Originally Posted by Galo
You always claim here that whatever is around you colleagues, students, residents, patients... have the best experience in military medicine. That you somehow are immune to all the problems of military medicine, and that what you provide is better even than civilian medicine.
You really expect people to believe this??
I'm not taking up for a1, but I think this is worth responding to.
You and others tend to speak of this system like we are all comletely at its mercy, like the smallest whim from above destroys all ability to care for our patients. But you of all people should know that is hardly the case, the policies and regulations can be ignored and worked around, and that ultimately you are the biggest determinant of the care that your patients receive.
Obviously I can't do anything about physician pay, deloyments, utilization, budgeting, and resource allocation. But there is one thing I can do: I have 900 Marines assigned to me, and when they need something I go balls-to-the-wall to make sure they get it. This usually requires far more work than I would put in on the civlian side. I am frequently in the ER at midnight overseeing disposition on my Marines. I fight with people much higher ranking than me when patients are inappropriately deferred to civilian providers, or turned down for a particular procedure or consult. I beg, borrow, and steal to get the supplies and medications that I need, but the Marine Corps does not see fit to purchase for me. I have acquainted myself fully with all regulations, laws, and orders related to my field, and I wield them like a bat when outside forces try to force me to change my medical practice to meet the latest bull**** metric.
You can give quality care in this system. You can give care that exceeds civilian standards, and I know because I see it every day. But you have to work at it. The worst physicians in the military are the ones who cower in the face of commanders and higher-ranking administrators, and whine about how bad the system is while they drive home at 1530 every day.
I don't know if the system is broken. I'm not even sure I really care. But I know that my clinic isn't broken, because I make sure it's not. So I wouldn't be so quick to dismiss those on this board who say that they provide high quality care to their patients.