Protocol
In some respects the PHS is a military organization that observes traditions of military discipline and courtesy. But the work of the PHS often demands a more collegial atmosphere, so some military standards are different for public health officers.
Hand salutes
The hand salute is executed much less frequently in the PHS than in other military forces. Generally, PHS officers salute each other only when civilians might shake hands — for example, on meeting a fellow officer for the first time. Salutes are also expected at formal occasions and in the company of very senior PHS officers such as Assistant Surgeons-General or the Surgeon-General.
The hand salute is only performed by officers wearing a cover, i.e. a hat. They are never performed in biosuits or in laboratory environments. The hand salute is executed by raising the right hand to the right eyebrow. PHS officers salute with the palm facing out.
Modes of address
Although the official ranks of the Public Health Service are different, PHS officers are generally addressed according to the naval equivalent of their rank. PHS officers ranked Assistant through Officer are addressed as Leftenants, Senior Officers are addressed as Commanders, Directors are addressed as Captains and Assistant Surgeons-General and Surgeons-General are addressed as Admirals.
Although Interns rank with naval midshipmen, they are usually addressed only as "Mister" or "Miss." Officers below the rank of Senior Officer are also usually referred to as "Mister" or "Miss" rather than "Lieutenant."
However: Physicians must always be addressed as "Doctor" rather than "Mister" or "Miss," as must surgeons who are not fellows of the Royal College of Physicians and Surgeons. Surgeons who are fellows of the RCPS must never be referred to as "doctor" (which would be insulting) but only as "Mister" or "Miss."
It is appropriate to address superior officers as "sir" or "ma'am." In some situations senior officers may grant junior officers permission to use the senior officer's first name, but this should never be taken for granted.
Chain of command
PHS follows a strict military chain of command all the way from line officers to the Surgeon-General to, in theory, the crown. The Surgeon-General reports to the Minister for Health but the PHS is in theory an independent agency. Officers who do not follow the lawful orders of their superiors may face a court martial.
In practice, some deference is given to PHS officers' areas of expertise — so, for example, an anasthesologist would have full authority over her work during surgery even if the lead surgeon outranked her. Consequently both military and medical protocols can apply with respect to the chain of command.
Swords
As a vestige of its naval heritage, the PHS does have officers' swords. These are however only worn for very formal ceremonial occasions and very few PHS officers posess one.
