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Airway

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In writing, then years taken away...



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I was affected by this policy (Navy). All of a sudden, 4 years of credit taken away, that had been credited. I have crossed the finish line now so it will be credited back.
I didn’t make any big plans knowing this was coming but information in the reserves oftentimes doesn’t reach in a timely manner
 
In writing, then years taken away...


Yep, I lost 4yrs because of this. We show the Navy their recruitment website clearly shows years of credit count towards retirement. The Navy says we are confused.
 

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In writing, then years taken away...



It's just "Stop Loss" with a different name and excuse. It's almost as if the Pentagon finally realized that they have failed to assure voluntary retention so badly over the past two decades, that they need to force physicians/dentists/pilots to stay in for the conflict on the horizon.

Or it could just be a sheer coincidence.

By the way, I am still salty about DOPMA reversing the policy on USUHS time counting toward retirement that started the year I arrived. However, I am still glad I left after 15 years toward retirement rather than seeing all of my earthly belongings (and maybe my family) destroyed by Katrina in Biloxi, MS, while being commanded by a CRNA with date of rank on me.

From circa 1999 until now, the system has done everything possible to encourage O-4 and O-5 physicians to punch out, in order to replace us with cheaper and more docile junior "providers". Every experienced physician/dentist who leaves before retirement saves Uncle Sam cold, hard cash the MIC (military-industrial complex) can use for more important things than medical care of our active duty, dependents and retirees.

Such as: All Freedom Littoral Combat Ships in Commission Tapped for Early Disposal - USNI News

Next week: Submariners need to stay in until we have defended all the island chains back to the Channel Islands.
 
Honest question. Is there no legal or congressional recourse for this? In a minor way, it's kind of giving me Bonus Army vibes.
 
Honest question. Is there no legal or congressional recourse for this? In a minor way, it's kind of giving me Bonus Army vibes.

I remember when I used to believe in "military legality". This was before I was told that the Air Force Core Value of "Shutting Up" was more important than patient safety. This was before an Inspector General explained to me with a sigh at my idealism that they don't inspect anything. They ask the Commander, "Did you do X?"; if the Commander says "No", case closed. This was before I was asked to poison a pizza to subdue simulated bad guys using my knowledge of medicine, because the Hippocratic Oath and the Geneva Conventions don't apply to those designated by someone in the government as an "unlawful combatant", even American citizens, without any due process or hope of appeal of that designation before the Hellfire missile kills you.

Sadly, they do what they want, without any legal limitations, because they are the ones both interpreting and applying the laws. It's the old judge, jury, executioner thang. Think of it as just one more fringe benefit you gain when you raise your right hand: the opportunity to get shafted without any recourse, like being assigned to Diego Garcia because you annoyed a general officer during an exercise by telling the truth (as happened to one of my Wilford Hall attendings). Unlike "space available medical care at MTFs after age 65", however, it's a fringe benefit that's not going away any time soon.
 
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I remember when I used to believe in "military legality". This was before I was told that the Air Force Core Value of "Shutting Up" was more important than patient safety. This was before an Inspector General explained to me with a sigh at my idealism that they don't inspect anything. They ask the Commander, "Did you do X?"; if the Commander says "No", case closed. This was before I was asked to poison a pizza to subdue simulated bad guys using my knowledge of medicine, because the Hippocratic Oath and the Geneva Conventions don't apply to those designated by someone in the government as an "unlawful combatant", even American citizens, without any due process or hope of appeal of that designation before the Hellfire missile kills you.

Sadly, they do what they want, without any legal limitations, because they are the ones both interpreting and applying the laws. It's the old judge, jury, executioner thang. Think of it as just one more fringe benefit you gain when you raise your right hand: the opportunity to get shafted without any recourse, like being assigned to Diego Garcia because you annoyed a general officer during an exercise by telling the truth (as happened to one of my Wilford Hall attendings). Unlike "space available medical care at MTFs after age 65", however, it's a fringe benefit that's not going away any time soon.
So what do you do when a medical student or resident asks you about joining the military?

And if you are stuck, I'm so sorry.

I hope that this story gets some media traction so the average American understands how awful the military really is.
 
So what do you do when a medical student or resident asks you about joining the military?

And if you are stuck, I'm so sorry.

I hope that this story gets some media traction so the average American understands how awful the military really is.
I got out in 2005.

No longer stuck.

The disintegration of WRAMC circa 2007 barely got any traction outside of D.C.. It will take far more than that to get the attention of your average TikTok watcher nowadays.

I would prefer not to say that the U.S. military is awful per se. Rather, we should focus on how the health care system designed to support our troops in peace and war has devolved since the 1990s by replacing anesthesiologists with CRNAs, physicians with PAs and NPs, and obstetricians with nurse midwives. Then it made all of the non-physicians "providers" commanders over the few doctors left in uniform, because shiny bling on the shoulder is far more important than knowledge in the brain. The system has broken promises of "space available MTF care for life" for our honored retirees, not to mention "Excellence in all we do". And, now, it is hurtling toward the final circle of the Bad Afterlife with the DHA takeover of what used to be military medicine.

Meanwhile, the Pentagon will continue to propagandize that the medical system is "world class" and "better than ever", while those who literally grew up in what used to be military medicine know better, but are ignored.

As far as medical students or residents, I am now in private practice, so I don't meet any, which is probably for the best for everyone's blood pressure.
 
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I think it is safe to say many negative things have come from the military's drinking from the well of managed care (or eating the fruit of the tree, if you prefer a different metaphor.)

Lifetime benefits like retirement annuity and medical care within the military hospital system were a given at one point, as was active duty and retired dependent care. The military medical system was structured to provide those benefits: there were many large training hospitals, robust residency programs, ample numbers of resident graduates, and there were patients at all age cohorts to provide a population to support training enterprises. It was unnecessary to send residents outside of the military for rotations in order to meet ACGME and specialty training minimums. Military retireees preferred to go to military hospitals. There was goodwill, trust in the beneficence and competence of the military medical system, and it was cost-free, even if somewhat spartan.

Then the prospect of "saving" money by not paying so many doctors and not running so many hospitals for all those retirees not working as "warfighters" gained traction in the military management circles. Of course the "savings" was a canard, the government saved nothing, it just shifted the check writing to another agency and pretended that money was saved. And make no mistake, it was an abandonment of a promise made to active duty personnel about what the services would provide them in their retirement.

Naturally, there were consequences. Programs like HPSP, which once recruited competitively from the best medical schools found fewer applicants there, largely because it became widely understood that military hospital training opportunities were far fewer and far more strained for adequate pathology exposure and that HPSP had become largely an inlet pipe for filling general medical officer jobs the services needed to fill, even as that model for use of medical trainees was both archaic and inappropriate. That change started in the 1980s, first with CHAMPUS and then its successor, TRICARE. Many training programs closed completely along with their supporting hospitals. Others shrunk to become almost unrecognizable. (Portsmouth Naval Hospital's general surgery program by half, for example.) Of course you can't hide that kind of thing, it gets out, and fast. Medical schools that had the resources to help their students needing finances find alternatives to military commissions did so. Those that did not have the resources did not. USUHS continued to graduate their classes of more heavily time-obligated graduates who had to be given residency slots where possible. HPSP grads, typically less heavily time-indebted could take what they could get. Or not.

So here we are, with a "system" that cannot train the numbers of professionals needed to support combat contingencies (at least in a peer/near-peer model) that has degraded to the point of alienating most of its junior accessions, that has de-professionalized with heedless and baseless pretense of equivalence with everyone offered "providers," extending even to the highest corps leadership, where the Surgeon General is not a medical doctor. It should be chilling to think that a person in that post has never had to make a difficult clinical decision and stand by it. Would the line tolerate an officer assigned to a fleet command never having been a skipper of a ship?
 
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So here we are, with a "system" that cannot train the numbers of professionals needed to support combat contingencies (at least in a peer/near-peer model) that has degraded to the point of alienating most of its junior accessions, that has de-professionalized with heedless and baseless pretense of equivalence with everyone offered "providers," extending even to the highest corps leadership, where the Surgeon General is not a medical doctor. It should be chilling to think that a person in that post has never had to make a difficult clinical decision and stand by it. Would the line tolerate an officer assigned to a fleet command never having been a skipper of a ship?

"Hate to say I told you so
...
Do believe I told you so

Now it's all out and you know..."



...and you told me so, as well, even before I got here, as I recall :cool:
 
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How much benefit do they get from ganking a bunch of reservists with this vs the PR and recruiting hit they take? It doesn't seem worth it.

Wonder if the intent is purely to reduce the number of MDs in the reserve in the first place, rather than wring more time out of current reservists. It probably disincentivizes a lot of HPSP people who finish their AD commitments around the 8-10 year mark.
 
How much benefit do they get from ganking a bunch of reservists with this vs the PR and recruiting hit they take? It doesn't seem worth it.

Wonder if the intent is purely to reduce the number of MDs in the reserve in the first place, rather than wring more time out of current reservists. It probably disincentivizes a lot of HPSP people who finish their AD commitments around the 8-10 year mark.

I think Uncle Sam just thinks they will pull a ton of folks from the IRR if we go peer to peer and if that doesn't work they know they can dangle a ton of cash in front of folks and several will jump on it and they are also just depending on good ole fashioned "we'll put a boot in your ass it's the american way" patriotism to fill the ranks.....
 
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Wonder if the intent is purely to reduce the number of MDs in the reserve in the first place, rather than wring more time out of current reservists. It probably disincentivizes a lot of HPSP people who finish their AD commitments around the 8-10 year mark.

"Mr. Bond, they have a saying in Chicago: 'Once is happenstance. Twice is coincidence. The third time it's enemy action.'." Ian Fleming, Goldfinger (the book, not the movie, 1959)

If you go back over my posts since 2006, this is a typical modus operandi: the U.S. military "reinterprets" a written contract to force physicians, pilots, and others to serve more time than they signed up for.

Apoptosis is the word. They want everyone to quit, which will save DHA money.

Luckily, there soon won't be any military health care facilities left in CONUS at all, which will maximize the number of yachts civilian Tricare "partner" company CEOs can buy for their mistresses.

Also, there will be no need for whiny military "providers" once International SOS takes over all DHA health care facilities overseas, now that they are already responsible for all dependent air-evac OCONUS. Remember to support the revolving door of Senior VP ex-MSC, MC, and RN officers making tons of money by arranging for expensive civilian corporations (International SOS, TRICARE, GlobalMed) to "provide" what used to be (less profitable) military responsibilities.
 
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