Working primarily with military community without being commissioned

[epsilonprodigy]

I hope it's OK that I've been posting here occasionally, despite my lowly rising M-1 status. If there's a more appropriate place for this post, feel free to let me know.

So, after 6 years as a (civilian) critical care nurse in an inner-city hellhole, I'm feeling jaded, frustrated and hopping mad at so many of the self-defeating and ignorant behaviors I see day after day. I feel awful about this, but the truth is, watching the other staff and I beat the crap out of the healthcare system and ourselves for patients who simply respond by asking for a 5th turkey sandwich because they already spent up their food stamps for the month is getting really, really old. I'm grateful for what I've learned there: the stresses of the inner city bring forth some of the most extreme conditions imaginable. Also, since no one is insured or ever pays their bills, we have no money and therefore next to no proper equipment or resources. We're all really, really good at doing something with nothing, and I'm grateful for that, too.

*end rant* What I'm getting at is, as I look toward the beginning of medical school, I'm thinking it might be nice to, I don't know, take care of some productive members of society for a change? I realize how awful that sounds, and I realize that we don't get to hand-pick our patients, but I worry that if I throw in the stresses of residency, boards, sleep deprivation, etc. etc., and continue working in a similar environment, I'll wake up one day and realize I'm a bitter, jaded old woman who doesn't give a rat's *ss anymore. No lectures please; I'm not proud of myself for feeling this way, and of course when a patient is in front of me, I do care about them and do my absolute best by them, always. I'm fully aware of all the barriers the inner city is riddled with. I guess I'm just frustrated and trying to use it to make wise decisions for my future.

I KNOW this wouldn't happen if I could find a way to work primarily with the military community. From what I've read, many of the things that irk me about the enviroment I've worked in are either absent or far less severe for military physicians. It sounds so cheesy and cliche, but I truly do feel a strong desire to apply my knowledge to helping those who dedicate themselves to our freedom. I think it would bring out the best in my work and desire to learn even in the most frustrating/exhausting moments of training. But, I'm really reluctant about joining the military myself, due to my family situation. I know there are jobs for civilian contractors, but what are the professional growth opportunities like in these positions? For instance, if you took one of these right after finishing residency or fellowship, would you be setting yourself up for an early "dead end" in your career? Is there some sort of organization of civilian physicians who work primarily in military hospitals? I've done some reading about the Civil Service Corps, but they don't really explain much on the website...email answer to some of my questions pending.

Thanks for listening to my rant! Please feel free to tell me if I just need to buck up and develop a more vigorous appetite for ****. I've only ever worked in the aforementioned inner-city hospital, so I don't have a great frame of reference. For all I know, all medical care is like that and maybe I just need to buck up.

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[NavyFP]

There are opportunities to work in military facilities as a civilian as a physician. It is hit and miss what is needed and when, but there are opportunities. The VA might be a reasonable option as well.

 

[grumbo]

There's really a lot of opportunity to work as a civilian physician within a military medical situation. There are really two types of civilians: GS and contractor. That goes for every area from front desk clerk to physician. GS is a more stable position, but contractor positions are easier to get. Once someone's hired as a GS doctor, it's very hard to get rid of them so they try to ensure they know what their doing first (clearly doesn't apply all the time). At my previous hospital, we had civilians in all aspects of the hospital. It just depends on what you want, where you want to go, and what happens to be available.

As a side note, I do understand your reasons you mentioned. One thing I really enjoy about working in the military is I hardly ever think of cost or insurance for my patients. I can order whatever I feel is reasonable for the patients and don't have to worry if they're going to be able to afford the medication. All of my patients have pretty steady income. Most of them have done something as far as service to their country. Of course, there's a decent number of malingerers who try to work the system and get as much for free as possible (PTSD fakers, fake knee pain for a profile, fake back pain for percocet, etc.). Despite those people, on the whole, the people we treat have done something for society in one way or another. Some are amazing people that make it worth while and give you energy to keep going for a while. You just have to look out for them and remind yourself that these are the people you keep going for.

 

[epsilonprodigy]

As a side note, I do understand your reasons you mentioned. One thing I really enjoy about working in the military is I hardly ever think of cost or insurance for my patients. I can order whatever I feel is reasonable for the patients and don't have to worry if they're going to be able to afford the medication. All of my patients have pretty steady income. Most of them have done something as far as service to their country. Of course, there's a decent number of malingerers who try to work the system and get as much for free as possible (PTSD fakers, fake knee pain for a profile, fake back pain for percocet, etc.). Despite those people, on the whole, the people we treat have done something for society in one way or another. Some are amazing people that make it worth while and give you energy to keep going for a while. You just have to look out for them and remind yourself that these are the people you keep going for.

I appreciate that. I feel like such a jerk for being fed up with so many aspects of our population. What is a GS? Sorry to be an idiot, I'm still learning the lingo. Also, how should I expect the patient population at the VA hospital to be different from the population at somewhere like Walter Reed? (Specifically the ICU's.) Thanks!

 

[NightGod]

I appreciate that. I feel like such a jerk for being fed up with so many aspects of our population. What is a GS? Sorry to be an idiot, I'm still learning the lingo. Also, how should I expect the patient population at the VA hospital to be different from the population at somewhere like Walter Reed? (Specifically the ICU's.) Thanks!

GS = General Schedule. People who are involved in civil service working alongside the military get paid on the General Schedule pay scale that also equates their level with military ranking.