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Originally Posted by DrMedal
Ok, so I follow you right, you're talking about a general 'auroa' of mediocrity. But there are individuals that become great doctors in milmed, and you certainly wouldn't label them (the individual) as being mediocre.
the doctor who treated me (and who I've been talking to at great length regarding mil med) is an O-6 internist (it think he's the chief, or just an senior attending, i dunno for sure). he kind of agrees with what you're saying. He claims that he could've easily taken the 'admin' path, work a 9 to 3 job four days a week. Instead, he chose to continue seeing patients and publish case-studies. He sais his work still involves a considerable amount of admin--and he agrees with you in the sense that if admin is not your forte, then you should steer clear of milmed. But he also made the interesting point that admin (and loss of patient contact) occurs in many parts of civilian medicine too . . .although of course in civi med you can chose to 'walk away' from a situation.
the other doc that I've come to know is my optimologist, he's an 0-5 LASIK/PRK guys, does about 30 cases/week. has done about 25K cases throughout his career . . . published numerous papers. He's quite happy, definintely not a 'mediocre guy'. He is getting out next month . . . but that's ok. If you get out of the military as an O-5/O-6, that's not nec. a knock on your community in the military. It's just time for you to go. (If you get out as a JO, then that's telling of problems).
So, you're a civlian now? What kind of institution do you work at? (large metro hosp, academic, small clinic?) How does it compare? (i know you'll say its 100x better than milmed . . .but honestly, is there anything about milmed that you miss or feel had a leg up on civi med???)
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Private practice as part of a hospital. There is no comparison. People do their job, and they do it well, or they do not see my patients.
What I miss about milmed is the fact that everyone is there with the same patient care goal in mind, although as I've said before, you know who to steer clear off, although sometimes that may not be possible. I liked the fact that no money is involved, so that's one issue you do not even consider while on the outside, that's how you pay your bills. Of course, on the outside, the money is so much better that its once again impossible for the military to get close.
Look, there are mulitple problems with mil med, as there are with medicine in the civilian world, but the problems with milmed are so much more fundamentally worse,(lack of choice or potential delay in training, potentially poor GME, poor infrastructure, POOR leadership, low pay, loss of skills, etc) that it's easy to say its by far better on the outside. The military does have a good medical prevention program, but not enough staff to see it through well.
The two docs you talked to are O-5/6, and are pretty high on the hierachy, and protected to some extent, especially the one that does alot of administration. Most of the docs are capts and majors, and have done their time and leave. Also, I disagree that in the civilian world you get shuffled into administration. You can do it by choice, if you want to, but most surgeons die being surgeons.
If you have no choice other than to do USHUS, you have prior military knowledge, your life will be alot easier than mine was. Unless you suddenly realize that your being put into dangerous situations and that people can be there to protect themselves, rather than to do the right thing. I'm jaded because I met alot of those MEDIOCRE people who stayed in, got power, and did pretty much whatever they wanted.