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away with local counseling. For personnel E-4 and above, including officers, there is no
second chance. One incidence of drug abuse, and they are discharged.
The bottom line is that the Navy s drug and alcohol abuse programs work! Keep your
role strictly medical, if possible, and avoid drug enforcement. You can best serve the
crew by being a consultant for the individual with a true problem who wants
rehabilitation. Discuss these points with your Commanding Officer; your drug and
alcohol program will run much better.
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PHYSICAL FITNESS AND WEIGHT CONTROL
The Navy has a significant interest in physical readiness and weight control. Of the
services, the Navy has historically had the least emphasis on physical fitness. The Navy
Department has acted to remedy this situation and has instituted a readiness program.
As Medical Officer, you have a definite role. As part of your collateral duties, you may
be appointed ship Fitness Coordinator, a combination of Richard Simmons and Jack
LaLlane. Resist getting this job by every means at your disposal. This job as outlined in
the instruction is a full-time job for an officer and at least two enlisted assistants. You
have too many other things to do. The Command Fitness Coordinator (CFQ) is
responsible for performing annual physical fitness testing and seeing that the results are
placed in the service records. The CFQ is also responsible for conducting a remedial
physical fitness program for those deemed unfit or who fail to meet body fat standards.
Even if you are athletically inclined, this, as a collateral duty, can be a nightmare.
If stuck with it, the CFQ is more work than it appears on the surface, so be prepared.
Inviting divisional representatives from all over the ship is about the only way to run this
program. This gets the entire command involved (as it should be) and takes some of the
burden of implementation off the CFQ. THESE HEALTH PROGRAMS WILL NOT
WORK WITHOUT ACTIVE COMMAND SUPPORT. Don t let the command dump the
title on you and then look the other way while you flounder. In the Medical Officer role,
you will prescribe exercise programs for those who are overweight, design workouts,
and check up on those people with specific limitations, all as part of your medical duties.
Beware! There will be epidemics of musculoskeletal disorders the day before the
Physical Fitness testing. Coincidentally, these seem to occur in those crewmembers
who need exercise most. They come to Medical because a Medical Officer must excuse
them with a medical waiver in order to miss the PRT. A Nobel Prize awaits the
discoverer of the nefarious virus that causes this problem. Why it doesn t strike just
before liberty call or a shipboard picnic and baseball game is an enigma. If you are
certain after an exam that there is no significant pathology, you rehab or motivate these
people as appropriate. Helping a slug be a slug does no one any favors.
You are also the diet control officer. You should counsel all obese individuals on weight
reduction methods that they can safely accomplish. Weight loss of two to three pounds
per week is a proven safe guideline, or they should lose it as fast as they gained it. If
properly motivated, most individuals can lose weight at this rate on a 1500 calorie diet.
The actual diet prescription will be up to you, of course. Avoid fad diets or
recommending those that will cost crew members a lot of money. The idea is for them to
lose weight by losing fat, not by losing the lump in their wallets. The dietitian at the
hospital is an excellent resource; just write a consult.
Progress should be measured by weekly weigh-ins and a monthly report filed with the
CO. Some commands may simply use the body fat percentage method of charting
progress, as outlined in OPNAVINST 6110.1 series. Weight monitoring, along with
following the percentage body fat on a monthly basis, is recommended because it can
be done easily and provides two measurements of progress. Getting rid of excess
adipose tissue is serious business. Valuable people are being tossed out of the Navy for
lack of body-fat compliance, even if they can perform all of the exercises in the PRT
successfully. You may need to aggressively help some people, but don t drop the ball or
90
let these people slide. Their next duty station might not tolerate their being overweight,
even if yours does.
If you are fortunate and escape this job, you will still be involved in the PRT program.
Before the PRT is run, you will be asked to review all the PRT screening sheets. By the
instruction you are to see anyone who has checked a yes answer. On large ships, that
could be several hundred people more than you can easily see. For those, you should
have a questionnaire developed to further screen the yes answers. A healthy 19-year-
old who checks that a relative had a heart attack at 45 can be easily screened out with
an additional questionnaire. When you first arrive, however, you will be seeing a lot of
these people until you get to know their histories; then they will be easier to screen (they
check the same yes answers, twice a year). Always put a short note on the patient s SF-
600 when you screen someone fit or not fit for the PRT.
As mentioned above, you are the only one who can exempt someone from the PRT test.
Use common sense. If a person has a minor injury that does not prevent them from
playing basketball, it probably won t prevent them from running the PRT. Also, many
people are convinced that, if they have knee or back problems, they don t have to run
the PRT. They are partially correct. They don t have to run; they can swim. But they
must do one or the other. You will get a chance to educate them. Some people will be
much relieved, most won t. You may need to remind the PRT Coordinator that a swim
must be offered for those who want it.
Once you have gone through the PRT sheets and declared who is and isn t fit to go, it is
a good idea to send a master list to the PRT coordinator of those who cannot run the
PRT and why (either medical or obese). NOTE, anyone diagnosed obese, over 25%
body fat for men and over 35% body fat for women, cannot run the PRT until they are
below those numbers no matter how fast they can run or swim. You are the final say on
matters of percent body fat. Measure by the book and to bare skin. For some people
that one-half inch makes all the difference between normal and overfat. The Navy is
taking body fat and PRT results very seriously and careers are lost on this issue.
Your only other responsibility for the PRT test besides running it and passing it
(remember, you have to set the example for your troops) is ensuring that two CPR-
trained individuals are present when the PRT is run. These do not have to be corpsmen.
It is better to train the two PRT enlisted assistants to be CPR-qualified so they can do it.
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