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Originally Posted by Gastrapathy
Attrition is one variable that can be easily measured and isn't subjective. To dismiss our dismal retention ignores the cost to training. We run training programs and our staff physicians are so junior that they lack the experience to do so. The most experienced gastroenterologist in the Navy is 7-8 years out of training. The rare people who remain tend not to be clinically oriented. The bottom line is that, as soon as they had the option, your silent majority of non-posting physicians all voted with their feet.
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Did you read my post? I think it is logical and expected that most doctors will leave the service after their obligation - I mean, give me a break, where in the civilian world are they going to deploy you away from your family for 6 months to a year or more, expect you to work extra hours without reimbursement, expect you to take a PT test twice a year, get moved to places you have no interest in living etc. These realities of military life will not and cannot change. Retention is a pretty stupid benchmark to measure during a war - Again, more important albeit more subjective benchmarks are detailed in my earlier post. Those staying in to retirement are going to be those who have tremendously long obligations, have no deployment risk and comparable salaries, and those who can't make it outside.
With regards to experience after about 10-15 years - knowledge and skills start to atrophy - I'd ideally like a doc 3-4 years out of training.
Quote:
Originally Posted by Gastrapathy
, the opinions of physicians who retired in the 90's are irrelevant. Military medicine is vastly different now from what it was then. Their memories, positive or negative are not germane to this discussion. I think that physicians who left the military in the 80s and 90s have a more positive outlook than the current crop of departing doctors. They had it pretty good in the pre-AHLTA, pre-RVU, once-a-career deploying medical corps.
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"Military medicine is vastly different now from what it was then." Duh - as is civilian medicine - find me a happy civilian doctor who was in practice in the 1980's. Medicine sucks overall... everywhere -- and it isn't getting better. RVUs are a civilian creation, Medicare is cutting reimbursement, the Federal Govt expects every doc to have an EMR but there isn't an industry standard and you are expected to pay for it out of your practice. Every year another "never ever" diagnosis gets crafted by the government as if the 600 pounder will never get a decub when vented for 3 months or a VAP, or the hypercoaguable cancer patient won't get a DVT.
Unlike my detractors who in the absence of ideas and facts resort to name calling, I try to lay it out there as balanced as I can. I'll continue to do so. The quality of information and posts on this site are a direct refection of the composition of the group.... This forum is mainly comprised of three groups... 1. wide eyed medical students who have no idea is going on be it military or civilian - and who have plenty of uninformed opinions, 2. disgruntled GMO's (whom I don't blame) and 3. former AF and Navy attendings. Each has a bias whether or not they have enough insight to realize so.