Conversation with a Civilian Military Physician

Discussion in 'Military Medicine' started by island doc, Nov 12, 2005.

  1. island doc

    island doc Senior Member
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    The civilian Air Force physicians are getting fed up too.

    I had a conversation this past week with a friend of mine who is working as a civilian contract physician at an AF Base. She has only been there for about 5 months and is already getting fed up with all the "BS" and is planning on quitting as soon as she finds something else to do. She is very frustrated with all the frivolous middle of the night telephone calls from patients for trivial complaints. Yes, she is required to be on call for the military FP clinic. She complained of long hours spent completing paperwork, after having been promised an 7-3 work schedule.

    USAFdoc is right.
     
  2. texdrake

    texdrake Stand-Up Philosopher
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    Hmmm...can't wait until she goes out an joins in FP practice outside....I am sure she will have no problem finding a 7-3 gig that includes her paperwork time as well...
     
  3. USAFdoc

    USAFdoc exUSAFdoc
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    there are certainly "burnout" FP jobs in both the civilian and military realms,but there are important differences:

    1) Almost 100% of current mil FP clinic jobs are "burnout" jobs
    2) If you are in a civ burnout job, you can leave
    3) In a civ job,your employer knows you can leave and therefore will usually at least listen to your requests.
    4) There are many "part-time" or locum FP jobs out there with GREAT hours.
    5) SADDEST (poor) argument I keep hearing in defense of the current FP state in the USAF is this "its bad on the ouside too!" What a crock that is. Every single doc I know has loved their new CIVILIAN FP job compared to working the military system. ALSO, since when is it the GOAL and STANDARD of the USAF to try and measure up to the WORST the civilian world has to offer its patients? What happened to core values and excellent patient care? I'll tell you what, they got buried underneath 20 ft of metrics, 30 ft of failed cost cutting surgeon general failed planss, 40 ft of unqualified supervisor resumes, and 50 ft crap.

    In other words,those of you enterring the realm of military primary care, prepare to get crapped on. You will be given the above 90 ft of worthless paperwork to wipe yourself with.
     
  4. USAFdoc

    USAFdoc exUSAFdoc
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    now that I got that off my chest,let me say some specifics on just what kind of worthless paperwork,and sometimes needed but someone else should be doing it paperwork going on.


    1. MEPRS. how about being askedevery month to list how much time you spend doing EKGs,seeoing patients,exercising, deployment training,commander meetings, leave,holidays,weekend clinic etc. Basically you have to track everything you do and send it in so the SG can have his metrics.
    2. Injury reports: so a guy sprains his ankle, well now you need to prepare a form 12 injury report,fill out an injury log, fill out a profile form, perhaps a sick quatrters form so he can be excused from mandatory PT,in addition to all the regular office notes, also,the mil keeps OTC meds like motrin so scripts for those meds as well,...all for just a simple ankle.
    3. 4T profiles: these are all the troops with some sort of illness,pregnancy etc that keeps them from being deployable. Every month forms must be updated,filled out,signed etc, Used to be done by a specific other dept, but like about 20 other things,all are now given to the family docs to do.
    4) PGUI: this is a pseudo electronic med health record. Docs mandated to use it to code patients, even though we already are paying coders to do that job and other paperwork contains the code. The system is slow and was developed for tracking statistics, not patient care. Frequent computer breakdown further add to the unnec part delay of this system. And it still must be printed out and signed to be put in a record (if you can find the patienrts record).
    5)Referals: if a mil doc needs to make a referral,get ready for "hoop jumping" to the nth degree. First the doc must type in the referral and all details into the computer (about a 20 step process NOT including the 1-2 paragraphs needed of patiet hx so that it is not denied). Then it goes electronically over to the other side of the base, then faxed to TEXAS (no matter where your base is). Then they either fax it back to the home base if there is a problem, and mail a copy to the patients home address (if they have it). Then it is up to the patient to call on their own to schedule their appt with the specialist. Results coming back to the doc follow a just a convoluted path.....in the end many referrrals never happen, the military doc left holding the "litigation" bag. This is a far far far cry on the steamlined simple referral process I have as a civ doc.
     
  5. GMO2003

    GMO2003 Senior Member
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    :laugh: :laugh: :laugh:

    my favorite is when people pull rank and make me get out of bed in the middle of the night for things like constipation, diarrhea, or a urinary tract infection...you'd also be surprised how persuasive some of these people are when they ask for a quarters slip for the next 72 hrs because of the cold...or my favorite...people who can and complain because I haven't returned their phone call within 30 minutes :smuggrin: :smuggrin:

    as far as the referral process..I explain this to patients until I am blue in the face...less than 25% of the patients actually f/u and contact the clinic I referred them to in order to confirm their appointment..they then proceed to call me to complain that I never set up their referral :thumbdown:
     
  6. USAFdoc

    USAFdoc exUSAFdoc
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    As I stated in earlier threads; the DESIGN of this health care system is terrible. It is designed to fail!!!!!!! both patients and docs.

    For referrals; how hard would it be to have a referral nurse call and set up the appt when the patient is in the clinic. That way, the doc, the pt, the referral doc all know when and who and where right then.

    I thank God daily that I made it out of that health care system.
     

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