Avoid Military Medicine, part II

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Just as a disclaimer, I'm not looking for sympathy at all, so please don't look at my post in that manner. I just genuinely want to see a change in the speed and quality of the medical treatment of our soldiers.
 
Just as a disclaimer, I'm not looking for sympathy at all, so please don't look at my post in that manner. I just genuinely want to see a change in the speed and quality of the medical treatment of our soldiers.

Sorry to hear your story. Many of us also wanted to see a change in speed and quality in medical treatment. The problem is, IT WILL NOT HAPPEN!! That is why we post here. One person alone will not be able to make this change, many of us tried and failed miserably. Its the culture of the institution that I do not think will ever allow medicine to have enough independence to run in an efficient manner.
 
the last 3 months of my active duty, I was a case manager for these OIF purgatory cases. Now this was back in 2004 when they were just starting to get a clue the mess they might be in.

I'd already made the decision to get out after over a decade. I knew the army to some extent, I knew what it was like to be both an enlisted, officer, guardsman, rservist, active duty soldier.

Once I dropped my resigination packet, it was sorta like being a lame duck president. I didn't have crap to lose and I didn't care who I pissed off, and I really didn't care what my last OER looked like. I did 2 push ups a day on remedial PT just to piss them off.

I was a huge pain in the *** and I intercepted an email once that advised just to give me what I want and I'll go away. I learned back in 1982 from a slimeball supply sgt., that's how you get things done in the military.. that and have dirt on the other guy, know where the bodies are buried and save every freakin email you ever saw in your life. I learned a litle something from J. Edgar Hoover too. The subtle art of the veiled threat. i.e. " It would be such a damn shame if this info about Col. X ever came out. He's such a good american.

You know I was able to ram though a lot of cases and I'd like to think I really helped a few guys because they're still googling me trying to help them with the VA some 7 years later.

That's just it... as long as you've got a guy handling your case that is trying to make his 20 years... YOU ARE FREAKIN SCREWED.
 
In what alternate reality is a PA qualified to be a case manager?

the same reality that breeds a military medical officer that has to come to me for help how to fill out a profile, start an MEB action, how to put his weapon back together, explain why a gunner with no thumb opposition in his dominant hand may not be a successfull 50 cal gunner in the future.

20 years in military medicine and working in the mud with the people who actually do the job, it really helps.

Those ego hangovers hurt more and hurt longer the older you get. Better to get off the nipple now before it's too late.
 
]The below read shows again, more of the smoke and mirrors/deception game that MilMed plays on those unsuspecting. Read the article and the claims made that MilMed is doing so well ("rivals and outperforms the civilian sector"), and when you look closely at what are the details to back up that claim from the article you will find 2:

1) The speaker claims that the perception and news coverage is getting better (ie... more about how MillMed is still MORE concerned about appearances than reality.
2) Immunizations rates are up. Not that this is not a good thing, but to make the jump that this somehow indicates a high quality healthcare system is ridiculous, especially when MilMed has the corner on the market in terms of patients that are most likely to get immunizations (everything is free and in some cases, your boss will say "go get your immunizations now"). As a primary care doctor, giving immunizations is about the least complicated and is the easiest part of my day (assuming the patient will agree to get one).[/QUOTE] Is this really the best the speaker could come up with to trick the listeners in to believing Milmed really "rivals and outperforms the civilian sector"? Probably.
Someone needs to piss test Dr. S.Ward Casscells, and those to might read his take on MilMed and be willing to buy it.😉


http://www.sg.af.mil/news/story.asp?id=123088081

Military health care rivals private industry, Pentagon official says

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by John J. Kruzel
American Forces Press Service

2/27/2008 - WASHINGTON -- Providing troops quality health care through a military system that rivals and even outperforms the private sector is a top Defense Department priotity, a senior Pentagon official said today.
In opening remarks to a packed auditorium at the Military Health System conference here today, Dr. S. Ward Casscells, assistant secretary of defense for health affairs, delivered a presentation featuring data comparing military care to treatment by private industry providers.

The data showed that last year, the Air Force provided complete childhood immunizations in higher numbers than the private sector, according to the Advisory Committee on Immunization Practices. Air Force health personnel immunized 86 percent of eligible recipients, compared to 84 percent immunized by the highest-rated state and 77 percent nationally. Complete immunizations comprised vaccinations of diphtheria, tetanus, and pertussis; polio; measles, mumps and rubella; haemophilus influenza type B; hepatitis B; and varicella.

Furthermore, the Air Force provided the same regimen of vaccines more promptly than the commercial sector and Medicaid, according to findings by a Health Plan Employer Data and Information Set evaluation. The Air Force met 75 percent of vaccination deadlines, the commercial sector 70 percent, and Medicaid 59 percent.

"The reason we collect this data is because I was told (on) Day One that we faced a crisis," said Casscells, who has served since April as the Pentagon's top health affairs official. "I believe we have got the brakes on this, and we're going to get it going in the other direction."

According to DoD Health Affairs data, the military health system is leading the nation in overall influenza vaccinations in the 18-to-65-year-old demographic. The numbers of flu vaccines performed by the military in fiscal 2007 dwarfed the latest national averages tracked by the Centers for Disease Control. The military also is ahead of national averages in administering vaccination for pneumonia, according to Health Affairs findings.

Despite the military's higher incidence of burn victims -- victims who often suffer more extensive injuries -- servicemember burn victims' mortality rate is comparable to those in the civilian sector. In his presentation, Casscells cited information from the June 2006 publication of Annals of Surgery that found "similar mortality ... (of) civilian compared to the military (burn) patient, despite longer time to definitive care, greater amount of full thickness burns, higher incidence of inhalation injury and more associated non-burn injuries."

Improvements in military health care between June and December were reflected in news media coverage during that time, Casscells said. In military health care news last June, 27 percent of the coverage was "positive," 55 percent was "balanced," and 18-percent was negative, according to information provided by Health Affairs. The data noted a dramatic shift in the tone of December's coverage, with 49 percent positive, 50 percent balanced and only 1 percent negative.

In a survey of Defense Department beneficiaries conducted by Health Affairs this month, patients' confidence in military health care appears to be rebounding. Of those surveyed, 17 percent said military health care is much better than in the civilian sector. Eighteen percent said military health is "slightly better," while 47 percent said the two systems offer roughly the same quality treatment.

Fifteen percent of those surveyed said the military's care is "slightly worse," and 4 percent called it "much worse." The main complaints cited about the military health system were a lack of adequate parking and hi-tech medical equipment, and difficult-to-navigate facilities.

In another survey, inpatient and outpatient care was significantly favored over the treatment administered at the average non-military hospital. Inpatient Tricare service rated an 89 percent satisfaction rate, and outpatient care fetched an 84 percent rating.

"I have learned from this perspective at Health Affairs ... that our military health clinicians are better than the outside world realizes," Casscells told the audience of military health professionals. "And you're better than you realize."
 
Its like the climate survey reports that are always spun in a positive way despite the overwhelming negativity, especially when it comes to job satisfaction, support, etc etc.

What a joke.
 
Lies, damn lies, and then there are statistics.

Had a pencil neck pharmacist call me in division once. Said, " Do you know you are the biggest prescriber of Viagra in the whole system ? "

I said " yeah, but my boys are happy. I got the lowest Suicide and AWOL rate in the whole outfit too "
 
Lies, damn lies, and then there are statistics.

Had a pencil neck pharmacist call me in division once. Said, " Do you know you are the biggest prescriber of Viagra in the whole system ? "

I said " yeah, but my boys are happy. I got the lowest Suicide and AWOL rate in the whole outfit too "

Wow, I thought you had to have a urology consult to get that. I missed out.
 
shoulda seen the hoops you used to have to just through for Celebrex.

Now if it isn't at least Vicoden, they just throw the Rx in the trash on the way out
 
Yes, like 10 years ago.

Newsflash Galo, things are different.

Well, at least no insults, better than some usual tirade.

When I got out on Nov 2004, you still had to get Urology approval in the antiquated AF. Maybe the army is more progressive in the sense of allowing viagra to be handed out nilly willy.
 
I believe Levitra is formulary now.

I do know that you can get it from Primary Care.

.

Pretty common to give out in Primary Care these days. I believe special paperwork is required for the under-50 crowd, though.
 
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