- Joined
- Jul 24, 2000
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😎 go!
--your friendly neighborhood fair and balanced caveman
--your friendly neighborhood fair and balanced caveman
Sledge2005 said:My two main gripes:
2.) Loss of control over where you live. Although, I try not to complain about this b/c it's something we all knew about when we signed up.
USAFdoc said:1) You might be a USAF Family Doc if the only clothes you have worn in 2 years are your uniform, your mandatory PT gear, and pajamas.
2) You might be a USAF Family Doc if you realize that you have spent more time in conversation with your frequent flyer patients than your own family.
3)You might be a USAF Family Doc if they told you that all the docs will be kicked out/giving up your offices because the enlisted folks need more office space.
4) You might be a USAF Family Doc if your car is always the only one in the parking lot when you come/go.
5) You might be a USAF Family Doc if your entire chain of Command is filled with doctors in specialties other than your own.
6) You might be a USAF Family Doc if you accidently keep referring to your dads Recreation vehicle (RV) as a RVU.
7) You might be a USAF Family Doc if your favorite clinic phrase is "unbeleivable".
8) You might be a USAF Family Doc if your Vitamin D levels are outta sight low.
9) You might be a USAF Family Doc if your support staff gets changed more times than a babies diaper.
10) And finally, you are likely now an ex-USAF Family Doc if you were ever a USAF Family Doc for more than 3-4 years.
Galo said:Those are awesome, and easily applicable to any specialty in the military!!
As if it were not bad enough, here is yet another reason to not be in military medicine:
http://www.veteransforcommonsense.org/?Page=Article&ID=6370
this is just wrong
RichL025 said:This is also a politically-motivated attack that merits no mention whatsoever in a supposedly 'balanced' discussion. I have read the both the NEJM * Lancet articles they mentioned, and they are portraying it in a very slanted manner with regards to physicians engaged in "abuse and torture".
There are some legitimate claims that military medical personnel, both medics, nurses and physicians, violated their professional ethics by not reporting abuse they saw evidence from.
There are also legitimate concerns about the role of psychiatrists in interrogation of detainees.
No where in those 2 articles (I just reviewed them to be sure) do those authors directly charge that medical personnel engaged in torture. Both of them raise concerns that further investigation IS necessary, but they do NOT rise to the level of claims that the Veterans for Common Sense article makes.
Furthermore, I find the allegations about psychiatrists making spurious diagnoses of mental illness to 'silence' whistle-blowers... slanderous. During my psych rotation at Walter Reed I worked under and for many of these doctors, and helped evaluate soldiers who were evacuated for psychological / psychiatric reasons. Not once did I see any soldier who did not have valid symptoms.
Galo said:You say it merits no mention here, but then go on to say that there are legitimate claims of ethics violations. Is it such a stretch to believe that this could not have happened, or do you believe as well, that a bunch of enlisted folks just decided one day that torture is the way to go. Yet another instance where enlisted are treated as second class citizens, and the military protects officers, and those with rank. This is the syndrome where people who are so pro the system are unwilling to admit even the possibility that something like this may happen. Again, that is part of the problem.
Do you have a link to both those articles by chance. I would like to read them for myself
Thanks
I was enlisted myself for 14 years. I believe it is very realistic that a small number of them could commit the Abu Ghraib abuses, espescially if they were stretched thin (which no one denies), and had poor supervision (which is allegeged, and why a brigadier general was fired for it).Is it such a stretch to believe that this could not have happened, or do you believe as well, that a bunch of enlisted folks just decided one day that torture is the way to go.
To be honest with you, it's kind of frustrating that on one hand, you berate posters for criticizing YOUR comments which you claim come from your experience, yet if _I_ offer a comment based on MY experience, you automatically dismiss it because it doesn't fit with your view of what must have happened.It seems surprising that you would believe just a handful of NCO's would perpetrate this witout higher orders.
Without providing their names, the Army also said Thursday that one colonel and two lieutenant colonels linked to detainee abuses in Iraq and Afghanistan were given unspecified administrative punishment. Also, two other lieutenant colonels were given letters of reprimand.
More than a dozen other lower-ranking officers, whose names were not released, also received various punishments.
# Three majors were given letters of reprimand and one of the three also was given an unspecified administrative punishment.
# Three captains are to be court-martialed, one captain is to be given an other-than-honorable discharge from the Army, five captains received letters of reprimand, and one was given an unspecified administrative punishment.
# Two first lieutenants will be court-martialed, another got a letter of reprimand and one was given administrative punishment.
# One second lieutenant was given an other-than-honorable discharge and another was given a letter of reprimand.
# Two chief warrant officers are to be court-martialed.
RichL025 said:To be honest with you, it's kind of frustrating that on one hand, you berate posters for criticizing YOUR comments which you claim come from your experience, yet if _I_ offer a comment based on MY experience, you automatically dismiss it because it doesn't fit with your view of what must have happened.
Rich, yes you have 14 yrs of experience in the army as an enlisted person, congratulations, you by default are far more knowledgeable than me when it come to enlisted matters. I do not dismiss it because it does not fit with my view that the military is full of people who like you said, are not the brightest bulbs, and mediocrity is an accepted behavior. Also I have every right to criticize anybody who is making comments based on NO PERSONAL experience. You are still not a practicing physician, yet seem to give advice, or criticism that you really have no basis in giving. Try your hand at being a physician before you make the statements you make about medicine. TO date, I have yet to see an experienced physician make an honest criticism of the people who post their negative experiences.
What happened at Abu Ghraib is not clear-cut and easy to understand. But civilians (and people like yourself who were commisioned specialists for a few short years) seem to have the idea that enlisted people are robots, marching in lock-step to the orders of their 'betters'.
I hardly think 6 LONG years, would be considered short by anybody. Also in dealing with enlisted personell for those many years, I never got the impression that they were anything like robots, as much as some of the higher leadership wanted to treat them as such.
So if they did something bad, it MUST have been an officers fault, right? Why? Because you can't conceive of a Staff-Sergeant having any independant authority.
Caveat: I am not offering the gospel truth of what happened at Abu Ghraib. We simply don't know because we weren't there. What _I_ am saying is that despite what you and others believe, the official explanation is plausible.
NCOs operate independantly without explicit orders for what they are doing EVERY DAY. 99% of them are smart, dedicated, and want to do the right thing. A few of them are stupid, lazy, greedy, incompetent or just plain evil. The only thing required for the abuses at Abu Ghraib to have been perpetrated is "stupid" along with a poor command climate.
(Incidentally, I had opportunity to meet one of the more infamous defendants several times in a health care setting. Obviously HIPAA prevents me from being more specific, but this soldier was not the brightest bulb in the bunch. The soldier may not have even been fully intellectually mature - that's how dull the soldier seemed to me. But I digress....)
I completely agree that their higher commanders bear responsibility - but for failure to supervise properly, NOT for abusing prisoners. The general I mentioned had her career ended NOT because she abused prisoners, or because she was somehow complicit, but because she failed to properly supervise her troops. To be honest with you, from my tenure in the military, I would wager that the true failures resided in the O3-O4 levels, but the commander is responsible for THEM as well... and I honestly don't remember if there were other officers who received official reprimands & were relieved because of it.
Higher command _does_ bear responsibility for the "mixed messages" that were going out to the troops also, vis a vis the status of prisoners and what interrogation techniques were allowed (although this doesn't apply directly to those convicted, because they were only guards and not interrogators) - the defense at trial made the very valid claim that conflicting messages from the DoD made the soldiers unsure of what was right & what was forbidden. Unfortunatly, this is at the level of politicians, not soldiers, who are responsible only at the ballot box.
So to help put it in perspective for you - think back to when you were a very unhappy doc at your last USAF clinic. Suppose the OSI caught one of your medics pilfering supplies, would they send YOU to jail for it? Even if they felt you had not properly supervised the medics, you would not have gone to jail - you might have gotten a reprimand for the poor supervision (if warranted) that enabled him to steal, but that's due to your command responsibility, NOT legal culpability for his transgression.
Oh, and as far as other officers being punished for failure to supervise here's from a news article I found :
Now let me make something perfectly clear: I am not absolving them all of responsibility. I am not saying that the army's explanation is true. What I am saying is that it is PLAUSIBLE and fits with what I know of how the army works. You are certainly free to believe whatever you want in the way of conspiracy theories, but then again, you might as well believe the moon landings were faked using the same logic 😉
Galo said:I will try to reserve my comments on things that I am not an expert in.
Galo said:Those are awesome, and easily applicable to any specialty in the military!!
Homunculus said:seriously?? hmmm.
"any" specialty in the entire military? so included in that would be army pediatrics, yes? please tell me what part of USAF doc's post is applicable toward my specialty. after all, you reserve comments on things you're not an expert in . . . 😛 😀
i was going to let it slide, but after saying you reserve your comments i had to say *something* lol.
unless, of course, you are an expert in army pediatrics in which case i sincerely apologize. 😳
--your friendly neighborhood tried to leave it well enough alone but couldn't caveman
p.s. this is a lighthearted post-- please don't take it as a personal insult or anything 👍
Galo said:Lighthearted as it may seem, I think its pretty shameful of you to act as the administrator, and be so biased at the same time. You are only a resident and seem to think you have a handle on being an attending. Even though I am not a pediatrician, I worked with many of them at Offutt, and at Wright Patt, where they basically lost hospital priviledges, and were confined to a building that was not even close to the hospital..
Galo said:You get the drift, they are applicable, as they are common generalizations that make our live's as military physicians more and more difficult, but then again, as a resident, you have not fully experienced that. I'd love to see a post from you in a year or two after you are actually in the field, when you actually will have experience to post..
Galo said:In the mean time, as administrator, I think you should remain a little more neutral.
Galo said:Lighthearted as it may seem, I think its pretty shameful of you to act as the administrator, and be so biased at the same time. You are only a resident and seem to think you have a handle on being an attending. Even though I am not a pediatrician, I worked with many of them at Offutt, and at Wright Patt...
colbgw02 said:Galo,
All other things being equal and your many years as an Air Force attending surgeon notwithstanding, I have to admit that I think a reasonable person would believe that a current Army pediatric resident would know more about Army pediatrics than an Air Force surgeon. So, I'm hoping you'd share why you don't seem to except Homunculus's relative expertise? Can you cite any specific experiences with Army pediatrics which have led to your conclusions? Furthermore, since you appear to believe that Homunculus's opinions concerning his career will change once he's been an attending for several years, I'm wondering on what specific experiences with Army pediatrics you're basing those beliefs.
You see, it's not that I think you're wrong; it's just that I'm having a hard time connecting the dots between your own experiences with Air Force surgery and your conclusions regarding Army pediatrics. Rather than just stating your thoughts and discounting the opinion of anyone who, in your eyes, isn't experienced enough, I'd appreciate a thorough, step-wise explanation, based on the principles of logic and deductive reasoning, of how you relate your own field of expertise with Army pediatrics.
If my requested format for your argument seems like overkill, then I apologize. It's just that in a forum such as this, lacking visual cues and voice inflection, I think it's important to state things as clearly as possible without leaving anything to assumption.
Additionally, I'd like to hear how your experiences with Air Force surgery changed, presumably for the worst, after you finished your residency.
Thanks in advance.
Cheers.
It will be impossible to turn a 19 yr army veteran against the army. Its the only life he has known, and by the defensive nature of his posts,
HumptyDumptyMil said:I do believe that there is that pattern of physicians being unhappy AFTER they start their payback. I really havent noticed any negative comments about residency training from anyone.
So my question is why there are so many full-fledged physcians with negative experiences, but not as much negative comments from any residents in training right now(They just too busy to even bother with such a forum)?
Personally, I was wondering if Galo, AFDoc, MilMD, etc. will be willing to share their residency experiences as well. Just to get a more complete picture of their experiences. Thanks!
RichL025 said:Defensive? Hello, pot? This is kettle calling....
Once again we see your condescending stereotypes crop up. Since I've been in the army 19 years (and... *gasp* as an enlisted man no less) I'm obviously blindly obediant to the "only life I've ever known".
I don't know how much plainer we can make it. You say that you're getting tired of having to explain things over and over again, think about how WE feel....
I give up. Reason won't work. I'll just limit myself to tossing out the BS flag when you make impossible statements.
Have fun, and welcome to the forum.
RichL025 said:Defensive? Hello, pot? This is kettle calling....
Once again we see your condescending stereotypes crop up. Since I've been in the army 19 years (and... *gasp* as an enlisted man no less) I'm obviously blindly obediant to the "only life I've ever known".
I don't know how much plainer we can make it. You say that you're getting tired of having to explain things over and over again, think about how WE feel....
I give up. Reason won't work. I'll just limit myself to tossing out the BS flag when you make impossible statements.
Have fun, and welcome to the forum.
r90t said:Here are a few to ponder....
1. Deployments. Everyone should go, not the same 30% over and over again. Get the O-4 to O-6s NC officers the opportunity to deploy to Iraq and those people will retire ASAP.
2. MSC/NC in top hospital positions where clinical decisions may be affected. Do not give command of a hospital to a NC/MSC, just because they are an O-6 striving for higher rank. Give command of a medical facility to someone with a medical license. As a former MSC, in hindsight, I had no idea what physicians/interns/residents do on a day to day basis. Putting someone in control of decisions that directly affect them is not wise.
3. Experienced nurses gravitate to admin positions an banker's hours. After O-4, you never see a NC officer in the ICU after hours. They leave junior staff to the worst shifts, when there is the least support.
4. I thought our FP call schedule (q 4) for 3 years was much more than many civilian programs that my friends attended.
5. Poor professional training. Everyone assumes that a physician is smart and needs no further military training to function as an officer. They have multi-week Div-O, Dept Head, XO and CO schools for line officers, yet we get assigned to these types positions without further "leadership" training. This in turn leads to poor command climates, leading to the above types of postings.
Sledge2005 said:My two main gripes:
1.) Much less control over your internship and residency training when compared to civilians.
What is your point?Galo said:Kettle? Is that a racial slur?
I used to fear it, but now I'm sort of warming up the idea. Although it still sucks compared to the options people in the civilian world have.deuist said:My big fear is that I'll get stuck doing a GMO or some other field that will waste 4+ years of my life.
dpill said:What is your point?
Fair enough, but not what I asked.Galo said:I think I have been more than clear on why military medicine as a whole is in a steep decline.
Good stuff here, certainly a lot of experience to back up your claims. For my money though, in matters strictly regarding Army pediatrics, I'll defer to Homunculus.Galo said:The majority of my experience comes from what I endured as a surgeon, but I did work at what was once a regional medical center, Offutt AFB, and what is now ready to become the premier AF medical center, Wright Patterson, after WH closes down. In those 6 years I was not inside a bubble of general surgery only. I participated and interacted closely with all of my collegues in all specialties including peds, medicine, Familiy practice, ortho, gi, GYN, hem onc, etc. I also for some time allowed my family to be treated by some of these specialties, as I had some say in who and how they saw someone. So I may not be an army pediatrician, but having lived and seen what is happening to the medical corps as a whole, in the AF, and knowing from conversations with other surgeons from the Army, and reading what is happening to the navy, I know it is not only an AF phenomenon, but a problem that is facing the military as a whole.
I'm still with you here.Galo said:I think a big part of the problem is money. There is not enough to go around, and like other big industries, health care is becoming increasingly expensive. The military as a whole, is now getting funding to send active duty personell off base to get medical care. There is now a budget in congress for this. It was in an article in the Washington Post. Unfortunately I do not have the date, of the article. They are all making a big change towards primary care. You have heard the experience of primary care physicians on this board. So while some specialties are being overflooded with patients, others are below acceptable limits. There is no support, whether its intentional, poor planning, money related, you can pick the reason, there is just no support.
More good stuff here. Nice examples.Galo said:As I have stated before, there is an increasing difficulty in maintaining a separation between being a good physician, and an officer. At times they will conflict, and in the military being an officer comes first and foremost. This also ties in with the widespread acceptance of mediocracy as the norm. This is not just in surgery, but in all fields, across military medicine. As a quick example, at my last base, the chief of pathology cannot have a path report released unless it has been reviewed by one of the junior staff. The chief of nuclear medicine is not allowed to read stress thaliums, the cheif of surgery has been investigated twice, once in Germany, and once at our base for poor outcomes in vascular surgery, but no credentialing actions were ever taken. He killed a patient with one week of active duty left, retired without a problem. One of the cardiologists missed an ongoing myocardial infarction on the base deputy commander. The chief of medicine was an alleged chronic adulterer, and was eventually PCS'd. And everysingle one of these people were 0-6's with the exception of the cardiologist who was an 0-5. This is just at my hospital, but the stories abound. I posted a link to a pulitzer price winning expose on military medicine earlier in this post, or on my decline of medicine post. You will find that retention is extremely poor, and those who stay and ascend in power are usually, (not always), poor doctors and poor leaders.
You just lost me with that last sentence. You see, I'm capable of acknowledging the legitimacy of your claims while simultaneously not taking them as 100% gospel. I'd prefer to keep a skeptical eye not just about what folks say on this board, but about everything, to include my attendings, my residents, my recruiter, my textbooks, and the guy I just passed on the street who said that the end is near. I'm really glad that you and folks like you like to pass things on to us as-yet-undoctrinated folks, but I just don't think you should get too upset when we're not ready to recognize it as unassailable fact. Keep in mind, that doesn't mean I think you're wrong either, just that I'm trying to take everything with a grain of salt.Galo said:You clearly have seen a very vocal few here that have mirrored my concerns about why military medicine as a whole is in a decline. I have tried to explain why some of my collegues who have had similar experiences just do not bother to post. I have yet to see someone post overly positive experiences refuting the ones of people with experience. I can see people, (me), getting tired of having to explain this over and over. I have discussed personal experiences, experiences of others in all fields, I have placed literature both internal and outside media, and personal letters. But you seem to want logic and deductive reasoning. I don't think you want to believe that there are problems to the magnitude I and others are describing.
True, a good point that is often made. But I'm more worried about the student who accepts information wholeheartedly at first glance than the one who questions everything he/she is told.Galo said:There seems to also be a few vocal people that want to make intelligent or appropriate observations, and want to have them acknowledged as fact, that their experiences are not what we had, and that somehow this invalidates our observations. This is supposed to be a place where potential students learn about what is going on in the military, and whether or not it is for them.
Me too.Galo said:I certainly wish I had this resource before I made my decision to join.
Don't know much about that.Galo said:It will be impossible to turn a 19 yr army veteran against the army. Its the only life he has known, and by the defensive nature of his posts, he has made up his mind that everything will be OK, and with that mindset, it may be OK for him.
Certainly understandable, but thanks for doing it.Galo said:Taking all the time that I am taking to put down my experiences and frustrations over the last 2 weeks has certainly brought out some angry feelings on my part. I am posting here only to allow others to make more informed decisions.
Galo said:OK, richlo25, since you seem to be full of knowledge, why don't you contribute something that you know to be the truth about military medicine, perhaps leaning toward the army since that's where your area of expertice is. You are posting on the con thread, so let's hear from you, what are your observations of the way military medicine is now,..
Since I can't seem to make criticism of the system without you taking it as a personal attack, tell everybody what makes the army such a good and safe place for you.
Umm, it's an age-old aphorism akin to "glass houses" - "The pot calling the kettle black." I have no idea what your race is (nor is it remotely important) but to the best of my knowledge that saying has nothing whatsoever to do with race.Kettle? Is that a racial slur?
Sledge2005 said:I used to fear it, but now I'm sort of warming up the idea.
colbgw02 said:You just lost me with that last sentence. You see, I'm capable of acknowledging the legitimacy of your claims while simultaneously not taking them as 100% gospel. I'd prefer to keep a skeptical eye not just about what folks say on this board, but about everything, to include my attendings, my residents, my recruiter, my textbooks, and the guy I just passed on the street who said that the end is near. I'm really glad that you and folks like you like to pass things on to us as-yet-undoctrinated folks, but I just don't think you should get too upset when we're not ready to recognize it as unassailable fact. Keep in mind, that doesn't mean I think you're wrong either, just that I'm trying to take everything with a grain of salt.
Galo said:Some of these responces seem to be getting to a personal level on both sides. Also I dont particularly personally like that phrase.
1. out of the military soonerRichL025 said:Why? Just curious....