have time
carved out to practice emergencymedicine. So I have an amazing,
amazing opportunity to translatesome of my practical and
clinical work, excuse me, to, topolicy that affects our
(06:05):
warfighters. And to admiralspoint, I know, we don't
necessarily talk aboutlethality. But really what we
are here to do, whether we are acorpsman or a medic, or
emergency physician, or nurse,all of that really is to provide
confidence in our leadership toexecute mission. Right? That's
(06:26):
really the bottom line, in myopinion. And with that
confidence, there's two ways Iknow how to support that
confidence and that we're goingto be able to provide the very
best care in whatever settingthat we are in thrusted upon
whether it's in the field,whether it's in a submarine, or
on top of the burning aircraftcarrier, we have to provide that
expert level of medical care.
(06:50):
The second is human performance.
How do we enable our soldiers,sailors airmen to fight in these
challenging conditions andenvironment to exceed their
normal capacity and really winthat battle? Because as we
learned in T, Triple C, the bestbattlefield care is overwhelming
superior firepower. Right? Okay.
(07:15):
So, I'm kind of hard headed. Andit took me a long time to
understand some of theseconcepts. And I'm very good at
binary thinking, yes, no blackand white. But that doesn't
really translate in real world.
And sometimes it doesn'ttranslate in medicine as well.
So let me highlight some of theexamples. Instead of yes, no. Is
your best possibility for maybeor if certain parameters are
(07:37):
met? You may have heard theterm? Not no, because but yes,
if right, so that's probablyimportant concept in talking to
your commanders and leaders onwhat is possible? Not know,
because but yes, if theseparameters are met, what about
admit or discharge, right?
Sometimes this is a clinicalone.
(07:59):
But how about different aspectsof how we practice medicine, it
could be close follow up, ormaybe there's home care
available? Maybe they go homewith a PICC line, or they have
IDI follow up? How crazy isthat? Hey, I'm going to be on
the shift next day. Come onback. And I'll check out your
wound to see you know, if weneed to do anything different or
pack it or get more advancedcare, observation stays right.
(08:22):
There's plenty for our Rob'sunits and some advanced EDS have
smaller, shorter stays thatsomebody let's say a kiddo with
croup in the middle of thenight, can stay till the morning
and see how they do. So and thenthere are either other step down
care facilities availableinstead of being a fallen
impatient for months on end,there might be a step down care
available. So I think how wepractice medicine can be applied
(08:42):
to a lot of aspects in not onlyour clinical practice, but in
daily life. Other commondiscussion is, is it medical or
surgical, but why not? Both?
Right? There's interventionalradiology, who is not either
medical or surgical, but cancertainly help stage procedures,
like try to stop the bleeding inthe liver. And then because the
patient is on the or table forso long, that you know they
(09:06):
expire, right? And maybe westaged the procedure. How about
new adjuvant therapy? Can wehack out the whole cancer? Well,
maybe we shrink it down whenmedications or radiation and
then go after the cancersurgically. And then minimally
invasive, and othernanotechnology that is available
to us. So both medicine andsurgery is advancing at a very
(09:26):
rapid rate. And then instead ofthinking about now or never
think about, well, is this theoptimal time? Should we do this
now? Or can this wait a littlebit? We love making decisions
with what information we havebecause we're emergency medicine
physicians that that's what wedo best. However, sometimes it's
better to delay that decisionand make it when it's necessary,
(09:49):
especially in let's saysomething like business or
policy right now versus later orwhen the resources are
available. And when it isrequired, all right?
So how do we prioritize andthink about what is important to
(10:14):
us, and that self reflection, Iwould argue, is the most
important thing to allow you tothink clearly about clearly
about what might be yourdecisions and, and decision
points in the future. So I'llhighlight a couple of them that,
you know, we may have thoughtabout, or you may see other
people will reflect on. Butfirst is kind of like
(10:36):
popularity, right? You know,that little burst of dopamine
you get when somebody hits alight button, or you get a
positive feedback, you know,that's, that's something that's
real. And then maybe some peopleare driven by money. And, and
opportunity to make money as anemergency physician, both as a
within the military, butcertainly outside as well. What
(10:58):
about rank? How do you put $1cost to the rank? Now there are
certainly $1 figure that you getfrom whatever your service,
years of service and what rankyou are, but there are other
intangibles that just money fromthe rank? What about power, your
ability to change or stop changein something from happening?
(11:21):
Right. So that is, at least inmy mind, from a person and
leadership perspective, isdefinition of power? Or is it
for experience, I love thispicture of this kid looking at a
butterfly. And there's justgenuine surprise and wonderment
and excitement and engagement.
And, you know, maybe that's you,when you teach residents in DC a
(11:42):
new way to insert a centralline, or new way to approach a
patient disease process when thewhen that light bulb comes on,
that's a powerful thing. And inthat might be something that you
value, is it for legacy of whatyou're leaving behind whether
it's written words, or whetherit's the number of people you've
trained, or interacted with, orhelped along the way, that can
(12:04):
be a certainly a powerful force.
But what I have to say that'scommon to everyone here in this
audience is service, you'vesigned up to serve the nation's
call. But not only that, toserve those who fight for our
nation's causes. So I think thatcould be one of those unifying
things, and something that weneed to consistently think about
(12:27):
whether we're in the uniform ornot as we move forward. All
right. So I sometimes see thecareer decisions as a midlife
crisis, not from a you know,should I buy a sports car? Or do
I run a, you know, run off andget married to somebody else.
Not in that sense, but in asense that some doors open and
(12:51):
certain doors close. There wereopportunities to maybe for me to
stay more operational or utilizesome of my aerospace medicine
training to go to the astronautcorps or other things, but those
open and close certainopportunities and avenues. So
you have to really carefullythink through that those
(13:13):
decision points, and it'sstressful. But it's okay, it's
stressful. And I feel that thisis us stress, because this
really is a first world problem,isn't it, you're having an
opportunity to do amazing thingsand affect people's lives. And
doing it in a positive,altruistic, hopefully, and in a
socially acceptable way. Soalthough it is a challenging and
(13:36):
sometimes stressful situation,take advantage of it. Because
with each openings, there mightbe closings, and with each doors
closing, there might be newopportunities that open, it may
lead you down to a new path. Andsometimes it can be a very
circuitous route, maybe you doan operational tour, and then
you come back to teaching, andthen teach your residents the
value of understanding how todeal with the line and the
(13:58):
leadership. Maybe you do an MBAafter you know or an online MBA,
you will utilize those skills toaffect the healthcare system to
help out the very people whoyou're serving. So these are
some challenges and then thereare pitfalls, right? If you are
not clear on what you havethought through and what are
(14:18):
your values, and orient yourlife goals and future with those
values. I would posit that therewill be future challenges and
second guessing that comes aboutand cause more stress. So that
self reflection I think iscritical piece of understanding
where you might want to gookay, so how do you find your
(14:40):
passion? And these are some ofthe questions that I pondered
and loved and none of these arenew ideas under the sun. I'm
sure you've seen this at youknow, the 12 o'clock Saturday
infomercials. So I'm not sayinganything new here. But these are
kind of important questions thatI felt helpful in May making my
decisions. One is what am I goodat? Or what can I excel at?
(15:04):
Right? So I may want to playprofessional basketball, but I
know I'm not going to excel inthat field, I haven't had the
training, I probably don't havethe size and speed to do that.
So okay, but are there thingsthat I am uniquely able to do
because of my talents andexperiences? Alright, so next
(15:24):
is, Am I on the path towardseudaimonia. So this was a taken
from a speech that JFK deliveredin the 60s, and the meaning of
eudaimonia, it really isprobably best translated to
human flowering, right, humanflourishing, and your ability to
really understand and reach yourfull maximal potential. So is
(15:48):
what I'm pursuing or about topursue in the next five to 10
years, what will bring meeudaimonia. And to the Greeks,
that was the true definition ofhappiness, in pursuit of
happiness, knowing that you'reon the path to really fully
realizing your capabilities. Andeudaemonia, I think is a
(16:09):
wonderful word to illustratethat. And then third, do I have
to do this? Or do I want to dothis? That perspective is
amazingly powerful on when yougo to work, or when you are
making your living, both duringmilitary career and afterwards,
right? If you have a passion todo it, you know, as a retiree,
(16:31):
many people would say, Well, whyare you working? Now? Why do you
work as hard as you do? Or whyare you involved with certain
groups in organization? Well,because it brings me happiness.
And because I want to do it, notbecause I have to do it. And
because I enjoy the company andthe people that I've worked
(16:51):
with. And I also feel that Ihave to give back to the
community that has helped me somuch. So again, looking through
this, and deeply thinking aboutwhat you're passionate about,
will help you find that answer.
So I'm sorry, I don't have acanned answer in saying you
should do this, this, this andthen this, because everyone's
experience, interests, passionsare going to be different. But
(17:14):
I'm what I'm trying to lay outis a general principle in
general idea where I found mostuseful in making my journey, but
also, as I discussed openly withother people on how I made that
decision. Okay, so as that timecame nearer, and nearer and
(17:35):
nearer retirement, how do I makethat and retirement decision?
And for some of our medicalstudents, and someone, some,
some of our folks starting offearly in their career, this
might be a long ways off idea.
You're like, Oh, am I ever gonnasee till retirement? And quite
honestly, I thought verysimilarly at that time. But as
time came closer, some of thesediscussions and thought
(18:00):
processes were clarified. And Iwas able to kind of put it down
into these three ideas. And thenI'll give you my cynical one,
because, you know, I told you atthe start, I can't compete with
other folks here to make it alittle humor, sorry. So
about five years before the endof my active duty time, I
(18:21):
started thinking about what aremy values? And are they aligned
with the values of myorganization, and you see the
core values of our three sisterservices up there. And, and
these are amazing, time testedand true values that will help
you not only in the military,but is so sought after outside
(18:42):
of the military, that you have ahuge leg up on a lot of your
other peers, who do not havethese amazing experiences,
though challenging as they maybe. Next is, am I developing and
working towards a goal right? AmI in that pursuit of eudaimonia?
And am or am I just checking thecalendar on the shifts work that
(19:04):
I've done? Or, or you know, justgoing through the motions? Well,
you have to find joy in what youdo. So you have to think deeply
in about what is it that you'reworking towards? And then
lastly, am I holding others ormy organization back? Right? I
mean, I can't speak for anyoneelse but myself. But if there
(19:26):
are other capable subordinateswho should be taking on your
roles, it's part of your job asa leader to help develop them
and get them ready for that nextrole. So that was one of the
things that I looked at. Now. Ihad a chance to discuss this
with one of my close colleaguesand he says, You know what, I
think this can be all turneddown into what we call, don't be
(19:50):
an appendix, Colonel. Anyoneever heard of that term before?
Okay, so don't be an appendixColonel. So let's think about
the anatomy of the appendix.
Right? One, it had a purpose,but now we don't know what it
really is about. Alright,second, if it's removed, there's
no significant harm to theperson or the organization.
(20:10):
Okay. And then third, when it'snoticed, it's usually a problem,
because it's usually full ofstuff. All right, so don't be an
appendix girl. All right. Youknow, when people say I'm going
(20:32):
to retire from active duty, alot of people think about, this
guy is gonna get a boat, movedown to the panhandle of Florida
and fish and you know, chill outin the water. But you know, a
lot of things occupying eat upyour time. So don't think that
once you get out of the activeduty military that you're gonna
have any more time, thecumulative trauma, both mentally
(20:53):
and physically over the courseof your career is going to have
an effect. And you're going toprobably need some time to get
some things that are fixed thatyou have neglected because of
career deployments, etc,including your family. So
personal health needs of theimmediate family. And what I've
recently discovered and havinghad been working through is
(21:18):
aging parents, I never thoughtI'd have to think about wills,
power of attorney. You know,anytime there's a illness or a
challenge, medically, guess whogets the call, right. And it's
even too extended, of course,all two cousins, sometimes
friends. So it's a true, I callit a, it's a honor to be able to
(21:43):
advise and help in thosecritical moments of somebody's
life, not only for my parents,but to my extended family and
their friends. So I appreciatethat. But it will certainly eat
up some of your time.
And then whatever your new roleis, or new job is, or maybe you
have a serious hobby that youwant to turn into a business. So
(22:07):
that'll certainly may be able toeat up quite a significant chunk
of your time. And thenopportunities to enrich yourself
and others through social andcommunity volunteer involvement.
And part of what I do is to tryto improve what we do as GSA CEP
and I find that very rewarding,and then I've been able to
(22:29):
connect and work with my churchbecause, you know, I found peace
and, and solace during some ofthe more challenging times in my
life. So it's, again, anopportunity to get back, but
whatever it is, that drives youand your passion. Being
emergency medicine, doctors andbeing physicians, you it will
(22:49):
consume your time. So don'tthink that just because retire
life is gonna get necessarilymore relaxed or easier. Or other
things I wish I knew beforeretirement. Separation doesn't
mean you give up all the creditsof your service. Did you know
that you could buy back some ofyour time if you go into the GS
(23:10):
system as a retire it towards aGS retirement? Interesting,
right. So there areopportunities there. And I'll
have links in the talks. Andhopefully, these talks will be
available to download for ourparticipants. And those links
will take you to the sites thatgives you kind of the source
document and where you can findthese things. So I hope you guys
(23:31):
use it in the future too. For asa reference. Military service
buyback time towards first timeI mentioned that anyone heard
the rumor that like serviceacademy time kind of counts
towards your retirement. Anyoneheard of that? Okay, so some
some folks who may be serviceacademy grads, but there is it's
(23:52):
not towards your militaryretirement. But if you do the
government service retirement,it will pay back we will add to
that government service. So forexample, if you retire at 16
years with government service,you'll get credit for 20. So
there's interesting things thatcan happen with your service
academy time. And thoseprocesses and and source
(24:15):
documents are listed here foryour reference. A couple of
other things. Anyone heard thekind of the thing about if your
Uniformed Services Universitythat you'll get time added
towards your retirement, right,we've probably heard that and
seen maybe the documentsfloating around so there's a
source document in that link,it'll take you directly to that
PDF that was signed in 2003. Ibelieve that gives you that
(24:39):
extra time at the end. So youhave to hit 20 and then you get
credit for roughly for it's likethree years and nine months
afterwards. And and theimportant thing here is it's not
20 Let's say you go to 22 yearsand you add four years of you
shoes, you multiply that by thebase pay at 22 years highlighted
(25:00):
In the red circles, rather than26 years, right, so even though
the difference is relativelysmall, their math is a little
bit nuanced, you know, that'sthe personnel system doing its
thing. So I would consider thatcarefully if you want to fully
fully retire, and you want toutilize your monetary retirement
benefits appropriately. Okay.
(25:24):
Okay, I'll cover these in theslides. But I put this year as a
reference for different websitesthat you can go to look at, look
into some of these things. Andthis is kind of near and dear to
my heart now, because my oldestson is about to go off to
college. So the 911 GI Billbenefits are just amazing. And
(25:47):
if you are looking intoretirements, and if you are
within maybe four or five yearsof getting out, I would highly
encourage you to look at how youcan be eligible to transfer
those benefits that benefitstransfer will, will open so many
opportunities if you havechildren, or dependents. And
(26:07):
what that allows you to do aftersix years, you're eligible for
buying into that transfer, andthen you sign up for for more.
So if you're at the 10 yearcareer mark, that's usually
early majors mid majortimelines, if you are make
thinking about that decisionfour to five years before
whether you separate or retire,making that decision to look
(26:30):
into the benefits are awesome.
And let me tell you why. First,you can transfer the benefits to
multiple kids, or spouses. Andin many colleges, if you apply
for one year, it translates overto the rest of the three years
while they're in college. So youcan so I have four children, I'm
going to divide each of thosebenefits, nine months each to my
(26:50):
children, because you get 36months. And during that time,
they'll get paid for the instate tuition rate plus the five
base rate for their food androom and boarding. What an
amazing, amazing benefit. Butwait, there's more. The Yellow
Ribbon programs, the lot of theuniversities have recognized the
(27:14):
benefits of and the sacrificesthat military families have made
in their service along withtheir active duty member. So
they have a matching program forso you might be in a private
school or a private institution.
And they have matching programstowards a Yellow Ribbon Program.
Oh, and by the way, some yellowprograms extend out to graduate
(27:39):
school. So if you're able tosave some portion of your post
911 GI Bill, and then they canmatch the Yellow Ribbon Program
for the graduate programs, whichare typically much more costly
than you would have a hugebenefit. So look at the options,
and carefully consider when youmight want to use that gi
(28:00):
benefit or Yellow Ribbon Programmatching. Right. So it doesn't
always have to be for undergrad,I think the limit is up to age
26. So they have some time anddepending on what their long
term interests are, there mightbe a very strategic advantage of
waiting a little bit more. Andin the talk, you'll see this
link there. But there's thisthing called the GI comparison
(28:21):
tool put out by the VA. And ifyou go there, you can search the
school by names and locationsand compare what they offer,
what G What Yellow Ribbonprograms they have, what gi
programs they have 911 GI Billprograms they have matching. So
this is like one of the coolestsites I've seen in helping plan
my family for further educationand future.
(28:45):
And then, as a service member,amazing, amazing scholarship
opportunities. I'm not at allaffiliated with this
organization, but it's Folds ofHonor. And if you have honorably
served in the military, yourfamily and children are eligible
for significant scholarshipopportunities. And the cool
(29:07):
thing about scholarships anddepending on whether it's a
scholarship or a stipend, it mayallow you to save some of the
911 bills and then use that forroom and board. So sometimes you
can't use sometimes if some ofthese scholarships take away
from the total amount paid outfrom your 911, post 911 GI Bill,
(29:31):
some of them add on to it. Soit's a careful it's something to
consider as you look carefully.
But the great thing is there'sthis amazing thing called
Facebook that allows you to lookat these things and there's
Facebook families within thatuniversity or college that
they're very helpful in reachingout and helping you navigate
through those challengingwaters. I'm not a big Facebook
(29:53):
user, but my wife convinced methat hey, there are some
redeemable and really made Needstuff that's available when use
well and appropriately? Okay?
Maybe you guys are interested ininterested in opening a
business, or maybe you'reinterested in developing a new
device that's going to not onlybe able to help pediatric
(30:16):
patients, but OB patients andyou know, various other, you
know, sized folks and you'relike, hey, I have this idea. And
I'm going to start this, thereare Veterans Assistance programs
to help you get started on thesebusiness ideas. Because you are
a veteran, and if you have aservice connected disability, so
how many people are flightsurgeons or have a flight
(30:37):
surgeon billet, okay? Did youknow that as a flight surgeon,
because you're exposed to a lotaircraft noises, you're going to
have some hearing loss. Now,whether that's just through
normal aging or through exposureto loud aircraft, hard to say.
But that's a service relateddisability. And you get in you
(30:58):
have an automatic competitiveadvantage and bidding for
government contracts and insmall business business
initiative. So understand thoseroles. And the links hopefully
in that system will guide you tosome of the resources that are
available. So it's reallyamazing to see that all these
benefits are within our easygrasp only if we ask or only if
(31:21):
we seek out rather than I don'tI, it would be very tough for
Let's see our veterans returningfrom the Vietnam War, right, a
very different picture. And avery different situation that
we're in today. So what what agreat time to be military
service member. Okay, my chair,Dr. Glenn Hamilton and right
(31:46):
Wright Patterson, er right stateprogram, said during residency,
he said, you know, you get threethings in the job. One is job
satisfaction, second is pay. Andthird is how great the location
is just pick two out of thethree, because you're not going
to get all three of them. Andthat kind of happens also with
pay. So your gross earnings mayincrease as a civilian, whether
(32:10):
you're a civilian or contractor,or even if you're out in the
community working in theemergency department, or your
gross pay will definitely go up.
But I think most of us havefound out that Florida,
California and Texas provide thebest tax shelter for a while or
serving active duty, right, alot of that goes away. So
sometimes there's state taxes orcity taxes in such that take
(32:33):
away from your overall take homeor net pay. So however, the
disability pay is not taxable.
Right. So just to be clear, thatyou guys understand, and some
states allow a reduced rate ornon tax for retirement purposes.
(32:54):
So I think there are 33 statesthat offer that. So whatever you
wherever you settle down, kindof look at that aspect. Because
when you when you're making realmoney and outside, then then it
may make a little bit more of adifference on where you settle.
Okay,spouse and children Survivor
Benefit Program. So there is anopportunity, if you're a retiree
(33:15):
to pay a certain amount ofmoney, in that in case you die,
your survivors get about 55% ofyour retirement pay for the rest
of their life. So it's pay upearlier, it's almost like a
disability income or disabilityinsurance, right, you're paying
up earlier to protect them, ifyou were to pass away earlier.
(33:37):
So there's a calculator outthere that's available to do
that. And if you get intocontact with me, I'll make sure
that you get that calculator tomake that discussion. Because
even though the average agemight be 78, for males in the
United States, currently in aalmost ad for females, if you've
lived to 45, or 50, that numberis much different. It's maybe
(34:00):
85, or 88. So it'll allow you tohave a mathematical inflection
point on whether to do thesurvivor benefits or not. Right.
So it's a pretty cool tool, andI'll be happy to share that with
you. Now, going specific intothe general schedule, we call g
s, sometimes government service,but in the parlance of the
(34:21):
personnel list, and payroll, g sis general schedule. And then
there's a grading system fromgrade one early, you know,
younger, less experienced tograde 15, which is the highest
GS grade before you go into theSES grade, which is kind of the
geo equivalent or flag rank orequivalent. But within the GS
(34:43):
system, you have steps steps onethrough 10 Depending on your
seniority and experience. Soalthough you may think that uh,
hey, I'm an experiencedemergency department, physician,
I'm going to work in a residencywhere I'm What was you know,
supervising residents workingwith, you know, complex issues,
I should be Gs 15, grade 10,there may be some advantages to
(35:08):
going, you know, Gs 15, and thengrade one because it allows for
increases in your salary downthe road. But where that is made
up is the next line, there'sthis thing called a locality
pay. So if you look at the GStable on any DoD resource, you
will see that it's maybe half ofwhat a em physician might make.
(35:31):
But if you look at the localitypay, it's different for each
geographic area and for thespecialty, so they try to get
you to market value in thatarea, right. So that locality
pay is the real negotiationpoint, in my opinion, rather
than what your step grade is GS,because it's going to go up to
(35:53):
understand understanding some ofthe areas where you can argue or
not argue, but discuss what theright concepts are, right GS
position is, will help you bethat, that much more employable
with that process and program,annual leave, this isn't
negotiable as well, who wouldhave thought and leave would be
negotiable. But depending onnumber of years of service, if
you've had 15 years of servicein that career field that you're
(36:16):
working for, you're allottedeight hours of paid leave for
annual leave per pay period,which is about two weeks, versus
if you only have like, you know,if you don't have much
experience at all, then you onlyget like four hours per that two
weeks. So it's almost a double.
So with your experience as amilitary physician, especially
(36:38):
if you're going to join on as anemergency physician,
highlighting your experiences,that career field can help
significantly and how muchleave, you accrue. Sick leave a
standard at four hours per payperiod, which is amazing,
because you know, now you havetime and, you know, time
allotted to take sick leave. Andwhen used correctly, I think
(37:02):
it's a real boon becausesometimes I don't, you know, if
I have a kid who needs to gofollow up for an appointment,
that I might use only two hours,right, and you can take leave in
smaller increments. And you cando it almost by half day or
sometimes even by the hour. So,you know, your 40 hours of leave
may be much longer than yourtraditional military leave of
(37:24):
five days versus seven days,right? Because when you're on
leave with the civilian system,you're not, you know, count the
weekends, you know, becauseyou're not expected on that
time. The Federal EmployeeRetirement System, again, with a
military retirement and theFederal Employee Retirement
System, it's one of the fewpension programs that are
(37:45):
available anywhere in the UnitedStates. Right. So
I think this is a amazingopportunity. And there's math
and calculation that goes withit. And then most of all, you
know, if Congress votes forsomething as a savings program,
you know, it's a pretty gooddeal. The TSP is an amazing
process. And you should, Ithink, as an active duty member
(38:07):
take full advantage of that. Butespecially as a retiree here, or
if you're going into thegovernment service, because
they'll match your TSP as wellup to 5%. So great resource.
Okay. And so I said I'd bring,I'd have a little twist at the
end. There is this thing calleda retired individual mobility or
(38:32):
mobilization, Augmentee, orretired ima. So I'm currently
going through a process to be aretiree who also serves as an
ima. Now, how does that work?
Right? So one, you have to getthrough this indispensability
clause. So somebody's gonnareally want you to be there,
because you have some experienceand knowledge that they want
from you. Usually, flag officerhas just kind of helped sponsor
(38:55):
that. And then but during yourcareer, you might, you may get
an opportunity to work with somepeople that really want want you
and want to work with you, evenafter your careers done. retiree
status, you stay and you stillget your retiree pay, but when
you're activated, you get paidas the reservists but the cool
thing is that time when you'reactivated, counts towards your
(39:17):
added retirement time. So if youretire with 26, you work towards
maybe a 30 year retirement, butyou also get to serve your
country and be involved with themission. So those are some
interesting opportunities. Andif you have any questions, I'd
love to talk about it with you.
(39:38):
All right, homestretch here. Sowhat are my three takeaways,
first scheduled time to selfreflect right? You can call it
journaling, meditation, prayer,mindfulness, single tasking,
whatever it is. Take time andschedule time to self reflect.
Know yourself and know yourenemy and you will need not fear
the result of 100 battles SunsooWe don't learn from experiences
(40:02):
we learn from reflecting on theexperiences of John Dewey. And
if I had an hour to solve theproblem, I'd spend 55 minutes
thinking about the problem, andfive minutes thinking about
solutions, Albert Einstein, Ithink those are some wise words
and important as you set thatfactor on where you want to end
up in the future. Second, planto win the long game. We love
(40:27):
rushing to decisions, becausewe're emergency medicine, we got
it, we have the abilities, we'regoing to do it right. But life
is maybe a little bit differentthan emergency medicine. So I
think transitioning and thinkingabout the long game is
important. And really isn't thisthe definition of resiliency,
right, as we're all trying toget there and to make ourselves
(40:47):
more resilient. So plan for thelong term and the long game,
life is a marathon, not asprint, the winner of the
marathon has the fastest averagespeed, not necessarily the
fastest top speed. And to win aquick victory at any cost, is
that worth losing the ability tobuild a team of supporters in
(41:08):
the future? Right, this is ateam game, we can't do it alone.
And my last point here isbolster integrity, and build
relationships. During the Romantimes of the Republic, the
soldiers will strike the palm oftheir sword on their caress or
(41:29):
breastplate, and the ringingtone instead of a whack or a
thud would indicate the armorscompleteness and, and unbroken
miss, the soldier would thenshout Integritas. letting their
commanders understand that theyare dressed, but not only that,
they're mentally ready for theduties at hand. This is a
(41:50):
paraphrase from generalCoolatta, the Commandant of the
Marine Corps speech in 1999, hewas our commencement speaker at
you shoes of my graduating year.
So this kind of resonatedwith me, as you know, as I read
about this, so again, thatintegrity is the core value and
the thing that is gonna help setthe right factor on where you
(42:15):
need to go. However, it'simportant to understand that
through low integrity is thecommon courtesy. Respect is a
delivery mechanism. If people donot want to work with you, or if
they fear you, you'll never getthe best answer or full
participation, and integrity andrespect are earned and exchange
with both supervisorysubordinates across across the
(42:37):
way your family. So it's notjust a one way thing up or down,
it goes side to side, up anddown. And everywhere else in
between. Stated differently, theamazing and positive effect of
integrity is lost when practicedwithout the purpose of building
relationships. So mentor, coachand be an advocate for our
(42:57):
future leaders, build teams thatcan solve yet unknown problems
for the future, and pay itforward. And always don't forget
your family, because they'vebeen with you the whole time. So
my last slide here, I'll leaveyou with this. You know, as he
looked back and review some ofthe literature I got, I didn't
(43:20):
really understand what theymeant when I read this play by
William Shakespeare as a highschooler. But as I look back and
think I go, Man, this guy had itright. He understood what was
happening. And I'll just readyou a small snippet. So if you
concentrate on the soldier andthe person with that powdered
wig or the magistrate I'll justread you the excerpt from there.
(43:41):
As he described the differentstages of life. Then a soldier
full of strange oaths andbearded like the part I think
he's talking about a leopardjealous in honor sudden and
quick and coral seeking, seekingthe bubble reputation even in
the canons mouth, and then thejustice and fair round belly
(44:02):
with good Capen line Capen beingfed and fed chicken with ice
severe and beard, a formal cutfull of lies, saws and modern
instances. And so he plays hispart. So with that, I just would
like to say thank you forletting me play a small part in
your your time here at GSA setconference. I'm looking forward
(44:26):
to having the conversations withyou, learning from you, and
conveying any messages orhelpful hints that I might have
to better connect you and haveyou ready for the future. I just
want to thank my amazing familyand my wife who we met at
issues. She is kind of the sheis definitely the wind beneath
my wings and sail as we gothrough our life journey
(44:50):
together. And the QR code willlink you to the GSA CEP or I'm
sorry, Jess s feedback forms.
And I would sincerely appreciateyour feedback on on not only my
talks, but the other talks,because our goal is to improve
the delivery and the value thatwe bring to our organization. So
(45:13):
with that, I know I'm definitelyout of time. I thank you for
your attention. And if there'sany time for a question, I'd be
happy to answer any Laura, arethese two questions I am Allah.
Yes, stepped down.
Unknown (45:36):
As much as a suggestion. If you haven't
looked into the idea ofincorporating yourself and
becoming or treating an LLC foryou or your family, there's
various ways of doing that. fromstate to state. But I would
highly recommend it as a way toprotect your assets, especially
if you step out into thecivilian world practice
(45:56):
medicine. It will help protectyou from adverse events. It's
also a way to shelter yourassets from taxes and things
like that. It's an easy andcheap thing to do, you can do it
at any time. Suppose you'regonna do something unusual in
(46:17):
your military career? That's nota standard, a nine to five?
Max Lee (46:22):
Yeah, why is it advice, and there's some nuances on what
you can and can't do anddifferent advantages of S corp
versus LLC. And I'll be happy todiscuss some of those finer
points if you have questions.
One more question. Yes, sir.
Unknown (46:38):
Madigan, first of all, thank you for your service and
your ongoing service. It'samazing. I have a question about
how long did you actually takewhile you were still? Prepare?
Max Lee (46:51):
Yeah, great question. I think I thought about it after.
Honestly, after my, my fun time,my time with the units and with
the teams were over. I said,What is you know, what am I
really about? What do I want topursue? Do I want to do the
command track? Do I want toclimb the military, you know,
(47:15):
ranking system. And so I had toseriously think about what my,
you know, talents, as well aswhat my interests were, and also
with what my family was willingto support and work together on
and from the onset, I told them,hey, this is a, this is
something I can't do alone. Andwe'll have to work together. So
probably about six years beforeI started thinking about it.
(47:40):
Probably in the start of my lastjob as the F sock aerospace
medicine, the SGP and F sock Imade the decision to retire. And
it took about two years to planall these things. And then COVID
threw everything in a loop, Icouldn't get my VA appointment
(48:03):
to get all my physicals and youknow those things done, but have
faith in the system. The VA doesa really amazing job of
following up I got a call likesix months after I retired. And
then, you know, my pay hadn'tcome in from my disability
retirement stuff. And theyfollow it up and they say, Hey,
we've adjudicated your lettersin the mail. And oh, by the way,
(48:24):
we're going to back pay for allthe months that you weren't paid
for. And then I got a call fromHerbert field at headquarters
FSOC and say, Hey, currently, Iknow you've retired and you did
a partial duty. It's been about10 months, I'm sorry, it took
this long to process, but youwill be deposited this amount
that you're owed, I hadcompletely forgotten about that.
(48:47):
But especially from a retirementperspective, the system and the
VA and the processes are thereto really protect you and work
with you. So have haveconfidence in that and take the
tabs class multiple times if youcan, because you'll you'll learn
a lot about the all theseresources that are available
into much greater than detailsand I have outlined here. So
(49:10):
thank you very much. You guysare amazing group of people. I'm
here to assist or advise in anyway I can. And I look forward to
meeting you and getting to learna little bit about your life
story. Thank you
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