"Fighting for Life" movie

[ravager135]

I really could not agree more with the above post and I am a naive, HPSPer currently working in operational medicine. I have not been challenged a single day since I left the MTF. While ultimately as a medical officer you ARE supposed to support the line as a priority, in practice we serve many bosses. Gastrapathy hit the nail on head of the inherent problems of Navy medicine. They are just a few of the many reasons my next PCS will be to my civillian residency.

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[pgg]

Here's an idea to spice things up: Maybe we should just get rid of HPSP and restrict military medicine to prior service officers, enlisted and Corpsman who fit the requirements and who actually feel blessed to be where they are. Who maybe are a bit more mature and savvy in dealing with common military bureaucratic issues when they get into this business.

Oh, and they might do a better job actually serving the line - because they know what its like to be a line officer.

SDN needs a emoticon.

Finally, the arrogance implicit in your post is stunning. You actually believe that your SWOness will make you a better Navy physician. Operational medicine is EASY. Taking care of a cholangitic 85yo WW2 vet on coumadin with GNR bacteremia and an acute MI is HARD. That is what being a doctor is and it has nothing to do with driving a ship or starting IVs or taking advancement exams.

grotto, read this twice.

Consider the possibility that he may know something you don't.

Your devotion is admirable.

Your perspective will change.

 

[grotto]

SDN needs a emoticon.




grotto, read this twice.

Consider the possibility that he may know something you don't.

Your devotion is admirable.

Your perspective will change.

Thanks for your responses... I actually wasn't serious about having a prior only medical corps, but I'm glad I got you to unite on something for once - which was actually the point of the post. I just think that there is a bit too much of a standardized voice on this site, mostly negative.

There is no way I believe that I have a monopoly on good ideas, and I am made (sometimes painfully) aware every day about what I don't know. While I do think that the medical corps in general does a very poor job of taking care of the line (from a customer standpoint) I understand that everyone has many masters.

 

[AF M4]

Thanks for your responses... I actually wasn't serious about having a prior only medical corps, but I'm glad I got you to unite on something for once - which was actually the point of the post. I just think that there is a bit too much of a standardized voice on this site, mostly negative.

There is no way I believe that I have a monopoly on good ideas, and I am made (sometimes painfully) aware every day about what I don't know. While I do think that the medical corps in general does a very poor job of taking care of the line (from a customer standpoint) I understand that everyone has many masters.

Heh. At first you're saying you're trying to achieve unity amongst the forum, then in the next breath you rail against the near-universal negativity of the forum. Do you also stand on the beach and scream at the waves for wetting your feet as the tide comes in?

The line, and patients in general, are not customers. A doctor's office is not Burger King. Burger King has customers. You pay $4.99 at the drive-thru for a Whopper your way, no pickles, extra ketchup. The restaurant advertises that you may have your meal your way, and so you have a right to complain if there are indeed pickles on your burger.

When you go to the doctor, you do not have the right to demand extra morphine with a side of demerol for your dealer down the street. You do not have a right to be satisfied with the outcome of every visit, because (1) the outcome may not be possible (your diabetes will not cure itself) and (2) the outcome you desire may not be in your best interests as a patient (giving you a grab-bag of Excedrin, Viagra, nitro pills and narcotics). The doctor is not a customer service representative; he or she is your physician.

 

[Gastrapathy]

Thanks for your responses... I actually wasn't serious about having a prior only medical corps, but I'm glad I got you to unite on something for once - which was actually the point of the post. I just think that there is a bit too much of a standardized voice on this site, mostly negative.

There is no way I believe that I have a monopoly on good ideas, and I am made (sometimes painfully) aware every day about what I don't know. While I do think that the medical corps in general does a very poor job of taking care of the line (from a customer standpoint) I understand that everyone has many masters.

In what way do we do a very poor job of taking care of you?

In my clinic, every AD consult is seen within a couple of weeks. Out in town, the wait for GI consultation is 60+ days.

Do I occasionally anger a line CO with a disposition decision? Of course I do. If I catered to the whim of every O5 in the Navy, I would have to commit malpractice daily. Its a common misconception that my decision to LIMDU a patient can be overruled by a CO. It can't. It can be overruled by some senior physician (I'm not actually sure who). But it never will be. That can be inconvenient and when I pull someone out, I know that it means that someone else will go in his place. But thats my job. Its infinitely better than seeing someone who's command bullied him past medical and now I need a midnight helo from my FOB.

My bet is that our "very poor job" taking care of the line is really your "incredibly entitled expectations for VIP medicine that are only met for Saudi princes at Mayo."

There's a good chance you'll work for me in the future and, if you act at all interested, I'll stay late to try to teach you how to actually take care of that patient I mentioned earlier.

 

[Gastrapathy]

a side of demerol

Come see me for your versed with a side of demerol. Of course, it also comes with a meter of scope up your backside.

Oh, and anyone who rotates on GI has to get an unsedated flex sig. Its not hazing. Anesthesiologists make your start IVs on each other. No drugs because we wouldn't want to keep you from rounding with the fellow that day.

 

[pgg]

While I do think that the medical corps in general does a very poor job of taking care of the line (from a customer standpoint) I understand that everyone has many masters.

"Good care" to the line means having a doctor available at 1800 to do the "ammo driver physical" paperwork they need by 0500 tomorrow, and have known about needing for 2.5 months.

"Good care" to the line is a clean waiting room and a stack of magazines no more than 12 months old.

You could give them the wrong antibiotic or screw up their child's asthma management and so long as you did it with a smile during a same-day appointment, they'd think you were delivering "good care" ...



Tell me, "customer" - what is the basis for your claim of substandard care?

 

[pgg]

Come see me for your versed with a side of demerol. Of course, it also comes with a meter of scope up your backside.

Oh, and anyone who rotates on GI has to get an unsedated flex sig. Its not hazing. Anesthesiologists make your start IVs on each other. No drugs because we wouldn't want to keep you from rounding with the fellow that day.

Ain't no way you just compared a 20g needle in my hand vein (after alkalinized lidocaine) to reaching out to touch my splenic flexure.

You IM guys are sadists. All that endless rounding ... now this?

 

[Gastrapathy]

Ain't no way you just compared a 20g needle in my hand vein (after alkalinized lidocaine) to reaching out to touch my splenic flexure.

You IM guys are sadists. All that endless rounding ... now this?

I still have the scar on my hand from one of those med stud "lets start some IVs" practice sessions. I don't remember any lidocaine, alkalinized or otherwise.

Oh, and although urban dictionary has alternate definitions, the term I favor for reaching out and touching the splenic flexure is "spleening."

Its always funny when that junior sailor with hematochezia just can't make eye contact with me post-procedure. One med stud actually thought we were serious when our nurses kept telling him that everyone who rotates gets a flex on their last day. He showed up ready to take his medicine.

 

[EMDoc0411]

Its always funny when that junior sailor with hematochezia just can't make eye contact with me post-procedure. One med stud actually thought we were serious when our nurses kept telling him that everyone who rotates gets a flex on their last day. He showed up ready to take his medicine.

That is awesome. I had to laugh at that one. I have heard of Marines who are afraid of Narcs taking a scope up the butt without any pharmacologic help.

 

[Shokdoc]

You both are right. I did not watch the movie, nor claimed that I did. I was making an observation based on the reviews available on the site.
I did not comment on the care given in Iraq, or the physician they followed.

And what of ALL the deployed physicians, (surgeons, ortho, neuro, anesthesia), who did not go to USHUS??? Are they somehow less ready to be in Iraq, than those who went to USHUS?? It seems like at ushus they give you what would be the equivalent of teaching a general physical exam, its something that's developed at residency training (military or not), and then when you are in active duty, you do go specific training, (not that intensive), to be a deployed physician. The bulk of what a physician does in Iraq, is hopefully what he was trained to do, ie, surgery, ortho, anesthesia, etc, what I am saying, and what was my experience is that most of those are likely not ushus graduates. So? I still think that PART of the film is akin to a recruitment tool.

If you want to discuss the failures of mil med, that has been done ad nauseum, with much emotion, examples, fights, name calling, less than professional behavior, etc. It still gets reviewed here nearly every day. Also, Moosepilot, you're right, I may never make a difference in how many people choose not to learn enough about milmed before they sign up, but perhaps the one's who care to try and learn about their potential future will be able to make a much more informed decision. I know myself, others, (pro and con), have already turned away many, and the stories that emerge from milmed will hopefully continue to make it to this forum, good and bad, so people can continue to make informed decisions.

I think its a shame that the current predicament of milmed is all they have available. They deserve much better. Also much in the same way that I may be deluding myself that I am going to make much change, I could say the same for you. I hope that you can effect change in the immediate area, staff, and patients around you, but you will never change policy, much as you remember from your days as a pilot.

Anyways, I would like to see the movie, though from the reviews, the propaganda about ushus will not change.

"You do go specific training (not that intensive)?!?!?
Have you ever heard of the Ryder Trauma Center (ATTC)???? Wow.
And yes, it is extremely important for a doctor to have line officer experience. You are a military officer first, and a military physician second.

 

[j4pac]

"You do go specific training (not that intensive)?!?!?
Have you ever heard of the Ryder Trauma Center (ATTC)???? Wow.
And yes, it is extremely important for a doctor to have line officer experience. You are a military officer first, and a military physician second.

BUMMMPPPPPPP!

But hey...at least the thread you super bumped had entertainment value.

 

[Shikima]

le sigh. Did it in another thread that was 5 years old.

 

[Gastrapathy]

I was at the peak of my frustration back then. Just back from an unnecessary army deployment to a dysfunctional hospital.

Civilian life is good for my mental health.

I wonder how @grotto feels now.

 

[Gastrapathy]

Oh, and anyone want to bet me that @Shokdoc is a fellowship trained critical care physician? My paycheck vs yours.

 

[pgg]

One day, two necrobumped threads, and this gem:

You are a military officer first, and a military physician second.

You should necrobump a third thread and hijack it with a poll to see how many people here agree with this statement.

 

[Shokdoc]

Anybody who has ever served at least 1 day in the medical corps of the 3 branches can echo my statement because it is pounded into the brain housing group from TD1. I sincerely apologize if I stepped on any toes by replying to 5 year old thread. I've enjoyed reading these conversations, I even know a few of you on here professionally and personally, but I had to open my fat mouth regarding a statement that was far off the mark.

 

[DrMetal]

I'm going to make the more accurate sequel to this movie: "Fighting for LIMDUs and ADSEPs"

 

[Gastrapathy]

Anybody who has ever served at least 1 day in the medical corps of the 3 branches can echo my statement because it is pounded into the brain housing group from TD1. I sincerely apologize if I stepped on any toes by replying to 5 year old thread. I've enjoyed reading these conversations, I even know a few of you on here professionally and personally, but I had to open my fat mouth regarding a statement that was far off the mark.

This idea far worse than the other meaningless platitudes repeated by those who lack the critical thinking ability to understand the ethical complexities of being both a physician and a military officer.

If he is a "military officer first", it absolves the physician of any ethical responsibility for following orders. That's how we get military doctors doing bad things. These "military officers first" have betrayed their medical training by working in CIA secret prisons supporting torture, force-feeding patients in GTMO prior to malnutrition in accordance with instruction but violation of worldwide medical ethical standards and generally working against the interests of individual patients so they look good to their superiors.

Officer first is fundamentally a cowardly view of the role of the military physician. You are not one thing and then the other. You are both at all times. Each choice you make has to balance that and you are the arbiter of that balance in each of those individual moments. More fundamentally, if you are a military officer first and a physician second, you aren't really a physician.

 

[Shokdoc]

You certainly don't have to agree with what I said, quite a few service physicians dont. But if you accept funding from the military to pay for your education, then for the forseeable future you're going to be marching to the military drum beat regardless of your political views...which sure as hell don't belong in this forum. Oh, and those "military officers working in CIA torture sites" have kept your ******* safe from threats which you couldn't possibly fathom.

 

[Gastrapathy]

It's not about politics. And you need to stick around for a few days before you get to tell me what belongs here.

I don't believe you are a physician. If I'm wrong, then have the courage to share your views about subjugation of your personal medical ethics to military authority with your state board. I'm sure they will be relieved that you are out there with Col Jessup.

 

[pgg]

Anybody who has ever served at least 1 day in the medical corps of the 3 branches can echo my statement because it is pounded into the brain housing group from TD1.

It is, but that doesn't make it right. It's worth talking about, if only because it's so wrongheaded and dangerous, and parroted so often as gospel.

I must've heard it 100 times in the 6 weeks I was at OIS and the 2 weeks I did field med service school at Lejeune. I heard it periodically at USUHS and as an intern, probably even during residency. Again and again during pre-deployment workups I'd like to say I never fell for it, but for a while during my GMO time I probably would've agreed with it. I was fortunate that a conflict never arose, that I never had to decide between an illegal or unethical order and my duty as a physician.

The line has plenty of officers. As I've written on this forum a bunch of times, whatever the line thinks it needs and wants, what it really needs are doctors, not medical corps doofuses who think they're at adventure summer camp ... or worse, doctors so enamored with the rank on their uniforms that they neglect or subvert their responsibilities to patients (whether coalition, enemy, or 3rd party) in the name of following orders from non-doctors. Non-doctors who never took the Hippocratic Oath and who aren't answerable to state medical boards for ethics violations.

To be clear, we're not talking about the cliche example of patching up the rifleman so he can get back on the Alamo's wall, even though that's not in the best "medical" interest of the rifleman. There are obvious scenarios in which the good of a military unit or the completion of a mission take priority over a servicemember's health. Fortunately, they are rare. And I think the vast majority of physicians in the military do a wonderful job of balancing the two obligations.

What you blithely dismissed as "political" in gastrapathy's reply (force-feeding prisoners at Gitmo) is an excellent and recent actual example of "officer first, doctor second" gone horribly wrong.


And last ...

kept your ******* safe from threats which you couldn't possibly fathom.

This is the statement of a coward, one who's so terrified of vague and nebulous "threats" that he's willing to compromise his own integrity and honor for some thin illusion of safety.

 

[DrMetal]

I was fortunate that a conflict never arose, that I never had to decide between an illegal or unethical order and my duty as a physician.

And I think it's unlikely that you'll come across such a situation, in the purest sense where you're really going to have to decide, "Should I be a good doctor or a good officer?" This conflict that we discuss here often (doctor vs. officer) is really a conflict that we, in the Medical Corps, dwell on too much. The unrestricted line officers who run the military really don't give it all that much thought.

Hell, I'd bet if you asked most of them, they'd rather you er on the side of being a good doctor. They know its much harder (and more meaningful) to get an MD after your name than a LCDR before it. They may patronize you, but they know that what you do as physicians---cutting people, managing meds---is way more important than what most URL officers do (powerpoint and outlook junkies galore). Plus, if the doctor side of you fails, that's more likely to make worse headlines....so carry on, be a good doctor.

My must we ban ShockDoc so early, this was entertaining.

 

[WernickeDO]

For the last few days, I have taken ShokDoc's suggestions to heart and have tried to become a better line officer. I cancelled all my clinic patients and went to the S3 shop at battalion. They were a little surprised to see me there and were welcoming at first but soon got annoyed when I asked them to stop using all those acronyms. The S6 shop was less welcoming, saying my presence there "wasn't necessary". Finally, I stopped by the XO's office for some mentoring. I was escorted from battalion and returned to the clinic. I don't know if I was able to inspire my soldiers with my leadership skills, but I noted that people were happy when I refilled their meds.

 

[Shikima]

Reminds me of Frank Burns.

 

[Re3iRtH]

Of course your years are amazing--you are very well paid medical student paying zero tuition! Most if not all USUHS students enjoy their school and training. I enjoyed mine as a HPSP student and residency. Hell, I enjoyed my few years during enlistment before medical school and I can take the pain. However my experiences as attending have not been relatively great filled with psychological frustration, disrespect for and from nurses/administrators...and the most frustrating part is that I cannot work well with these difficult nurses who command over you. So I spend more time doing operational work, prefering to work outside of hospital leading to skill atrophy.

One good thing about the military: PCS--Hoping for better place.

Since I had many people tell me I don't know what I am talking about since I am just a medical student, and "wait until you experience it" etc.

Well, now almost a decade has passed and am now staff physician several years out of residency.

If you thought I was overly optimistic before..

My time in military medicine has exceeded my expectations by a mile. I matched into my dream specialty (diagnostic radiology), got to live in paradise for 5 years (Hawaii), got into real estate and worked on it, became financially free in my mid 30s. I would have never been able to do this if I went the civilian path.

I met some great people, lived in some kickass locations, learned a couple more languages to an upper beginner level, and developed as a person, physician, and investor in a way I couldn't have imagined. To top it all off, I just got my dream assignment in East Asia. And, I wasn't the best radiologist nor the best officer.

So yes, my time in military medicine has otherwise been even better than it was at USUHS.

 

[d2305]

I remember that long arse duty at Makalapa on weekends. I'm sure it's shorter now. Yokosuka was fun, when I wasn't underway.

 

[Matthew9Thirtyfive]

They still show that film at second look.

Also, glad I’m not the only overly optimistic person on this board lol.