1 year out update...

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Homunculus

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Greetings everyone...

I've been lurking, and thought I'd give an update for anyone who may be interested. I'm a peds subspecialist, and separated from active duty in 2018 after 14 active duty years. i'm currently in the IMA as a general pediatrician, so i'm still accruing points and thanks to having HPSP years count in the reserves (each good reserve year "activates" 1 good HPSP year) i should have my reserve retirement polished off shortly. we also transferred our GI bills to our kids and managed to get a little VA disability which is nice. 😉

first-- getting out (even at 14) was 110% the right decision for us. my wife is also a peds sub, and was also active duty. the dual military physician lifestyle sucks-- it's twice the abuse and risk exposure for operational tours and deployments without any perks (except for 4 day weekends?). TRICARE and other benefits that normally would be considered as part of your compensation isn't utilized. which is why anytime the "get rid of dual BAH" folks crop up i get a little agitated...

work wise things are great. we basically stood up our clinic and had all the backing (and then some) from admin. we are paid well for our specialties (i almost doubled my salary, she increased hers by 30-40%). we still get 5 weeks paid vacation. weekends are free-- you don't get charged for them! we're treated like adults and don't have to have 12 different mandatory trainings to take vacation. our EMR isn't perfect, but i have IT support immediately available on business skype when issues arise. when problems come up, and i ask about them, people listen.

honestly, it's been so good i think my institutionalized military brain was apprehensive about the other shoe dropping, the honeymoon ending, the shininess to wear off, whatever expression you want to use. but at 16 months her and counting things are the same. we may just be lucky but we're happier than we've ever been and just moved into a house we built on acreage we own and feel like we can finally "put down roots" for our kids and not game plan 3 years out when we may have to go be a brigade surgeon. or be reluctant to plan vacations because we may have an NTC rotation or deployment.

timing wise i feel lucky. we're in the old retirement system which will kick in at 60, and still have time to get a reasonable addition to our TSP we saved during the military days, which is even better now because our employer matches up to 5% of our income we put away. it's free money! we transferred our GI bills, got a little VA disability (tax free forever, woo hoo!) and still keep our CAC cards for TSA precheck and those sweet military discounts (lol). the IMA isn't a bad gig, either, and gives you just enough taste of the military medical dysfunction to remind you of why you left.

DHA appears to be hell bent on killing itself. buckets, reverse PROFIS, and budget cuts all brought to you by the horde of good idea fairies. and now the surgeon general of the army is a MSC officer. when i was in, the older folks would always tell me how the pendulum would swing back. well, several years later i'm not sure how much worse things can get while people bide their time for improvement. fool me once, right?

-your friendly neighborhood the the grass is actually alfalfa on this side of the fence caveman
 
How did you find the workload in a civilian setting compared to expectations on active duty?

extremely manageable. i see more patients, *but* i have proper staffing. ie, i'm not sharing staff with other doctors. my notes are completed every day and i'm out of clinic routinely before i would have been going home when i was AD. more pay/higher QoL and a supportive administration. can't really ask for more.

and they call us "doctors" instead of "providers." which also took some getting used to (sadly).

--your friendly neighborhood there's no bourbon coming from the water fountains though caveman
 
Glad to hear the simple caveman, ex-mil doctor isn't frightened and confused by the outside world.

Best of luck to you and your family. One day, mayhaps, I'll see you on the outside.
 
yeah local IT support sucks in military base I am in. Real Lazy. 2.5 years to go before my retirement. I cannot wait!
 
Echo the feeling of OP. I am three years out. I did 11 years active duty. I make 2.5x as much as a medical subspecialist. I am hospital employed. We use Epic for in and outpatient which is very good once one gets their templates and customization (100% better than AHLTA, no periodic crashes). Administration is generally very responsive and accomodating to our requests (hiring, new equipment/devices purchases etc). Much more varied patient population in terms of disease and illness. I did have enough disability rating to get a monthly check from the VA and get a VA health card for healthcare if I desired (I am 20 minutes from a large VA medical center). Looking back the disparity between professional experience is sobering while i was on active duty and now. I completely got out and did not do any type of reserve.
 
Glad you guys are thriving on the outside!

Not sure I understand the "I'm not sure how much worse things can get" statement. But I am getting used to not really understanding or relating to a lot of the discussion on this forum. We are still enjoying our time in. It continues to still serve its purpose for us.

This thread is great for those of us who are in and contemplating stay or go. Although hopefully we all know this isn't civilian medicine and there is a lot of improvements waiting for us on outside.

For PreMeds coming to this forum the question they will likely learn the most from those leaving or recently left is: Was MilMed the right thing for you and your family when you signed up and during initial payback? I know a lot is changing. But a lot has also changed since we all joined. Hopefully they already know that MilMed is not civilian medicine. If not it is good to see your perspective on differences having recently left.
 
and they call us "doctors" instead of "providers." which also took some getting used to (sadly).
Funny you mention this. Not that I correct people when they call me a provider. But it will be nice when I don’t have to hear that anymore.

Hell....the pharmacist at our outlying clinic get bent out of shape when people don’t call her doctor. Yes...i know, they are doctors too.

I did go to med school the least they can do is call me doctor *shrug*
 
It beats living in a tent in Kuwait?
 
Congrats.
Welcome to the dark side, ie Reserves. 😉

How you earning IMA points?
Everything I've read makes it seem difficult.

yeah, seems difficult to get a straight answer, so far it's been in person CME conferences and larger CME things such as grand rounds. we hosted an HPSP student and thought we may be able to squeeze some days for that but my coordinator said no. i think they said online training doesn't count, but i haven't really put anyone's feet to the fire. i keep telling them i don't care about pay, i just want the points, lol.

It beats living in a tent in Kuwait?

beats living in a tent anywhere. and with the recent events Kuwait may be a little more anxiety provoking than it was before...

--your friendly neighborhood wouldn't want to be around FOB Delta (if it's even still around) caveman
 
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