i'm torn with this. as a community the primary care specialties have been bearing the brunt of brigade surgeonships and battalion surgeonships for over 10 years. we would deploy for a year or more, while the surgical folks rotated in and out every 6 months or so. it was great being "lapped" but people rotating in and out of Baghdad while i lived the high life down south at a real FOB.
i could live with some of this, but the argument of skill atrophy at the time was met with deaf ears. as a pediatrician, for instance, we did zero newborn care for a year. but an anesthesiologist, whose job in theater and back CONUS were arguably pretty damn similar, but they only had to spend half the time deployed? the same could be said for the surgical fields. at least it semi related to their jobs. the argument didn't work then, and it's not working now. because (as they said at the recent CCC-- "we will do whatever you need to get trained back up when you return"-- whatever that means)
the reason why the pain is being spread amongst other specialties now is easy. there is no more blood to give. the retention rates for pediatrics at the first "get out" point is near zero. granted, those that stay in tend to stay in for the long haul, but there's no one else in the well to draw from. they have run the primary care people into the ground and still need more bodies. spreading the burden is the only solution, and i think it's more than time for the other specialties the primary care folks have protected for so long to give their pound of flesh, too.
that's my vent session. now for the schizophrenic flip, lol:
on the other hand-- i, too, am going to be a subspecialist with a specialized skill set and at some point in the next few years will probably be tagged with one of these. we have had other subspecialists who were the n of 1 or 2 at their MEDCENs get sent to these positions as well. so we are by no means exempt. i know of a LTC who was sent for a 1 year stint as a flight surgeon in korea-- the reach of this is broad and nearly impossible to fight off. he, like many, had done a deployment (15 months), a utilization tour at a dumpy MEDDAC, and fellowship and assumed he had done his duty for the line. well, not quite-- the rules we graduated residency with (operational during CPT years then left alone during the MAJ-LTC years) have changed.
it's a complex issue-- but to me boils down to a few simple concepts.. the line gets what they want, and they don't want green wet behind the ears CPT's straight from residency. and to be honest, as a battalion surgeon i would have preferred some more rank at that position as well. they want rank because rank= respect and rank = experience/skill-- true or not. that's problem 1 for those of us in middle management.
problem 2 is that because we are intelligent, driven people (for the most part) when we are handed these "opportunities" we do a pretty good job at them. our skill set at multitasking, dealing with people (ie, patients), handling stress-- these are all things we've been doing on a daily basis that the average trigger puller doesn't appreciate. so in a way we have shot ourselves in the foot doing such a good job. it's why they absolutely refuse to have these positions filled by PA's-- they've been spoiled by overqualified doctors.
problem 3 (at least for peds) is that our TDAs for our hospitals are grossly inaccurate. so we look overstrength and fat-- when in reality we have people in leadership admin only positions, and because we only have 1 subspecialty MOS (60Q) we all look the same on paper-- whether we are peds cardiology, GI, endo, genetics, etc. it's a mess.
this is hitting everyone, everywhere-- you aren't alone, and i imagine at your brigade surgeon course you will find plenty of people in the same situation. not that it helps, but at least you can see this isn't an arbitrary "let's screw turkish" scenario. . .
at any rate-- i'm sorry you've been tagged with this, and i hope you can get some clinic/OR time to maintain your skills. and hopefully you get a unit that is near civilization and isn't deploying anytime soon. keep us posted on your travels and doings-- i'm not sure if we have any current brigade surgeon types, but it would be good to have some input into what their daily life is like for others on the board.
--your friendly neighborhood may be replacing you in a couple of years caveman
some of this blame may be with the medical corps, and given the recent developments i don't necessarily think a doctor in that position will look out for us any more than a nurse given the track required to get there.
