i honestly think there are three tiers in AF Medicine.
1) hardworking doctors dedicated to learning their craft and working hard to do the right thing... they usually separate due to the shortfalls, crappy pay, callous nature, and aim low expectations of the AF
2) doctors who are, for the most part, competent but have no real drive. They don't want to see a lot of patients or do a lot of operations for example. Underachievers who want to stay in for 20 years and retire... they typically have found ways to work the system, see few patients, fly under the radar, and create no problems... they typically are good at fixing the younger guys to deploy and are good at digging in to their assignment. We had colonels at travis who had never deployed or PCS'd and where at year 16-18. They have no command aspiration. They are too lazy to work hard and make a lot more money. They typically aren't very patriotic either.
3) Command oriented climbing doctors. these people typically want to progress in rank and want the power over other people. They will never call you doctor but by your rank. They are a nurse colonel and you are a major... not a doctor. If they are a doctor, they answer their phone by saying Colonel Irrelevent,,, rather than Dr. Irrelevent. they have completely bought in. they strive to make rank early. They learn not to care about patients or colleagues but to manage money, put spin on situations, and most importantly, NETWORK and apprentice to other command type. Typically these doctors have little to know clue about real medicine. At any given moment, they would miserably fail any impromptu board exam of their specialty. Often, they have some flight time and love to talk about their days in T-38s or some super irrelevant topic. They have completely bought in. These guys protect each other and when some event like this happens
they are good and dodging blame and responsibility. They move around a lot to other commands and are hard to pin down because they never are around much. they are either fresh on the scene or off to another base or command. More and more, these aren't really doctors but pharmacists, physical therapists, nurses, flight surgeons who have never done a residency.
None of these people have any real leadership or management credentials. Few to none have MBAs like you would see in real corporate leadership. They, instead, do military professional education like Air War college. Great... you studied Linebacker II of the Vietnam war and wrote a term paper on it.
Our surgical commander at Travis was a physical therapist. he had never been in an OR before his assignment. Prior to my arrival at DGMC, there was a pharmacist as the hospital commander.. or as he was called, Colonel Motrin.
Leadership represents the worst of the worst... people who aren't really good doctors or good managers. They do, however, have the extreme skill of self preservation. That is why nobody of any leadership consequence will get fired or demoted.
