Military Medicine compared to Civilian Medicine

[PROBOSS]

Can anyone give me some pros and cons of civilian/military medicine? Do you have much of a day in your specialty in military medicine? How bad really is the hierarchy of the military?

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[Kingfisher]

Can anyone give me some pros and cons of civilian/military medicine? Do you have much of a day in your specialty in military medicine? How bad really is the hierarchy of the military?

Multiple threads on this. Look around a bit.

 

[jabreal00]

Can anyone give me some pros and cons of civilian/military medicine? Do you have much of a day in your specialty in military medicine? How bad really is the hierarchy of the military?

Life in a big military medical center is very similar to civilian life, in training or as a staff. However life in a smaller MTF can be hell and nothing like civilian life. Larger MTFs approach what civilian life is and is tolerable. The gist is that there are huge variable differences in experience in military medicine. Often times there is no way to control for this.

 

[PROBOSS]

@kingsfisher, most of the ones I have found are about residency, do you know of any specific threads?

 

[IgD]

Compared with a civilian hospital, a military MTF is chaotic. In the military docs rotate every 3-5 years where in the civilian world you have some physician who spend an entire 20-30 year career at the same institution. It's hard if not impossible to have a well run cohesive program with that kind of "churn rate".

 

[Kingfisher]

@kingsfisher, most of the ones I have found are about residency, do you know of any specific threads?

The sticky: Military Medicine, Pros, Cons, and Opinions has about 10 pages of juicy info that looks like what you are after for starters.

 

[bustbones26]

Compared with a civilian hospital, a military MTF is chaotic. In the military docs rotate every 3-5 years where in the civilian world you have some physician who spend an entire 20-30 year career at the same institution. It's hard if not impossible to have a well run cohesive program with that kind of "churn rate".

MTF have those too!! They are called Colonels, or perhaps the ones that stayed around long enough to be called Colonel.

 

[Kingfisher]

Compared with a civilian hospital, a military MTF is chaotic. In the military docs rotate every 3-5 years where in the civilian world you have some physician who spend an entire 20-30 year career at the same institution. It's hard if not impossible to have a well run cohesive program with that kind of "churn rate".

Indeed the turnover rate can be a road block in things. Turnover for your support staff is huge if you are trying to keep things running smoothly in your clinic.

I feel the biggest driving force in the civ sector is the bottom line. In order for the hospital/clinic to make money, things have to run efficiently. For instance, in the civilian world a GI provider can utilize 2 ORs when doing scopes. While doing one scope the other room is getting turned over. I have seen one room used in civ hospitals but there is always a huge sense of urgency to keep on schedule that I don't see in the military hospitals. Lost time waiting for the room to be ready is lost revenue. Just like time spent away from making clinical decisions is lost revenue in the clinic. In my experience with this same situation, there is no revenue incentive for the military, so the provider is more likely to only get one room with minimal staff to do the scopes. The result is at least 60% fewer scopes. Most civ hospitals recognize this and take appropriate action to improve efficiency. With the military you just don't get the support you need most of the time.

 

[idq1i]

Indeed the turnover rate can be a road block in things. Turnover for your support staff is huge if you are trying to keep things running smoothly in your clinic.

I feel the biggest driving force in the civ sector is the bottom line. In order for the hospital/clinic to make money, things have to run efficiently. For instance, in the civilian world a GI provider can utilize 2 ORs when doing scopes. While doing one scope the other room is getting turned over. I have seen one room used in civ hospitals but there is always a huge sense of urgency to keep on schedule that I don't see in the military hospitals. Lost time waiting for the room to be ready is lost revenue. Just like time spent away from making clinical decisions is lost revenue in the clinic. In my experience with this same situation, there is no revenue incentive for the military, so the provider is more likely to only get one room with minimal staff to do the scopes. The result is at least 60% fewer scopes. Most civ hospitals recognize this and take appropriate action to improve efficiency. With the military you just don't get the support you need most of the time.

As much as I hate to say it, no revenue incentive = no incentive to increase skills and knowledge = skill rot and slow descent into mediocrity (mostly for the lifers and mimed cool-aid drinkers)

Come to think of it, there is virtually no incentive (aside from personal sense of achievement) to improve yourself in an MTF setting. If I do 0.1 or 10 FTE, I still get the same pay, the same rank, same office. No one appreciates what I do, and no one cares. I am just one of the "providers," together with the chiropractors, NPs, PAs and accupuncturists

 

[PROBOSS]

Thank you kingfisher

 

[IgD]

Also there is a lot of "central control" in military medicine. It's messed up you can't control hiring and firing of your own personnel or facilities issues. There is bureaucracy in any organization but in military medicine its 10 fold.

 

[PROBOSS]

Are certain specialty's worse than others?

 

[Kilgoretrout 65]

As much as I hate to say it, no revenue incentive = no incentive to increase skills and knowledge = skill rot and slow descent into mediocrity (mostly for the lifers and mimed cool-aid drinkers)

Come to think of it, there is virtually no incentive (aside from personal sense of achievement) to improve yourself in an MTF setting. If I do 0.1 or 10 FTE, I still get the same pay, the same rank, same office. No one appreciates what I do, and no one cares. I am just one of the "providers," together with the chiropractors, NPs, PAs and accupuncturists

Agree and add that no longer funding CME TDYs is a recipe for more knowledge and skill atrophy.