Where this amendment and the September sections below differ, this amendment governs. The earlier text is kept unchanged as history.
paper/appendix_calculations.py must reproduce all 56 checked figures in Appendices B–E (result in paper/appendix-calculations.md). paper/lab_reconciliation.mjs shows that the lab, given these assumptions, returns the paper’s −$58,419, and attributes the lab’s own defaults step by step.Requested by the instructor’s October 2 review (PR #6). Drafted with AI from the paper’s appendices at the author’s request; the author should confirm it.
Use the documented O-4 profile below and a 5% real base-case discount rate throughout the current paper and lab. The paper’s primary figure compares general internal medicine with Marit’s published San Diego all-employer average of $459,057. The $239,000 fixed O-5 scenario is superseded. This is a representative officer scenario, not a measured average Navy internist.
Cash flows are discounted at year-end: the first year uses t = 1. Basic-pay longevity uses starting years of service plus the zero-based year index: years 1–2 at over-10 and years 3–4 at over-12. The updated lab follows these same conventions. A four-year path from 10 active years does not reach the usual pension eligibility threshold; excluded future pension value is unpriced, not zero.
The initial policy selected by the author is a limited social-media and advertising pilot emphasizing accessible nonfinancial opportunities. Lower implementation cost is a hypothesis requiring staff-time, production, approval, distribution, and evaluation cost data. Measure observed acceptance and later retention, not only clicks or awareness.
Estimate the financial opportunity cost of another Navy agreement for a San Diego-based general pediatrician, general internist, or family physician using the existing compensation package. Compare the present value of continued Navy service with a feasible civilian path over the same period. The current model does not recommend, enter, or calculate a new retention-bonus rate. The revised research brief states the same working hypothesis; GitHub history preserves the earlier bonus hypothesis.
San Diego is the labor-market case within a global readiness problem. Naval Medical Forces Pacific is headquartered there and includes commands in Hawaii, Japan, and Guam. Its mission is to keep assigned medical forces staffed, trained, equipped, and ready to deploy. The pay model does not estimate how much a local physician departure changes Pacific staffing or operational readiness; those are separate outcomes to observe.
At current pay rates, a targeted effort to make eligible primary-care physicians aware of verifiable Navy-specific nonfinancial opportunities will increase their awareness and, among physicians who value those opportunities, increase agreement acceptance or later retention relative to otherwise similar physicians who receive standard information. The estimated financial opportunity cost may moderate that response: communication alone is less likely to change a choice when the physician faces a large, credible civilian advantage. This is a prediction to test, not a measured effect.
“No additional financial compensation” means no pay increase beyond the current package. Pension, TRICARE, GI Bill eligibility, tax treatment, and existing bonuses belong in the financial comparison. Clinical practice, leadership, research, teaching, operational work, mission, and assignment experiences are candidate nonfinancial attributes. Advertising can improve awareness of real opportunities; it cannot create an opportunity that is unavailable to the physician.
The reproducible baseline is a board-certified O-4 just past 10 years of service, with dependents, at duty-station ZIP 92134. The comparison covers 2027–2030 in constant 2026 dollars. Years 1–2 use the 2026 O-4 over-10 basic-pay rate; Years 3–4 use over-12. Rank stays O-4; 2026 BAH, BAS, special pays, and civilian benchmarks are held fixed. This is an illustrative path, not a pay forecast. The additional-service number and slider are synchronized from 1 to 30 years; the label shows 2026 through the selected end year, while the cash table lists each projected year beginning in 2027. The ZIP field accepts any five-digit ZIP in the 2026 DoD BAH crosswalk, mapping it to its Military Housing Area before selecting the O-4/O-5/O-6 rate and dependent status. The ZIP is the permanent duty station, not the physician’s residence. If a ZIP lacks a published mapping, the lab clears BAH and waits for a verified manual amount; it never carries over the previous location’s rate. A manual BAH entry also permits an individually rate-protected amount.
Current annual retention bonuses in the modeled new FY26 four-year agreement are $35,000 for pediatrics and $48,000 each for general internal medicine and family medicine. The lab allows entry of a different actual current agreement rate, since contract vintage and eligibility vary. Navy annual gross cash equals twelve times monthly basic pay, BAH, and BAS, plus applicable incentive pay, board certification pay, and the current retention bonus. It includes housing and subsistence allowances before any tax adjustment.
The default civilian comparators are Marit Health published San Diego city estimates: $303,974 pediatrics, $459,057 internal medicine, and $373,038 family medicine. They are mixed-employer, self-reported city estimates, not ZIP-specific or verified civilian-only offers. The lab also offers national Doximity and Medscape averages and SalaryDr’s 2026 national attending medians as separate sensitivity benchmarks. SalaryDr reports $310,000 for pediatrics (n=261), $345,000 for internal medicine (n=157), and $310,000 for family medicine (n=143); its internal-medicine grouping includes hospital medicine. MGMA and AMGA were removed from the selector because the project has no licensed specialty/geography values to display. MedMoneyGuide’s 2026 page reproduces ranges attributed to Medscape or Doximity rather than an independent dataset, and the NEJM CareerCenter article discusses benchmark use but does not publish a matched three-specialty dataset. Never average unlike geographies, dates, compensation definitions, or practice settings without documenting why they are comparable.
For an individual estimate, obtain a written civilian offer including hours, call, location, employment type, incentives, retirement contributions, health coverage, leave, malpractice coverage and tail responsibility. Record the physician’s actual Navy pay statement, agreement start and end dates, obligation, years of service, retirement system, expected further service, and promotion assumptions. The public lab asks users to transcribe only needed pay figures from an LES. It does not accept document uploads or promise de-identification; an LES may expose identifiers, pay accounts, allotments, and other sensitive details.
For each service year, calculate after-tax civilian cash plus civilian benefits that differ between the paths, less civilian costs actually paid by the physician. Subtract after-tax Navy cash plus incremental Navy benefits. Discount each year’s difference to the unobligated decision date. Add only pension or education value that changes because the member stays. A positive present-value difference favors the civilian path financially; a negative one favors the Navy path financially.
The annual equivalent divides the present-value difference by the present value of one dollar paid in each year. The nonfinancial threshold is the positive part of the financial gap: the minimum net value the physician would have to assign to Navy-specific nonpay attributes for staying to be preferable in this simplified model. It is not an observed preference, reservation wage, or predicted retention probability.
The 12-row audit table reports each specialty and year with the Marit benchmark, current Navy cash, and current gross cash gap. The figure plots cumulative current gross cash gap by specialty. At an illustrative 5% real discount rate, with year-end payments (2027 is t = 1) and no extra taxes or benefits priced, the four-year present-value gross cash gaps are about $132,390 for pediatrics, $636,209 for internal medicine, and $331,190 for family medicine. These are incomplete financial comparisons, not recommended bonus amounts.
This threshold describes the size of the tradeoff, not an amount a message can claim to supply. Report it by specialty and person-specific scenario alongside a separate inventory of opportunities actually accessible to the physician. Do not convert awareness or stated interest directly into a dollar value.
Compare BRS or legacy pension rights using service credit, expected future service, retirement eligibility, projected High-3, real discount rate, and payment period. The lab makes the comparison conditional on completion of the entered paths; it does not assign a numeric probability of retirement. Do not count already vested rights as incremental to staying. The optional leave-active-duty path includes a Reserve pension only with at least 20 projected qualifying years; retirement points divided by 360 determine equivalent service years for the BRS or legacy multiplier, and payments generally begin at age 60 unless an eligible reduced age applies. This simplified path omits drill pay, Reserve TSP, and gray-area health costs. Compare household TRICARE costs with an actual civilian health plan. Count GI Bill transfer value only when staying changes dependent eligibility or use; an earned personal entitlement is not lost merely by separating. Model civilian malpractice premium and tail only if the physician, rather than the employer, pays them and they are not already reflected in the compensation figure. The optional $9,000 premium entry is merely the midpoint of a published $4,000–$14,000 primary-care range, not a local quote. Record assignment predictability, clinical opportunities, family time, mission, and geographic flexibility separately; their dollar values are not observed in salary data.
For the communication strategy, identify specific available opportunities and their eligibility conditions: protected specialty practice, leadership billets, teaching or research roles, operational experience, professional development, and assignment options that can be promised accurately. Record whether each physician already knew about, wanted, and could access the opportunity. Exclude claims that cannot be verified for the relevant billet or career stage.
The White Coat Investor’s 2012 stay-or-separate essay motivates a second, longer career-path sensitivity: compare earlier civilian earnings and consumption with the probability-weighted value of completing active-duty retirement. Its annuity price, tax percentages, pay schedule, and legacy pension example are historical illustrations, not current model inputs. For a physician at 10 years who stays four more years, the four-year cash horizon ends before retirement; a $0 pension entry in that narrow horizon does not mean progress toward retirement is worthless. Use current DoD rules and the individual’s actual retirement system and service credit for any lifetime extension.
For a retirement scenario, set expected additional service long enough to reach the intended retirement date. The starting civilian salary grows at an entered real annual rate, and an optional marginal tax rate applies to those pay changes. Year 1 total tax remains a separate input. The lab lets the user select O-4, O-5, or O-6; 2026 DFAS basic-pay steps and BAH for the selected duty-station ZIP update with grade, while the selected grade remains fixed over the projected years. It does not assume a promotion date. The High-3 pension input must be set separately for the expected retirement grade and service path. Other pay and tax inputs stay fixed unless the user changes the scenario. Enter expected future government TSP contributions separately from the pension, and compare them with civilian employer benefits not already included in the salary benchmark. Changing ZIP does not create a local civilian salary: Marit remains a San Diego city estimate, while Doximity, Medscape, and SalaryDr remain national checks. For a different market, enter a comparable local offer or documented salary manually.
The lab offers an optional Apply or refresh sample estimates button for users without household figures. It previews the amounts before changing any input; once applied, sample amounts recompute with pay, filing-example, and civilian state-tax changes until the user edits a sample field. The tax example uses 2026 federal brackets and standard deductions, 2026 Social Security and Medicare rules, the 2025 California schedule as a state-tax proxy, and 2026 California SDI for civilian wages. Users choose single or joint filing with no spouse income and a Navy tax state from all 50 states. The Navy tax state is selected separately from the duty-station ZIP because military residency and tax rules can make them different. California uses the 2025 income-tax schedule as a proxy; every other state uses an editable 5% hypothetical flat rate on taxable Navy pay until the user supplies a better estimate or enters 0 for an exemption. This is not an automatic calculation of each state’s military-pay rules. The user may include the California schedule and California SDI, exclude civilian state income tax, or enter a custom flat state income-tax rate. The Navy tax-state choice remains separate. The custom rate applies to all civilian wages and to later changes in wages; it is not a state-specific tax calculation and omits other state payroll deductions. The estimator excludes other income, credits, pretax contributions, state-specific rules outside California, and later tax-rule changes. The tax rate on later civilian raises is the modeled change in total applicable taxes from an extra $1,000 at the selected civilian salary, divided by $1,000. A roughly 50% result under the default high-salary California example is a marginal rate, not an effective tax rate on the full salary or a fixed input. The civilian-benefit example is a hypothetical 4% employer retirement contribution on pay up to the 2026 $360,000 qualified-plan compensation limit; it is not an observed physician average. The Navy sample is 5% of basic pay under BRS when the member earns the full match, or $0 under legacy retirement. The health example uses KFF’s 2025 national average employee premiums of $1,440 self-only or $6,850 family, with $0 comparable TRICARE premium and no out-of-pocket adjustment. Malpractice, tail, and incremental GI Bill value stay at the user’s entries unless the user explicitly chooses the $9,000 malpractice example. These are scenario starters, not a personal tax calculation or new default model inputs.
When the horizon reaches 20 active-duty years, the lab estimates annual retired pay as projected High-3 basic pay × service years at retirement × 2.0% for BRS or 2.5% for legacy High-36, then applies the entered pension tax rate. The optional Reserve path uses the same multiplier with points ÷ 360 and delays payments until the entered pay-start age. It discounts each pension stream to the decision date and adds only the active minus Reserve present-value difference to the stay-versus-leave result. The default 22% pension-tax assumption is an illustrative federal marginal bracket for pension dollars added to other retirement income, not a national average or a forecast of effective tax; users should replace it. The 5% real discount rate is an inflation-adjusted time-value assumption applied consistently to future cash and pensions; higher rates reduce the present value of distant Reserve pension payments more strongly. Test 3%, 5%, and 7%. DoD active and Reserve rules govern eligibility and multipliers. The year-by-year table shows gross cash gaps; the present-value result adds net pension value, taxes, TSP, health, GI Bill, and entered expenses.
This remains a conditional two-path sensitivity. It assumes Navy service throughout the selected horizon and, if selected, enough Reserve service to reach the user’s projected points and qualifying years after leaving active duty. It does not estimate the probability of either career path. It does not model promotion, future special-pay changes, mortality, Reserve drill earnings or TSP, pension accrual after already reaching 20 active years, or different civilian earnings after military retirement. An individual’s Statement of Service, retirement-points statement, actual retirement system, projected High-3, civilian offer, and post-retirement plan are needed before interpreting the result as personal advice.
The 2019 White Coat Investor interview with Joel Schofer describes MCCareer.org as an unofficial way to gather dispersed career information and job announcements. It also gives examples of leadership and training opportunities, assignment uncertainty, and specialty-specific assignment processes. The interview concerns his experience, especially emergency medicine, and supplies no causal retention estimate. For this hypothesis, record whether each primary-care physician already uses official Navy channels or MCCareer.org, what they know before the intervention, and which advertised opportunities are actually available in their specialty and career stage. Compare a targeted, verified briefing with existing information access rather than assuming physicians currently receive none. Check current official policy before describing assignment processes or benefits.
Cronin et al. (2010) and Todd et al. (2025) support a career-path, specialty-sensitive present-value comparison, but their accession and scholarship scenarios cannot be used as FY26 Navy retention rates. The Army longitudinal separation study makes realized family, assignment, and duty-station conditions essential covariates and possible competing interventions. The family-physician satisfaction comparison shows why pay satisfaction should be measured separately from cash gap and observed continuation. The analysis evidence table reviews all nine studies and their transfer limits. None supplies a retention probability or monetary default for the lab.
Frank et al.’s Principles of Economics (4th ed., 2019) supports three calculation rules: compare the next agreement with the best feasible alternative rather than money already spent (pp. 5–8); use constant-dollar projections and a real discount rate for future cash and pension streams (pp. 324, 407–414); and distinguish an incentive from a measured response to it (pp. 73–80, 376–385). These principles do not supply a retention coefficient, an FY26 pay rate, or a civilian benchmark. See the course crosswalk for the chapter-by-chapter application.
The civilian path is the opportunity cost of another Navy agreement. The choice involves a bundle of pay and nonpay attributes, so a gross cash gap does not identify indifference between jobs. Current retention-bonus payments affect the marginal reward from staying; sunk training costs cannot justify future pay. A compensating wage differential may be needed for unwanted moves or loss of clinical autonomy. Labor-supply elasticity requires observed behavior after a compensation change, not a salary comparison alone.
Collect specialty-level and person-level eligibility, current bonus acceptance, agreement vintage, civilian offers where voluntarily available, assignment history, clinical practice, and separation after obligation. Measure baseline awareness, preferences, and access to the advertised opportunities. Also record realized duty-station choice, advance assignment notice, moves, deployments and family impact, mentoring, administrative support, and protected clinical work. Compare a clearly specified targeted communication group with a similar standard-information group, ideally assigned in a way that limits selection bias. Record actual access and uptake separately from exposure to a message. Predefine three outcomes: increased accurate awareness, agreement acceptance at the first unobligated decision, and retention after the agreement. Analyze whether any effect differs by estimated financial gap, specialty, rank/career stage, and actual opportunity access. Distinguish survey intentions from observed acceptance and separation. Account for the separate FY25–FY26 internal-medicine pay change. Where feasible, compare communication alone with a documented improvement in assignment or clinical opportunity; do not attribute the effect of a real change to advertising. Compare communication cost with any causal additional retention; the current model does not establish the program effect or cost effectiveness.
Specify the intervention before enrollment. The information arm provides a verified, specialty-specific opportunity inventory, eligibility rules, and a named path to apply; the comparison arm receives standard information. A separate operational arm, if authorized and feasible, offers a real change such as earlier assignment notice, protected clinical or education time, or structured career counseling. Record delivery dates, actual uptake, and whether advertised opportunities were denied or unavailable. Use the same unobligated decision date, retention definition, and follow-up period across arms; report retention after the new obligation as well as agreement acceptance, because a longer contract mechanically delays separation. Do not use an Army, rural, or civilian study’s percentage as the Navy baseline. Predefine a minimum meaningful retention improvement and compare the incremental program cost per additional physician retained once actual costs and separations are available. This is a prospective evaluation specification, not a claim that any arm is already effective.
The new evidence review reinforces separating intention from turnover and reporting follow-up consistently. Primary-care incentive reviews and the state support-for-service study make a future financial intervention a credible comparator, but do not supply a San Diego bonus amount. A 2026 military physician education survey links postgraduate education with stated likelihood of remaining; verify the opportunity and test observed retention before recommending it as a retention measure. The analysis reviews all 17 newly supplied items, including three already assessed in the prior evidence table.
For the Pacific-readiness rationale, collect specialty-specific billet requirements, vacancies, time to fill, deployability, clinical capacity, and assignment destinations for the relevant San Diego commands. Report whether retained physicians fill positions that support deployable forces. These measures test the staffing and readiness links; do not infer them from salary gaps or DOD-wide staffing totals.
The hypothesis would be weakened if awareness rose but acceptance and later retention did not improve relative to a comparable group, or if the advertised opportunities were rarely accessible in practice. A small effect for physicians with the largest verified financial gaps would limit the strategy’s scope. If improved assignment predictability or clinical access changes observed retention while communication alone does not, recommend the operational change. The obvious objection is that information cannot replace compensation or an unavailable opportunity. The narrower claim is that better information may matter for physicians who already place substantial value on attainable Navy opportunities, while the model quantifies the financial tradeoff they face.
Recalculate the three Year 1 current gaps ($40,008.24, $182,091.24, $96,072.24), all 12 rows, the four-year cumulative gaps ($148,793.76, $717,125.76, $373,049.76), and the 5% present values above. Changing benchmark source, specialty, years, dependents, tax amounts, physician-paid costs, GI Bill assumptions, or pension switch must recalculate results. Applying sample estimates must not change malpractice, tail, or GI Bill value; switching from BRS to legacy must set the sample Navy TSP government amount to $0 on reapplication. Before the button is used, sample figures must only be previewed. Each benchmark selector choice must have a cited value for all three specialties; SalaryDr must show its national-median and internal-medicine inclusion caveat. Verify that no proposed-bonus input or proposed-pay result appears in the lab.
The main threats are Marit’s small mixed-employer local sample, national comparator geography, unknown actual offers, tax and benefit assumptions, promotion, agreement vintage, and selection into bonus acceptance. GAO’s incentive review identifies gaps in replacement-cost, bonus-acceptance, and civilian-wage data. GAO’s staffing review gives DOD-wide context rather than a local Navy primary-care retention rate. Internal survey projections should be labeled as preliminary stated intentions, kept out of public figures unless release is approved, and checked against observed separations.
FY26 Medical Corps special-pay guidance governs physician rates; Medical Service Corps guidance does not. NAVADMIN 229/25 continues the pay authority. Use DFAS pay tables, the DoD BAH lookup, and DoD retirement rules for the military path. Marit benchmarks: pediatrics, internal medicine, family medicine. Doximity’s 2026 report and SalaryDr’s 2026 report are separate national sensitivity sources.