Pros of military medicine

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Originally Posted by MeBen

As far what you are saying about Surgeons, where they deployed, Antarctica? There is no way a surgeon deployed in Iraq or the ‘Stan is only doing 10 surgeries in 8 months.

Err, sorry, that IS a true statement.

I personally know one surgeon who did less than 5 surgeries during a 4-6 month tour. He got a whole buttload of experience treating URIs and sprained ankles, though.

The problem isn't with lack of work for the surgeons (obviously) - the problem was with the way medical assets were not aligned with the evacuation scheme - surgeons sitting in small FSTs were getting overflown (and rightly so) so casualties could go to a CSH instead.

I don't know if that problem still exists, or whether that misalignment was corrected, but as of at least as late as last year, there WERE surgeons sitting around basically doing nothing.

Originally Posted by RichL025

Err, sorry, that IS a true statement.

I personally know one surgeon who did less than 5 surgeries during a 4-6 month tour. He got a whole buttload of experience treating URIs and sprained ankles, though.

The problem isn't with lack of work for the surgeons (obviously) - the problem was with the way medical assets were not aligned with the evacuation scheme - surgeons sitting in small FSTs were getting overflown (and rightly so) so casualties could go to a CSH instead.

I don't know if that problem still exists, or whether that misalignment was corrected, but as of at least as late as last year, there WERE surgeons sitting around basically doing nothing.

No,

that problem is ongoing, and usually happening at the majority of Air Force bases where the army is unwilling, or unlikely to send their injured.

As far as quality, what milmed said is right on. It may hurt to hear this, and it may seem unpatriotic, but there is alot of incompetence going on. Two easy examples. In Kirkuk, where my AF buddy, (surgeon) was deployed, he watched two american soldiers die because of not following proper ATLS (advanced trauma life saving) procedures by army docs that were reservists, and not currently practicing trauma in their careers. THis is documented in the Morbity and mortality conference and should be a matter of public record. Another is an army doc that I called at some clinic to ask their current opinion about the service. He told me they shipped him off to Iraq right out of his residency, without even having privileges at his base hospital. He told me he found himself in a trauma case that he did not in the least bit feel comfortable. Nothing bad happend, but I surely would not want that surgeon taking care of me if I was wounded. Another: there is a Cardiovascular surgeon who does not even have general surgery privileges who was slated for deployment to a hospital in Iraq that was actually seeing lots of trauma. It took many manipulations to get him to a place where he would be unlikely to encounter trauma.

Unfortunately these types of instances are more the norm than the exception. There are very few surgeons deployed who are currently practicing trauma, or are even fellowship trauma trained. Most AF/army/navy docs are not currently practicing trauma because there is hardly any bases that have level one trauma certification. Also, the few that are now civilian trained have had varying experience with trauma, depending on where they trained. Generally, trauma has decreased markedly since I was first a resident starting in 1992. By the time I finished my training, in 1998, trauma was a much rarer disease than in 92, and I'm talking about gunshot wounds. Blunt trauma has a steady rate, and really does not apply to what surgeons are seeing in Iraq.

THAT IS THE TRUTH!!!

Originally Posted by militarymd

MeBen,


I've said this before, and I will say it again....unless you are a physician, how would you know what is good medical care, and what isn't.

It has been demonstrated again and again, that consumers of healthcare are notoriously poor judges of quality.

You got bamboozled by a bunch of people with a bunch of equipment.....that DOES NOT mean it is good healthcare....all it means is that an uneducated soldier saw a bunch of equipment he is not familiar with...being worked on by a bunch of enthusiast personnel......is that quality???? I can't say, I wasn't there to evaluate it....

However, having been involved with military medicine for 11 years , and seeing it in action many times over....I can say....I doubt it.

I do not have to be a physician to realize I had good medical care, I am alive.

You do not need to be a ‘brain surgeon’ to realize I got great care. I was not looking at all these wonderful toys saying “wow!” I am an owner of a company that brokers equipment sales to ERs. I know the difference between a monophasic defibrillator and a Holter monitor.

I don’t know why you had a problem with military medicine. Maybe you worked with the wrong people. Maybe the system has changed since we are at war and there is more work to do than treating a twisted ankle. Maybe you were not a good physician (you must have a lot of free time with 2.5 posts averaging a day. Lot more than my doc has).

Originally Posted by RichL025

Err, sorry, that IS a true statement.

I personally know one surgeon who did less than 5 surgeries during a 4-6 month tour. He got a whole buttload of experience treating URIs and sprained ankles, though.

The problem isn't with lack of work for the surgeons (obviously) - the problem was with the way medical assets were not aligned with the evacuation scheme - surgeons sitting in small FSTs were getting overflown (and rightly so) so casualties could go to a CSH instead.

I don't know if that problem still exists, or whether that misalignment was corrected, but as of at least as late as last year, there WERE surgeons sitting around basically doing nothing.

Are you joking? First of all the FSTs job is emergeecny suregery & stabalization then they pass the patient off to a CSH. Of course some patients go to a CSH. FSTs are small and can become swamped quickly. There are only 2 CSH in Iraq with a total of less than 600 beds and 12 operating tables.


Last month 74 US troops were killed and 481 were wounded. Then you had hundreds of soliders seeking ordinary care (fever, flu, sprains, pink eye, gallbladder, heatstroke, pulled muscles, etc etc) Then you have the the hundred or so Iraq troops kiiled and hundreds wounded. Then you have civilian that get sent to FSTs or CSTs. Or the doctors that go out to villages or help in Iraqi hospitals. I guess there is a lot of free time for a military doctor. No, sorry. I forgot to add the four hours a sleep they get a night. Ok they have no free time.

Originally Posted by MeBen

I do not have to be a physician to realize I had good medical care, I am alive.

You do not need to be a ‘brain surgeon’ to realize I got great care. I was not looking at all these wonderful toys saying “wow!” I am an owner of a company that brokers equipment sales to ERs. I know the difference between a monophasic defibrillator and a Holter monitor.

I don’t know why you had a problem with military medicine. Maybe you worked with the wrong people. Maybe the system has changed since we are at war and there is more work to do than treating a twisted ankle. Maybe you were not a good physician (you must have a lot of free time with 2.5 posts averaging a day. Lot more than my doc has).

If you think that, you, as a non-physician, know what quality of care is....then you are either a fool or someone with extraordinary abilities....I will withhold judgement on which you are....because many physicians are struggling with trying to figure out what great care is.

Someone who comes into the ER with a STEMI who gets treated with nifedipine for a SBP of 195 mmHg and lives through the experience....the uneducated may think that he got GOOD care....he lived...his blood pressure was treated...

However, anyone who knows how to treat STEMI would know that malpractice was commmitted on him...and he lived...because most patients with STEMI will live with no therapy or even wrong therapy.

Meben, don't be a fool and pretend to know what great care is...there is no way for you to judge.

I have a lot of free time now ...compared to before....and I am compensated at a rate many times what I was paid for before....and MOST IMPORTANTLY, I am allowed to practice in a system that I want...not a dysfunctional one that is forced on me...and even worse...on the likes of you.

Your preaching to the choir. I think many doctors are uneducated drug pushers. I think many procedures used shouldn't. Many people die every year because of horrible care. However I don't through the baby out with the bathwater. Not to boast, but since I am wealthy I have a very good doctor. He works outside the system. At 31 I am in the best shape of my life. My life was saved by military doctors. With the help of my doctor, his staff and my research I am in better shape than most people.

You sound like one of the doctors that are burnt out. I’ll give you the benefit of the doubt and assume you still practice. But really buddy, you need a different bedside manner. Put a smile on your face. Have a spring in your step. You have some big chip on your shoulder. You don’t have to be a physician to now anything about medical care, that is ridiculous. So why don’t you say it one more time. “I AM A DOCTOR. I KNOW EVERYTHING. YOU KNOW NOTHING.” Your telling my not to be a fool. A fool is a person who keeps repeating the same thing over and over excepting a different result. That also the defenition of insanity. So tell me one more time how you are a big, important smart doctor and I am one of the sheep of soceity, following the masses into healthcare hell.

Get a grip buddy. Deflate that ego and try not to embarrass yourself.

Originally Posted by MeBen

Your preaching to the choir. I think many doctors are uneducated drug pushers. I think many procedures used shouldn't. Many people die every year because of horrible care. However I don't through the baby out with the bathwater. Not to boast, but since I am wealthy I have a very good doctor. He works outside the system. At 31 I am in the best shape of my life. My life was saved by military doctors. With the help of my doctor, his staff and my research I am in better shape than most people.

You sound like one of the doctors that are burnt out. I’ll give you the benefit of the doubt and assume you still practice. But really buddy, you need a different bedside manner. Put a smile on your face. Have a spring in your step. You have some big chip on your shoulder. You don’t have to be a physician to now anything about medical care, that is ridiculous. So why don’t you say it one more time. “I AM A DOCTOR. I KNOW EVERYTHING. YOU KNOW NOTHING.” Your telling my not to be a fool. A fool is a person who keeps repeating the same thing over and over excepting a different result. That also the defenition of insanity. So tell me one more time how you are a big, important smart doctor and I am one of the sheep of soceity, following the masses into healthcare hell.

Get a grip buddy. Deflate that ego and try not to embarrass yourself.

I don't think it's burnout. I think its frustration in correcting yet another individual that he doesn't know what he is talking about.

Originally Posted by MeBen

Your preaching to the choir. I think many doctors are uneducated drug pushers. I think many procedures used shouldn't. Many people die every year because of horrible care. However I don't through the baby out with the bathwater. Not to boast, but since I am wealthy I have a very good doctor. He works outside the system. At 31 I am in the best shape of my life. My life was saved by military doctors. With the help of my doctor, his staff and my research I am in better shape than most people.

You sound like one of the doctors that are burnt out. I’ll give you the benefit of the doubt and assume you still practice. But really buddy, you need a different bedside manner. Put a smile on your face. Have a spring in your step. You have some big chip on your shoulder. You don’t have to be a physician to now anything about medical care, that is ridiculous. So why don’t you say it one more time. “I AM A DOCTOR. I KNOW EVERYTHING. YOU KNOW NOTHING.” Your telling my not to be a fool. A fool is a person who keeps repeating the same thing over and over excepting a different result. That also the defenition of insanity. So tell me one more time how you are a big, important smart doctor and I am one of the sheep of soceity, following the masses into healthcare hell.

Get a grip buddy. Deflate that ego and try not to embarrass yourself.

I'm not burnt out. I'm 10 years out from residency and fellowship. That puts me, according to most surveys, in my prime.....and I have to say...I feel it.

Long enough in practice to be not a newby....but short enough in practice the I am not burnt out....and keeping up with the current literature.

I don't have a big chip on my shoulder. I just realize how much there is to learn for myself....so it is very amusing that a medical student? (have you even been accepted) seems to know it all.

How would you know whether a drug is indicated or not...or a procedure is indicated or not....you have not been trained.

Your doctor who "works outside the system"....what does that mean?

Some guy who doesn't accept insurance and charge you 300 bucks a visit????

The reason charlatans like that exist is because there are enough fools out there who easily part with their cash that allow these "doctors" to work "outside the system".

I don't know everything....actually I learn everyday from my patients, from other doctors, on this forum...etc....but I do know that medical school and residency training means something.....that's why there is a selection process, and not any job-blow can go to medical school.

Originally Posted by MeBen

Your preaching to the choir. I think many doctors are uneducated drug pushers.I think many procedures used shouldn't. Many people die every year because of horrible care. However I don't through the baby out with the bathwater.

Based on what, your experience selling ER equipment? Your prior service?

Not to boast, but since I am wealthy I have a very good doctor. He works outside the system.

And what are we to understand from that, that quality care is something you have to pay to have? If so, does it follow then that if you don't have money then you shouldn't expect very good care? Most servicemembers are not from a moneyed class; they don't pay for care, should they therefore expect less? Military doctors don't work "outside the system" you speak of, which seems contrary to your earlier argument. Non sequitur.

At 31 I am in the best shape of my life.

And the reason is . . . . ?

My life was saved by military doctors. With the help of my doctor, his staff and my research I am in better shape than most people.

I may have to just take your word that you are healthy and for those reasons.

You sound like one of the doctors that are burnt out. I’ll give you the benefit of the doubt and assume you still practice. But really buddy, you need a different bedside manner. Put a smile on your face. Have a spring in your step. You have some big chip on your shoulder.

What bedside? Are you writing from your bedside? I thought this was an online military medicine educational thread. Do you know the writer isn't smiling? How? (I am).

You don’t have to be a physician to now anything about medical care, that is ridiculous. So why don’t you say it one more time. “I AM A DOCTOR. I KNOW EVERYTHING. YOU KNOW NOTHING.” Your telling my not to be a fool. A fool is a person who keeps repeating the same thing over and over excepting a different result. That also the defenition of insanity. So tell me one more time how you are a big, important smart doctor and I am one of the sheep of soceity, following the masses into healthcare hell.

I am not sure who has the worse attitude problem. So far, you aren't persuading me. I am a doctor and don't think myself qualified to judge every nuance of care outside my field. Evidently you think yourself very qualified, with whatever experience you have. How, I'd like to know. Brokering ER equipment?

Get a grip buddy. Deflate that ego and try not to embarrass yourself.

Good advice. Have some yourself.

Originally Posted by orbitsurgMD

Based on what, your experience selling ER equipment? Your prior service?
.

That's kind of funny. Sort of like the shoe salesman telling the foot and ankle orthopedic surgeon that he knows what's good care and what is not....and the orthopedic surgeon's training means nothing.

Unfortunately this is the type of person no matter how hard you try to explain to them the reality of military medicine, he will not get it till he gets there, if he gets it at all.

This type of back and forth unfortunately is too common in this forum, and it frequently seems to happen with people that have no experience as practicing physicians, some not even in med school yet. Its a shame that people can't take what we have lived, and try to incorporate it into something they are likely to experience in the military, (and life in general), and just be the wiser for it.

As always, any perspective student looking to go into the military, has this forum, (where we did not), and also has the ability to easily get phone #'s, and start calling up active duty docs to see if our stories mesh. I can bet that they will.

alright. enough's enough. everyone take a time-out and sit in your corners until you can get along.

create a different thread if you wanna rehash all this. otherwise please try not to derail yet another thread.

--your friendly neighborhood re-railing caveman

Originally Posted by Homunculus

alright. enough's enough. everyone take a time-out and sit in your corners until you can get along.

create a different thread if you wanna rehash all this. otherwise please try not to derail yet another thread.

--your friendly neighborhood re-railing caveman

I thought you corralled this thread inside one of the stickies. Looks like it got loose.

Orbitsurg, the only problem with you picking apart my argument is that I was not directing to you!

MilitaryMD, somehow you are under the impression that someone has to be a doctor to know anything about healthcare. Somehow spending four years in medical school will teach you everything you need to know about taking care of yourself.

I now a little something about doctors using drugs not needed. I am allergic to aspirin. My doctor at the time knowing this put me on Celebrex. I wound up in the hospital for two weeks. Ever since then I have done all I can to learn about drugs and there effect on the body. I do not have to be a doctor to know anything about drug interactions. Your not are Pharmacist, do you know everything about drugs that a Pharmacist does.

And my doctor is a charlatan? Just because I don’t sit in a waiting room for an hour with people coughing all over me to see a doctor that has a surly staff and who is talking to a drug rep; and when the doctor sees me he tries to rush me out in five minutes and gives me a script for pills that are unnecessary so that he can go to a ‘medical conference’ in Aruba paid for by the drug company, just because I don’t go to a doctor like that my doctor is a charlatan?

My doctor was smart enough and good enough to break free form the system that you yourself think is not up to par.

Look at these stories; this is why I don’t go to doctors in the system.

http://www.madison.com/wsj/mad/top/i...=82989&ntpid=2

http://www.nytimes.com/2006/05/04/bu...ffd&ei=5087%0A

I researched my present doctor before I went to him. I check his credentials and the status of his license and if he had and lawsuits or complaints filled. I also look up and read all the papers he wrote for JAMA, AOA, & New England Journal of Medicine.

Orbitsburg, unfortunately quality care is something you have to pay for. Of course there are good doctors that are in the system. For my family I want the best doctor. I want a doctor I don’t have to wait a month to see. I want a doctor who will take an interest in the healthcare of my family and me. I searched around. I found the best doctor I could for my family and pay what it costs. Just because someone else can’t afford it does that mean I should not take advantage of a doctor I can afford.

I am in the National Guard. I served overseas and had to deal with military doctors because I was wounded! I did not go to them ask them how to lower my cholesterol. These doctors where not dealing with drug reps, old ladies talking their ears off, having to pick up their dry cleaning and wondering who will win American Idol. They were saving lives. And considering the extent of my wounds it is a miracle I am alive.
The only reason I brought up that I broker ER equipment is because it was suggested all the medical equipment in the field hospital wowed me. Here is the quote from MilitaryMD,

You got bamboozled by a bunch of people with a bunch of equipment.....that DOES NOT mean it is good healthcare....all it means is that an uneducated soldier saw a bunch of equipment he is not familiar with...being worked on by a bunch of enthusiast personnel......is that quality???? I can't say, I wasn't there to evaluate it....

This whole thread started out talking about the PROS of military medicine. There are plenty of cons. Most of those cons are what occurs in the drudgery of the Army. Pre-Iraq many of the doctors did not have the situation where the performed the kinds of things they are doing in Iraq today. The Army was not ready for what is happening today. Just like every other war after Vietnam was over the Army went back top its old ways. Officer efficiency reports and how you got along with your commanding officer was more important than your medical skills. Of course that happens in the civilian world too.

All I am saying is that our troops need doctors. I am not saying that people should make a career out of the military. I am saying is that people that are doctors at the moment who want to go the military route should if the feel that obligation. The biggest PRO is that they are saving peoples lives. The biggest CON is that they could get killed doing it.. A doctor was just killed when and RPG hit him as he was talking to his family on the phone.

I am not talking about somebody stationed at the Pediatric wad at Fort Nowhere. I am talking about taking care of soldiers that have been wounded.

Sorry MilitaryMD, it was beneath me and a cheap shot to say you were burnt out. I am sure you are a good, caring physician who only wants the best for your patients.

This forum is so God-awful depressing to read for any of us who are thinking about doing military medicine.

I have since spoken to two U.S. Navy doctors who both had positive experiences to tell me about their military medical careers. They did mention the common problems such as the atrophying of certain skills, but they felt their other experiences were great enough to overlook these flaws. Basically, you don't go into military medicine to be a doctor but fill whatever service is required of you. If you have some obscure specialty, then you are not going to use it as much and you might have to do more rudminetary medical tasks that may seem useless to you but is of great benefit to the military. There is the concern of back-to-back activations, but that all comes with being in the military. That is the basic gist of what I got from speaking with the doctors one of which took his career to retirement and now works in the civilian world earning a ludicrous amount of money. I can't recall specific details of what they said since it was months ago, but if you had a bad experience in the military and have already told your story, ease off. Any career in the military is really what you make of it despite how much hardship you come across. I recently went on my 1 month MIDN cruise for ROTC and saw this to be a recurring theme: there are folks that regret their decision on joining the military and are counting the days while there are those who are extremely satisfied.

I have had my bad run-ins with Navy medicine already, but that has not discouraged me. I hope to help fix some of these problems when I begin my career, but who knows, it might be fixed by the time I get there.

Originally Posted by midn

This forum is so God-awful depressing to read for any of us who are thinking about doing military medicine.

Why are informational posts depressing?

Originally Posted by midn

This forum is so God-awful depressing to read for any of us who are thinking about doing military medicine.

. . . .

I have had my bad run-ins with Navy medicine already, but that has not discouraged me. I hope to help fix some of these problems when I begin my career, but who knows, it might be fixed by the time I get there.

Look, the thread is about the positives of military medical practice. If you have practice experience as a military physician and want to share, please do. Perhaps those doctors you speak of would like to post here. You might ask them.

But if you yourself are not a doctor and have no practice experience of your own, don't you think it is presumptuous to tell those who have posted here who are doctors and who have significant experience in military medicine what is and isn't acceptable for a medical organization to do? I just don't think you have the knowledge or experience or qualifications to know.

Originally Posted by midn

This forum is so God-awful depressing to read for any of us who are thinking about doing military medicine.

I have since spoken to two U.S. Navy doctors who both had positive experiences to tell me about their military medical careers. They did mention the common problems such as the atrophying of certain skills, but they felt their other experiences were great enough to overlook these flaws. Basically, you don't go into military medicine to be a doctor but fill whatever service is required of you. If you have some obscure specialty, then you are not going to use it as much and you might have to do more rudminetary medical tasks that may seem useless to you but is of great benefit to the military. There is the concern of back-to-back activations, but that all comes with being in the military. That is the basic gist of what I got from speaking with the doctors one of which took his career to retirement and now works in the civilian world earning a ludicrous amount of money. I can't recall specific details of what they said since it was months ago, but if you had a bad experience in the military and have already told your story, ease off. Any career in the military is really what you make of it despite how much hardship you come across. I recently went on my 1 month MIDN cruise for ROTC and saw this to be a recurring theme: there are folks that regret their decision on joining the military and are counting the days while there are those who are extremely satisfied.

I have had my bad run-ins with Navy medicine already, but that has not discouraged me. I hope to help fix some of these problems when I begin my career, but who knows, it might be fixed by the time I get there.

good luck fixing the problems; and realize that hundreds and hundreds of docs probably tried to fix the system and left after years of no improvement.

I will 100% disagree with you and your statement that any military career is what you make of it, desopite the hardship. Now "ATTITUDE" is up to the individual, despite the hardships, but if a healthcare system is too broken, I would argue that a quality physician is likely to exit that system, especially when they have no authority to fix it. Todays military medical career is NOT what the physicians have made, it is what the surgeon general has made, and it in many areas, a broken system run by people who have no responsibility in patient care.

Advantages to serving in the military medical service:
-You get free travel (albeit to place you never would go voluntarily)
-You don't have to worry about what to wear to work
-You get to see exciting and unique animal life during your travels (scorpions, camel spiders, etc)


Anyone else have any others to add?

Originally Posted by usnavdoc

Couldnt get it done in the military? lol

General Surgery internship at Portsmouth NMC, 4 years serving with the USMC as a GMO. 26 months deployed counting a few workups. 4 expeditionary medals including one with the FMF device for combat, Humanitarian Service Medal, Fleet Marine Force ribbon, Combat Action Ribbon, Navy Achievement Medal, 3 Navy Commendation Medals, not to mention several unit awards, on several occasions appointed to positions that would be held by a more seasoned medical officer leading finally to be appointed to run a unit in a position that is normally held by an experienced BCP family physician LCDR.

I think and know that I "got it done in the military" What have you done? Are you even a physician? I dont think so. You want to challenge my leadership ability and patriotism go ahead. I hope you do. Especially in this post. Show all who join what they are in for.

WELL SAID...the guy is a med student...he'll learn so enough

Okay we are missing Galo's post...
I think the biggest advantage in military is that those who stay wants to stay in and wants to contribute to the U.S.

Originally Posted by haujun

Okay we are missing Galo's post...
I think the biggest advantage in military is that those who stay wants to stay in and wants to contribute to the U.S.

I agree that military medicine is definitely a calling and not for everyone....just to reiterate your prior comment...If one decides to stay in the military as a physician you will surround yourself with a group of people that share in your desire for selfless service and duty to their country

Originally Posted by haujun

Okay we are missing Galo's post...
I think the biggest advantage in military is that those who stay wants to stay in and wants to contribute to the U.S.

uhhh....you left out the lame and incompetent ones who committ malpractice on a daily basis and can't cut it in private practice....as told to me by my ortho doc while in Gitmo.

I know...we've said it all and are just repeating the same thing over and over again....

well, same for you students and student want-to-be's who think you're going to save the world ....all by yourself.

Originally Posted by militarymd

uhhh....you left out the lame and incompetent ones who committ malpractice on a daily basis and can't cut it in private practice....as told to me by my ortho doc while in Gitmo.

I know...we've said it all and are just repeating the same thing over and over again....

well, same for you students and student want-to-be's who think you're going to save the world ....all by yourself.

Majority of viewers in this forum is medical students. Just because they do not agreed don't belittle their idealistic attitudes. We all know that you and many other posters have served already as attending. I am sure there can be some capable individuals out here than can improve the system as well as some capable military doctors serving currently in this military. There is always exception and as long as this is true there will be some hope.

Army of One.

you will surround yourself with a group of people that share in your desire for selfless service and duty to their country

*reaches for inhaler*

My wife recently had a surgical procedure at a Navy hospital. After reading this message forum you would think she was going to die. However she was extremely pleased with the procedure and care she was received. I was present for the procedure and was very pleased with my interactions with the corpsman, nurses and surgeon. The ambulatory procedure unit was very clean and well organized.

The critics have some good points but they have chips on their shoulders. This forum is not representative of how most doctors in the military feel. They represent a small vocal minority.

This forum is not representative of how most doctors in the military feel. They represent a small vocal minority.

*SNIFF, SNIFF* I smell something.....do you?

I asked for 8x10 space in a Quonset hut in Korea as a respite from demanding, self-entitled dependent wives.

.. and I wasn't the only one.

Originally Posted by IgD

My wife recently had a surgical procedure at a Navy hospital. After reading this message forum you would think she was going to die. However she was extremely pleased with the procedure and care she was received. I was present for the procedure and was very pleased with my interactions with the corpsman, nurses and surgeon. The ambulatory procedure unit was very clean and well organized.

The critics have some good points but they have chips on their shoulders. This forum is not representative of how most doctors in the military feel. They represent a small vocal minority.

Funny, your anecdotal account of a good military medical experience is somehow to be believed as representative of the larger organization, but the anecdotal experiences of other posters, who make observations to the contrary are somehow supposed to be suspect, and not representative. Explain, please.

And just how would you know whether this forum was or wasn't representative of how most doctors in the military feel (after all this is the "Pros of military medicine" thread, isn't it)?

orbitsurgMD, the reasons why readers should discount many of the opinions here is because of bias. Most of the critics have discussed personal motivations for making anti-military medicine remarks proving the bias. In fact if one looks closely at the critics posts here they can see a very clear pattern of trolling.

Originally Posted by IgD

orbitsurgMD, the reasons why readers should discount many of the opinions here is because of bias. Most of the critics have discussed personal motivations for making anti-military medicine remarks proving the bias. In fact if one looks closely at the critics posts here they can see a very clear pattern of trolling.

As far as bias goes, a "pros" thread is just as biased as anything else; people who think there is something good to say about military medicine will post those things here. The bias is toward positives and it is supposed to be. For contrary opinion, there is the "cons" thread.

True, some of the critics have revealed personal motivations for their comments. Others have not revealed their motives. Still others have refused to reveal their credentials and experience when asked and offered the opportunity to do so. I don't see how any one is better or worse than another, except that the most prolific critics don't seem to have a problem posting what they've done as the basis for their opinions. +1 for them.

Where is the trolling, though? That usually implies a leading question or a controversial opinion posted to a thread to deliberately draw out responses that dispute the OP. I don't see that here. However some posters, and you are one of them, have posted ad hominem comments that have done just that.

Originally Posted by orbitsurgMD

As far as bias goes, a "pros" thread is just as biased as anything else; people who think there is something good to say about military medicine will post those things here. The bias is toward positives and it is supposed to be. For contrary opinion, there is the "cons" thread.

True, some of the critics have revealed personal motivations for their comments. Others have not revealed their motives. Still others have refused to reveal their credentials and experience when asked and offered the opportunity do do so. I don't see how any one is better or worse than another, except that the most prolific critics don't seem to have a problem posting what they've done as the basis for their opinions. +1 for them.

Where is the trolling, though? That usually implies a leading question or a controversial opinion posted to a thread to deliberately draw out responses that dispute the OP. I don't see that here. However some posters, and you are one of them, have posted ad hominem comments that have done just that.

The bottom line is this. Some have had good experiences, other not so good. Are there issues in Military Medicine, yes. I don't subscribe to the depths of the problems that some purport, but I do not doubt the motives of the vast majority who post here. I have known many who have left the military with unfavorable opinions, and many had valid complaints. There is work to be done, and I have hope there can and will be improvements. All things government are cyclical. This too shall pass.

We should avoid name calling. It accomplishes nothing. Offering solutions is the answer.

This site should be productive. Many want to share their experiences with others to convince them they should or should not go the HPSP route. I get it, and their voices should be heard. The last thing military medicine needs is recipients who are unhappy with their decision. It is annoying and can be avoided if they understand what they are signing up for.

I'm an advocate. Hopefully, always will be. But the last thing I want is to quell honest debate. So despite how disenheartening it can be, keep it going. We will all be better for it.

Originally Posted by IgD

My wife recently had a surgical procedure at a Navy hospital. After reading this message forum you would think she was going to die. However she was extremely pleased with the procedure and care she was received. I was present for the procedure and was very pleased with my interactions with the corpsman, nurses and surgeon. The ambulatory procedure unit was very clean and well organized.

The critics have some good points but they have chips on their shoulders. This forum is not representative of how most doctors in the military feel. They represent a small vocal minority.

Once again it seems the pro thread seems to bring out more problems than good things. Earlier one of the posters, (clearly not a physician yet), said something that you are not in the military to be a doctor first. That is one of the most on the dot statements I have seen a medical student post(?). This is a fact that is lost on most people till they are standing there at attention while somebody reads off a list of a person's job, and why they are being rewarded for doing it while you are wondering why you have to wait a month to put a case in the OR. CLEARLY, the military expects you to be an officer first, and a doctor a distant second. That is why most doctors who are competent and spent up to 14 yrs in training want to do medicine first and foremost. These are the one's that quickly get frustrated to be in system of mediocracy that no matter what idealism naive students/docs place here, there is nothing one can do to change it.

Brain transplant reject, you should go back on meds. Whatever you are, if you are in the medical field, you are going to be treated prefentially. How many E-1's have been allowed in the OR to watch their wife's surgery??

You the worst and most worthless troll on this board, and you are the shining example why people should not join the military.

How's that for name calling?

Originally Posted by Galo

Once again it seems the pro thread seems to bring out more problems than good things. Earlier one of the posters, (clearly not a physician yet), said something that you are not in the military to be a doctor first. That is one of the most on the dot statements I have seen a medical student post(?). This is a fact that is lost on most people till they are standing there at attention while somebody reads off a list of a person's job, and why they are being rewarded for doing it while you are wondering why you have to wait a month to put a case in the OR. CLEARLY, the military expects you to be an officer first, and a doctor a distant second. That is why most doctors who are competent and spent up to 14 yrs in training want to do medicine first and foremost. These are the one's that quickly get frustrated to be in system of mediocracy that no matter what idealism naive students/docs place here, there is nothing one can do to change it.

Brain transplant reject, you should go back on meds. Whatever you are, if you are in the medical field, you are going to be treated prefentially. How many E-1's have been allowed in the OR to watch their wife's surgery??

You the worst and most worthless troll on this board, and you are the shining example why people should not join the military.

How's that for name calling?

Petty, Mr. Galo, Petty. Let us accept that IgD is on the green side. (and I don't mean with the USMC) But we must also accept that everyone who has chosen military medicine is not incompetant or an idoit (as many on this site would allude to.) I choose not to accept mediocrity. I will continue to fight the good fight. I know I am not alone. Yes, there are barriers. I know the wall is thick, and I will keep banging my head on it (my skull is thicker, I hope)

I know nothing I write will change your opinion. That is OK, but be constructive.

Originally Posted by NavyFP

We should avoid name calling. It accomplishes nothing. Offering solutions is the answer.

This site should be productive. Many want to share their experiences with others to convince them they should or should not go the HPSP route. I get it, and their voices should be heard. The last thing military medicine needs is recipients who are unhappy with their decision. It is annoying and can be avoided if they understand what they are signing up for.

I'm an advocate. Hopefully, always will be. But the last thing I want is to quell honest debate. So despite how disenheartening it can be, keep it going. We will all be better for it.

I've been advocating a kinder, gentler military medicine board for a while now. I've found very few shades of grey in opinions around here, so your posts are refeshing. Just wanted to say, I'm glad you're trying.

Originally Posted by NavyFP

Petty, Mr. Galo, Petty. Let us accept that IgD is on the green side. (and I don't mean with the USMC) But we must also accept that everyone who has chosen military medicine is not incompetant or an idoit (as many on this site would allude to.) I choose not to accept mediocrity. I will continue to fight the good fight. I know I am not alone. Yes, there are barriers. I know the wall is thick, and I will keep banging my head on it (my skull is thicker, I hope)

I know nothing I write will change your opinion. That is OK, but be constructive.

Petty indeed. I think orgitsurgmd said it best a few posts ago. Seems I too am a little green in self control. Its this type of person whom I continually allowed to let the worst of me out. Usually it involved patient care, but often things became personal. Clearly I am not one to turn the other cheek, and sometimes you have to say what's on your mind.

What's continually frustrating here, although in comparison to being on active duty its a breeze, is dealing with snot nose students, college, med, and even residents, who think they know so much despite what the vast majority of people who have experienced the farce that is current active duty military medicine, and somehow want to twist your experiences into a personal flaw.

This likely will be a never ending story. There are people who fit well into the system, and will defend it to the death. Unfortunately the majority of those people, (few notable outstanding exceptions), are poor physicians who are at best mediocre, and even worst leaders and will continue to perpetuate and environment of hostility, poor medicine, and self agrandization, till the system gets even worse than it already is, or something like an attempt at unification, or complete outsourcing is done.

I will continue to post my opinion that after what I and many other physicians experienced, expecially as a surgeon, that military medicine at this current point in time is a 100% big LOOSER. People like idg have some sick sense of duty that does not allow them to experience the frustration most of us did in trying to take care of patients, either because they just do not care, do not know any better, or just plainly do not have the experience yet.

I still think he needs to be on some kind of medication.

You know, you really are on to something there. I often felt the exact same way. Some of these people that were "successful" on AD had the exact same "deer in the headlights" look that Dan Quayle had. You'd look into their eyes and it was just a deep dark void.

I often had to wonder if they were so much more capable than me or just a total moron in a fully evolved denial state.

All I know is, they're retired and I'm still working.

Originally Posted by Galo

Petty indeed. I think orgitsurgmd said it best a few posts ago. Seems I too am a little green in self control. Its this type of person whom I continually allowed to let the worst of me out. Usually it involved patient care, but often things became personal. Clearly I am not one to turn the other cheek, and sometimes you have to say what's on your mind.

What's continually frustrating here, although in comparison to being on active duty its a breeze, is dealing with snot nose students, college, med, and even residents, who think they know so much despite what the vast majority of people who have experienced the farce that is current active duty military medicine, and somehow want to twist your experiences into a personal flaw.

This likely will be a never ending story. There are people who fit well into the system, and will defend it to the death. Unfortunately the majority of those people, (few notable outstanding exceptions), are poor physicians who are at best mediocre, and even worst leaders and will continue to perpetuate and environment of hostility, poor medicine, and self agrandization, till the system gets even worse than it already is, or something like an attempt at unification, or complete outsourcing is done.

I will continue to post my opinion that after what I and many other physicians experienced, expecially as a surgeon, that military medicine at this current point in time is a 100% big LOOSER. People like idg have some sick sense of duty that does not allow them to experience the frustration most of us did in trying to take care of patients, either because they just do not care, do not know any better, or just plainly do not have the experience yet.

I still think he needs to be on some kind of medication.

Originally Posted by DropkickMurphy

*reaches for inhaler*

I'm glad somebody got my sarcasm

Originally Posted by IgD

My wife recently had a surgical procedure at a Navy hospital. After reading this message forum you would think she was going to die. However she was extremely pleased with the procedure and care she was received. I was present for the procedure and was very pleased with my interactions with the corpsman, nurses and surgeon. The ambulatory procedure unit was very clean and well organized.

The critics have some good points but they have chips on their shoulders. This forum is not representative of how most doctors in the military feel. They represent a small vocal minority.

What is so alarming is that even though they are out of the military now they hate the system so much that they feel the need to talk about it. We all should become better listener and listen to their concerns so that they can find some closure from the military hell

Originally Posted by haujun

What is so alarming is that even though they are out of the military now they hate the system so much that they feel the need to talk about it. We all should become better listener and listen to their concerns so that they can find some closure from the military hell

Closure will come for me when military medicine closes its doors and starts consulting civilian medicine for its health care.

Originally Posted by haujun

What is so alarming is that even though they are out of the military now they hate the system so much that they feel the need to talk about it. We all should become better listener and listen to their concerns so that they can find some closure from the military hell

Recruiter?

Closure ?

I repeatedly asked for mandatory Pugil stick training every Friday afternoon at my MTF, restricted to staff participation only.

Organizing a staff Fight Club during payday actives was also rejected.

Originally Posted by haujun

What is so alarming is that even though they are out of the military now they hate the system so much that they feel the need to talk about it. We all should become better listener and listen to their concerns so that they can find some closure from the military hell

Isn't it so much easier to attack the motivations of your opponent rather than address the actual issues?
They point out problems in the system: They must just be filled with hate.
They are out of the military: They can't have an opinon, they must just be in some post military stress.

Why wouldn't someone who spent a large portion of their professional lives in a broken system not want to effect change, even when they have left? They could not change things when they were in because of the power structure in the military: Now they can have some leverage, however small, now that they are out. Why can't you get it through your head that they might not just be bitter and rather would like to see a better military health system? tsk tsk.

At my AF base one of the general surgeons wrote a letter into the AF Times. He complained about they typical low case load, low morale, frequent deployments for 4-6 months treating blisters, etc. He noted that a very small percentage of the deployed surgeons are actually seeing the CNN trauma casualties. He complained of the bonus system trap where your last year you need to stay until Oct 1 to get the previous year's specialty bonus. He was called into the commander's office and had some 'splainin' to do. I think I personally knew and spoke with on a routine basis over 50% of the physians at my hospital and many of the residents. I can say honestly that the majority were not happy and did not want to extend. The majority would take an instant out. The people who were happy or content tended to be the Lt Cols or Cols typically in Peds, Med, or FP who had prior commitments from the AF academy or ROTC plus USHUS or prior enlisted service who knew they had to be in for the long haul. The average hpsp turned doctor who could get out almost always got out. Some people enjoy being pounded with a hammer and many more don't/

Originally Posted by chopper

...Wouldn't someone who spent a large portion of their professional lives in a broken system not want to effect change, even when they have left? They could not change things when they were in because of the power structure in the military: Now they can have some leverage, however small, now that they are out. Why can't you get it through your head that they might not just be bitter and rather would like to see a better military health system? tsk tsk.

Look back at some of the most influential people who impacted change in society: MLK, Ghandi, the list goes on. The critics here aren't interested in reform. They are interested in throwing stones. The influential people I listed understood that hate undermines credibility and breeds discontent. If they were in this forum today they would be offended by the rhetoric here.

Originally Posted by IgD

Look back at some of the most influential people who impacted change in society: MLK, Ghandi, the list goes on. The critics here aren't interested in reform. They are interested in throwing stones. The influential people I listed understood that hate undermines credibility and breeds discontent. If they were in this forum today they would be offended by the rhetoric here.

MLK and Ghandi effected change by mass action: chaniging the hearts and minds of millions of people, which then brought about change. They also were involved in issues that affected a large majority of the populations they lived in.

The people who have the power in the military are a handful of beuracrats wearing stars (or public officials in suits). What are MilMD and USAFdoc to do, stand in front of the Lincoln Memorial, alone with a bullhorn, with an I have a dream that military service members have good healthcare speech? Come on.

I think change can be affected in many ways. And while I try to maintain a positive attitude, I understand that bringing the truth to light, no matter how much you may think is 'unpatriotic', is often better than just soldiering on and putting up with a broken system. Not speaking up when it is called for, can be even more dangerous than keeping silent.

MLK and Ghandi, I am still rolling on the floor laughing after you pulled than one out of your a*$.

Actually I'm all for reform. However I am also a realist and know that change in the military is slow in coming. Remember these are simply the continuation of the organizations that continued to march formed troops Napoleonic War style into oncoming fire after the development of rifled firearms simply because "That's the way we've always done it." They are taking the same type of approach with health professionals now.

By the way, peaceful protest doesn't work when dealing with people who believe they are "warriors" (the quotation marks are for the Air Force). But as Chopper said, thanks for a good laugh.

Originally Posted by DropkickMurphy

Actually I'm all for reform. However I am also a realist and know that change in the military is slow in coming. Remember these are simply the continuation of the organizations that continued to march formed troops Napoleonic War style into oncoming fire after the development of rifled firearms simply because "That's the way we've always done it." They are taking the same type of approach with health professionals now.

By the way, peaceful protest doesn't work when dealing with people who believe they are "warriors" (the quotation marks are for the Air Force). But as Chopper said, thanks for a good laugh.

What is required is a piecemeal approach. No one will create sweeping change in the system. The system must be molded, not smashed with a sledgehammer. I recognize there are areas that require a sledgehammer, but I don't have one that is effective. So I use the screwdriver I have. I was always taught the screwdriver is the way to go.

I am however a subscriber to the principal that there is no personal problem that cannot be resolved with the proper application of high explosives. I just don't happen to have any of those.

Originally Posted by chopper

Isn't it so much easier to attack the motivations of your opponent rather than address the actual issues?
They point out problems in the system: They must just be filled with hate.
They are out of the military: They can't have an opinon, they must just be in some post military stress.

Why wouldn't someone who spent a large portion of their professional lives in a broken system not want to effect change, even when they have left? They could not change things when they were in because of the power structure in the military: Now they can have some leverage, however small, now that they are out. Why can't you get it through your head that they might not just be bitter and rather would like to see a better military health system? tsk tsk.

It is you who needs to use your little cerebral cortex to understand the whole situation. Instead of reading my one post, Einstein, read the forum.

We all want the better military health system. I am working at it one patient at a time and continue to work "with" one administator at a time. What are you doing?? The bottom line is that I do not support their radical solutions!!! I am not going to make it easy for you. Read about them if you care.

As for militaryMD latest solution (depend the military medical care to civilian docs) this concept goes directly against military doctor role as an officer and a doctor. I wonder how many civilian doctors would volunteer to go to war or deployments to support our soliders then??? To MilMD You won't be taking that motor bike toy of yours to the battlefield not that you would volunteer.

What's next the military food sucks too--recruit world class chef to the battlefield?? well I forgot most of these doctors never spent time doing field medicine .

Pro of Military Medicine: Taking care of greatest patient of the world while helping to lead the solider as an officer during war time.

Originally Posted by former military

The people who were happy or content tended to be the Lt Cols or Cols typically in Peds, Med, or FP who had prior commitments from the AF academy or ROTC plus USHUS or prior enlisted service who knew they had to be in for the long haul. The average hpsp turned doctor who could get out almost always got out.

It's interesting that you say that, because it sort of jives with my own little hypothesis that says that much of the frustration with military life - to include medicine - may come from not really knowing what you're getting into. I used to see the same thing with plebes at West Point who didn't have any military background and who thought they were just going off to a tough college.

This issue may be magnified with medicine because HPSP isn't really honest with regards to what being in the military is like and the fact that you are expected to be an officer first.

Obviously, this is an oversimplification, as there are quality control issues to be addressed as well. And I'm not trying to say that frustration with military medicine isn't well-founded. All I mean is that, ideally, any sort of program designed to produce officers should give an accurate picture of military life upfront. Unfortunately, that'll probably never happen, since it's hard enough to meet quotas as it is.