Frustrations with MEPS/Surgeon General's Office

[bleeker10]

I am trying to apply for the HPSP in the Air Force. I went through MEPS and told them I had asthma when I was a kid. The doctor there ordered a pulmonary consult, so I figured they would consult me out while I was there considering I drove 3.5 hours to get to MEPS. No instead MEPS lets me leave and after I get home I find out the Surgeon General's Office wants my medical records for my asthma and they don't know why MEPS let me leave. Well my childhood doctor is no longer practicing and I find out another doctor I saw has records of prescriptions for inhalers but that's it. Now the SGO wants those records before they will send me to a consult even though I don't have asthma symptoms anymore. Wouldn't it make sense to consult me out for pulmonary tests rather than looking at a medical record from 8-10 years ago? I'm pretty sure they want to know if I have asthma now so why the wait? Is this the sort of inefficient bureaucratic bs I have to look forward to as a military physician? It's just so aggravating. Thanks for letting me vent.

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[giuseppe]

Is this the sort of inefficient bureaucratic bs I have to look forward to as a military physician?

Yes, assuming you are able to get a waiver. Most of my friends quit before getting that far. Luckily, I've found my professional and personal gains in the military far outweigh the inefficient bureaucracy so far. Eventually, you figure out ways of saving yourself some trouble by learning the system... like clarifying with all parties exactly what you're driving 7 hours roundtrip to do, since they can't read your mind or each others. And god forbid expecting them to try to talk to each other on the same day, let alone same week. Good luck.

 

[IgD]

...Is this the sort of inefficient bureaucratic bs I have to look forward to as a military physician? It's just so aggravating. Thanks for letting me vent.

Sorry couldn't resist:

Wait until the lives of you and your family are completely in their hands. When will they send you on a deployment? When will they give you new orders? Will your spouse have to quit a job? When will you pull your children out of school? When will they let your family come out to the OCONUS duty station? They just need medical clearance...

 

[crazybrancato]

Sorry couldn't resist:

Wait until the lives of you and your family are completely in their hands. When will they send you on a deployment? When will they give you new orders? Will your spouse have to quit a job? When will you pull your children out of school? When will they let your family come out to the OCONUS duty station? They just need medical clearance...

No, you really couldn't resist. Why don't you try giving the kid some advice that he could really use (specific to his question), instead of going off on your military-bashing tangent.

everything you described above is true and is a part of military life. has been for > 230 years. Many have done it, some for entire 20- or 30-yr careers. They come from all professions and walks of life. What are they, crazy?! Maybe in your opinion . . .

don't turn into a typical military basher, please. If you have specific/constructive criticisms about your experiences in milmed, then of course they're welcome and very much desired.

i saw your other thread about missing AD. well how bout that. you seem to be bored at your current civilian job, must be if you're posting here during the day.

 

[IgD]

everything you described above is true and is a part of military life. has been for > 230 years. Many have done it, some for entire 20- or 30-yr careers. They come from all professions and walks of life.

I'm not sure I agree with that. I suspect military medicine is very different than typical military life. I'm looking forward to hearing your feedback once you are in the system.

 

[i want out]

I am trying to apply for the HPSP in the Air Force. I went through MEPS and told them I had asthma when I was a kid. The doctor there ordered a pulmonary consult, so I figured they would consult me out while I was there considering I drove 3.5 hours to get to MEPS. No instead MEPS lets me leave and after I get home I find out the Surgeon General's Office wants my medical records for my asthma and they don't know why MEPS let me leave. Well my childhood doctor is no longer practicing and I find out another doctor I saw has records of prescriptions for inhalers but that's it. Now the SGO wants those records before they will send me to a consult even though I don't have asthma symptoms anymore. Wouldn't it make sense to consult me out for pulmonary tests rather than looking at a medical record from 8-10 years ago? I'm pretty sure they want to know if I have asthma now so why the wait? Is this the sort of inefficient bureaucratic bs I have to look forward to as a military physician? It's just so aggravating. Thanks for letting me vent.

Yes, this is exactly the type of thing you can expect.

you can also expect them to lose every piece of paperwork you ever submit at least once. Don't ever give anybody your last copy of anything always keep at least one backup.
don't even go to the crapper without keeping a copy of the toilet paper.

I spent my first three years on active duty trying to make things make sense, then gave up and assumed that if there was an apparent logical way to do something that there is no way the .mil will ever do it that way.

As for the last point, you will have at least a few people on here(crazybrancato) that will come along and tell you how all this makes perfect sense. They are the ones who have decided to stay in the .mil long enough that they have committed to learning how to manipulate the system rather than allow it to manipulate them.

My theory is that your first term in the .mil is spent learning how the system works, with the caveat, that every time anybody above you in the chain of command changes, the rules change. If you are flexible enough to enjoy and learn to manipulate the system, then you may stay in, but if your getting this frustrated with just the MEPS, then you need to think seriously about whether the .mil is the right place for you.

good luck, your going to need it.

i want out(of IRR)

ps one more thing, the .mil has lots of rules, that they don't really care if you follow or not, like declaring your complete medical history like the asthma you had as a child. The probably told you that you could be charged with fraud if you didn't list anything and it came back in your record search.

Think about how hard it has been for you to find these records of 'asthma'. do you think that the .mil would have spent the time and effort to look for it if you hadn't mentioned it? The answer is NO they would not have unless you pissed somebody off enough that they had a hard on for you and wanted to screw you no matter what.

Lots of kids join and don't bother to mention medical problems that they have had. ( I had one, and only one that proved to be life threatening in my 4 years as a GMO) Nobody does anything to them.

The .mil has those rules so that they can charge you with something if they do eventually have a problem, and so they have plausible deniability for putting you in harms way.

all that having been said, now that you have been to honest, you have to jump through the hoops to get the waiver, or you could do like I would suggest, and consider this a sign from God that you shouldn't be in the .mil and go on your merry way.

again, good luck, your going to need it.
I want out (of IRR)

 

[bleeker10]

I realize now that I didn't need to disclose the asthma but I panicked at MEPS. I couldn't exactly call my recruiter and ask him what to do. It's my fault. I am just frustrated that they are worried about the asthma I had 10 years ago rather than if I have asthma now. I still want to go into milmed and hopefully things workout. Thanks for all the responses, good and bad.

 

[notdeadyet]

I realize now that I didn't need to disclose the asthma but I panicked at MEPS. I couldn't exactly call my recruiter and ask him what to do. It's my fault. I am just frustrated that they are worried about the asthma I had 10 years ago rather than if I have asthma now. I still want to go into milmed and hopefully things workout.

I feel for you. I had my commissioning delayed by a few months for disclosing that I've had heartburn before. Welcome to milmed.

 

[IgD]

I feel for you. I had my commissioning delayed by a few months for disclosing that I've had heartburn before. Welcome to milmed.

Heartburn? No kidding

Then you have folks who pass or get around duty screenings with catastrophic illnesses!

 

[NavyFlightDoc]

It's probably best you don't lie, I don't know if he pissed somebody off or what, but one of my fellow interns only lasted a month because he found out he had asthma as a young child around the beginning of internship and put it on his PHA (you'll find out what that is later, if you stick around). He hadn't put it on his commissioning physical, because he had been asymptomatic since age 7 or so, and didn't remember it.

Anyhow, 1 week into July he was at home with the entire balance of his HPSP scholarship now hanging over his head, needing to find a job as an intern somewhere. The .mil can be efficient when it wants to be.

And this was in 2005, when HPSP recruitment was way down.

 

[244913]

Don't worry too much about MEPS.

The Military is so hard up for Docs they'll take you, might make you jump through a few hoops first. AF>Navy=Army

When you're on Active Duty, no one cares. Remember- they WANT to deploy you, and often.

Finally, your records from MEPS will most likely be lost or misplaced anyways.

Like I Want Out says, I'd use this opportunity to evaluate your decision carefully. HPSP is not the only way, and in my opinion is the worst way for a Doc to join.

61N

 

[disillusion]

Hang in there Bleeker10. The millitary is currently deploying most everyone to the geat overseas deserts. Asthmatics have proven not to do well there. The military just wants to know if they can send you there. But if not, you can still get in. As was said, the military is suffering hard for physicians right now. They will still take you and send you to other locations. As an example: I was initially turned down at MEPS because I said I had a hive reaction to strawberry pie once. I had to get a waiver to get in. Now, I have found out that I don't breath well in the desert environment. I underwent an MEB to see if I was retainable. I asked to be let go from active duty, but I was found retainable, even with only 83% of my lung function (and that is after 15 months of max therapy). Anyway, don't worry about it. If you really want in, let that be known and it will likely happen. However, I agree with the other posters that you should reassess if you want to do milmed, given you are already so frustrated. Good luck.

 

[ArmyDocDude]

I agree with I Want Out, the second part of the post.

I'm not saying you should lie about stuff, but as my father said to me, "You don't always have to say everything you know."

It also kind of depends on how much of a potential problem it is. Do you have asthmatic attacks now? Do they affect your daily routine? If not, and it has been years, then it might not be a huge deal.

 

[Galo]

Is this the sort of inefficient bureaucratic bs I have to look forward to as a military physician? It's just so aggravating. Thanks for letting me vent.

You're barely scratching the surface and you're frustrated already. Are you prepared to risk not doing the residency of your choice, being told where to work, who to work with, multiple deployments, (not necessarily in what you were trained), skill erosion if you are a specialist, piss poor pay compared to civilian counterparts other than peds, primary care..............????


You really need to ask yourself the real reason you want to do this. If its truly that you want to serve, why not become a doctor of what you choose to do, and then come into active duty? They will take you no questions asked. Going through HPSP closes too many doors, and potentially sets back your career for up to 4 yrs if you end up as a GMO/Flight Surgeon. Military medicine is a poor place to practice, let alone learn to become a physician. Ask many questions, talk to many people, read this forum thoroughly.

Just a few days ago a similar thread was started, (at least one a week), with the same spirit of finding out, and I think its pretty relevant and applies to you as well. I'd recommed reading it:

http://forums.studentdoctor.net/showthread.php?t=604758

Best of luck

 

[atomi]

Wouldn't it make sense to consult me out for pulmonary tests rather than looking at a medical record from 8-10 years ago?

They will make you do both. It is a PITA.

 

[former military]

i have asthma and had environmental allergies to animals as a child. I couldn't be around horses. Gradually this progressed to cats and dogs. I did very well away from animals and ran varsity cross country in college. I used to lead the hospital in the mile and a half run.

anyways, I was scheduled to deply in 2003 and was in the midst of the anthrax shots and getting all my ducks in a row. I had a new GF who had cats and I wanted to talk to the allergist about some sort of tolerizing regime so I could hang out at her house with her two cats. Before you can talk to the allergist you have to blow PFTs. My FEV1 was too low... they give me an albuterol nebulizer retested me it was still too low and I was taken off of world wide qualification status and told I couldn't deploy to the mid east. I could go to england or something like that but not the desert.

I was still stupid at that point and suggested I wasn't really going to be around any animals and I could take some albuterol inhalers, a prednisone taper package and some zyrtec and be fine. I had it in my mind I was going and had emotionally readied myself to go and wanted to just get on with it. She looked me in the eye and said, "you don't get it... it isn't whether you want to go or not. Your FEV1 is too low and your not going.

My ability to breathe in the desert, do surgery in the desert, or pass fitness tests in the desert had no relevance. I had failed the PFTs. There is no voice of reason in military medicine.

 

[notdeadyet]

Asthma has no place in the military. I wish the f-ing docs at MEPS would just screen it out based on DoD policy, instead of letting every fool with a good story get a waiver.

Your blame is misplaced. The docs at MEPS do an absolutely bang up job at DQing everyone they have any reason to. You'd think they were getting a bonus for each DQ.

The decision for waivers happens way above MEPS and I have a hunch it has as much to do with headcount and pipeline as it does medicine.

 

[i want out]

Your blame is misplaced. The docs at MEPS do an absolutely bang up job at DQing everyone they have any reason to. You'd think they were getting a bonus for each DQ.

The decision for waivers happens way above MEPS and I have a hunch it has as much to do with headcount and pipeline as it does medicine.

From some of the stuff that I saw show up in the middle east, I can assure you it has more to do with numbers of deployable troops than it does medical.

I lost count of the number of army reserve that showed up on my doorstep with a knee exam that demonstrated gross laxity of the ACL and were still deployed. I had several that told me that they had surgery scheduled with a civilian prior to being called up, but when they were MOB'ed they medical screener had told them to cancel the surgery, and get ready for deployment, they could get it fixed when they got home after their year deployment.

Imagine your in the sand pinned down by snipers after an IED has gone off, and the guy that is coming to drag your butt to safety behind a HMMV is one of these guys with an unstable knee, just as he gets to you, he turns wrong in the unstable sand, and under the weight of his kevlar, and flak he falls to the ground next to you screaming.

The Rear echelon MF'er that sent him over there to be another body apparently didn't think to much about that.

i want out(of IRR)

 

[crazybrancato]

that told me that they had surgery scheduled with a civilian prior to being called up, but when they were MOB'ed they medical screener had told them to cancel the surgery, and get ready for deployment, they could get it fixed when they got home after their year deployment.

I don't believe this for a second (not the fact that you saw a lot of members with knee/acl issues . . . I don't believe their sob story about having it prior to mob). Busted knees/torn acls were almost the #1 reasons why we scrubbed anyone from deployments, for exactly the example you gave below (too much liability), and the fact that they probably wouldn't even make it thru the 2 month workup. My guess is that they incurred the knee injury there in the sand, or they weren't clear during the premob physical, or something else went horibbly wrong during their mob indoc.

i want out(of IRR)

do you type this at the end of every post? there is a signature function here ya know. btw i think you can relax now, highly unlikely that they'll be recalling your from the irr. (in fact, even when you get out of the irr, you're not really 'out'. you're names still on a list somewhere, and you'd still be called up again before the draft. but this is all very unlikely. so i wouldn't lose any sleep over it)

 

[disillusion]

From some of the stuff that I saw show up in the middle east, I can assure you it has more to do with numbers of deployable troops than it does medical.

I lost count of the number of army reserve that showed up on my doorstep with a knee exam that demonstrated gross laxity of the ACL and were still deployed. I had several that told me that they had surgery scheduled with a civilian prior to being called up, but when they were MOB'ed they medical screener had told them to cancel the surgery, and get ready for deployment, they could get it fixed when they got home after their year deployment.

Imagine your in the sand pinned down by snipers after an IED has gone off, and the guy that is coming to drag your butt to safety behind a HMMV is one of these guys with an unstable knee, just as he gets to you, he turns wrong in the unstable sand, and under the weight of his kevlar, and flak he falls to the ground next to you screaming.

The Rear echelon MF'er that sent him over there to be another body apparently didn't think to much about that.

i want out(of IRR)

So sadly true, i want out. When I was deployed, there were a couple of soldiers in the unit diagnosed with pulmonary hypertension and untreated that were taken. The frustrating part is when people try to get out that know they will have trouble fulfilling deployment requirements, but are told they can't leave. This is exactly my situation (see above). My fear is that I will be sent and when I get there, will fall out and the soldiers that were depending on me will suffer. The crazy part is that I saw guys left on rear-d that were healthy and the sick ones sent to deploy.

 

[crazybrancato]

So sadly true, i want out. When I was deployed, there were a couple of soldiers in the unit diagnosed with pulmonary hypertension and untreated that were taken. The frustrating part is when people try to get out that know they will have trouble fulfilling deployment requirements, but are told they can't leave. This is exactly my situation (see above). My fear is that I will be sent and when I get there, will fall out and the soldiers that were depending on me will suffer. The crazy part is that I saw guys left on rear-d that were healthy and the sick ones sent to deploy.

i did some time at SURFPAC (lovely place), where I was the admin officer reviewing and putting together mob packages for potential active and reserve sailors for IAs for OEF and OIF. Had a PA there as my medical consultant. for anything joint (knee elbow) related, torn acl, severe HT, we disqualified the candidate and moved onto the next application. [interestingly enough, there were some pride-full sailors who tried to slip by PA and hide their fractured elbows, but a quick Rad consult at Balboa took care of that.] i dunno, i suppose things are different in the Army/USMC, they are bearing the brunt of these wars.

 

[IgD]

I don't believe this for a second (not the fact that you saw a lot of members with knee/acl issues . . . I don't believe their sob story about having it prior to mob). Busted knees/torn acls were almost the #1 reasons why we scrubbed anyone from deployments, for exactly the example you gave below (too much liability), and the fact that they probably wouldn't even make it thru the 2 month workup. My guess is that they incurred the knee injury there in the sand, or they weren't clear during the premob physical, or something else went horibbly wrong during their mob indoc.

I was at a flag officer dinner where the guest told the audience (officers+spouses) that there had been a service member showing up in a combat zone asking for a refill of his kidney transplant meds and another asking for a methadone refill for heroin dependence.

 

[i want out]

I was at a flag officer dinner where the guest told the audience (officers+spouses) that there had been a service member showing up in a combat zone asking for a refill of his kidney transplant meds and another asking for a methadone refill for heroin dependence.

I can confirm the methadone dependent pt, although it was for chronic pain.

Crazy, I didn't believe it either the first few times that I heard it. Then when you hear similar stories from several different people in different units, and they really have nothing to gain from telling you that their knee problems were pre existing, it starts to sound a little more realistic.

Yes, the Army does use some different parameters than the Navy, or at least it seemed that way from the folks that were deployed.

On my first deployment, I sent home some kids for psych issues (Navy). This wasn't made all that difficult partly because the command at least realized the liability of having head cases on board a ship.

Second deployment was IA with lots of Army around. There was one unit in particular that I was almost certain was made up of a national sick lame and lazy list. If there was a BS complaint in sick call, and you could be sure there would be at least a few everyday, it was almost always from this unit.

It was so bad, that by the end of deployment one of my corpsmen actually used the phrase, 'Doc, I know he's from the %#^% but I think he might actually be sick'.

One of their guys was sent to see Psych after shooting holes in the floor of his room with his M9, while 'robo-tripping'.

After four seperate psychiatrists on 4 seperate visits strongly recommended he be sent home, and he was repeatedly found with Robitussin bottles in his room, he was still there.
One day coming back through the wire, I noticed that he was standing gate guard with an M16. I immediately went flaming mad to his chain of command and they tell me that his M16 didn't have a bolt in it(unable to function). When I told them I wasn't sure whether to be more worried about this guy with a gun, or no means to protect his post, they only laughed.

Or the guy with impending renal failure (dehydration makes this more likely for you pre-meds) that was still in the desert in the summer after the nephrologist who was incidentally filling a primary care billet jumped up and down on his commands desk about how unsafe it was to keep him in the summer desert where dehydration was pretty much certain.

i want out (of IRR)

 

[Gastrapathy]

MEPS or where ever, someone is telling these guys how to put in for a waiver. They shouldn't even tell them. And whoever decided to grant these waivers should come spend the day with my battalion, because then they'd stop doing it.

I was on a 3 week training op in FT Pickett. Ended up hospitalizing a Marine who had been on three different asthma meds until age 18, then went off them for three months to prove he was "cured". Passed the PFTs, got in, and a few months later I'm getting him admitted for a severe attack.

They're DQ'ing everyone they can? Think again. In addition to the asthma cases, I have four Marines and corpsman with severe pes planus who were let in because it was "asymptomatic". Yeah, asymptomatic when they weren't running 3-5 miles every day. Now I have Podiatrists crawling up my ass because I want to admin sep them instead of letting them get surgery. As if that'll fix the problem . . .

Or the pectus excavatum cases.

Or the guys with multiple knee surgeries in high school.

My personal favorite: the kid who lost 120lbs to make weight to get in the Marine Corps, then demands body contouring surgery so that the MTV doesn't irritate his skin folds. C'mon, get real.

And on and on. So tired of it. I can now put together a sep package in under 20 minutes.

Tired, we need Marines. They may not all be the best and it makes their SSgts mad when they can't run 5 miles, but I'd argue that its your role to try to advocate for their retention whenever possible. The kid who lost 120 lbs...why not send him to plastics? Isn't that a better use of their time than boob jobs for O4 nurses? Wait a minute...maybe not.

 

[squad41]

Going as a sidebar as to what the original poster said, Im in a similar boat.

Ive already been accepted to a great med school.
I filled out all the paperwork in a very timely fashion

I fill out the MEPS pre screen stuff, they ask for all PCP records, Im healthy as a horse, lift weights, run every day, etc.... and there's a note in my PCP's chart that says approx one year ago I had a migraine med. script written (maxalt). Now, I had the script written because I wanted to have it handy in case I ever got another migraine. I havent had a migraine in YEARS but I wanted to have it handy, just in case. Even then, when I did get migraines years ago as a teenager, they did not keep me from missing work/school etc. Nevertheless, I got DQ'ed because I had a Rx in my file for migraines w/in the last 5 years. The recruiter says I might be able to appeal this to Surgeon general if I get my doc to write a note explaining how minor of a deal this was but that the surgeon general can take quite a while in granting a waiver and the last board is meeting in a couple weeks.....so I might be hosed.

Can anyone advise what to do? I have gone through hours and hours of paperwork, chasing down my PCP, faxing records, etc.... Cany any of my SDN amigos/amigas advise me what my options are to make this happen?

 

[IgD]

Can't get in on a technicality. Meanwhile some poor soul is on his third deployment due to short staffing while he and his family are praying for relief.

 

[former military]

relief is not taking the scholarship.

the government doesn't change because they don't have to. People sign up to be doctors and take the scholarship.

if you don't want to be deployed pretty much full time... don't enlist, or go to west point or what have you. you need to want to soldier full time. if you want to be a family man or woman or learn a skill you need a different line of work. They don't pay, they don't keep promises, and deployments are going to get worse and longer...

the government doesn't want to bring back the draft but it doesn't have to make the quality of life better for anyone in the military because people keep signing up at all levels.

 

[notdeadyet]

Can anyone advise what to do? I have gone through hours and hours of paperwork, chasing down my PCP, faxing records, etc.... Cany any of my SDN amigos/amigas advise me what my options are to make this happen?

You're doing it right.

I think the process is actually fairly transparent if you ask:

Confess to having a health problem of any kind in your life and you will most likely get DQ'd (something might slip through, but don't count on it).

After you're DQ'd, your recruiter applies for a waiver. Back up your recruiter with as much information as possible from past medical records and especially letters from the physicians involved stating categorically that it is not currently a problem and will not be a problem.

After a few weeks to a month, hope for your waiver. If you do not get the waiver, my understanding is that you have the right to one appeal (no idea how often this is granted). The recruiter should let you know prior to filing if your DQ is on the list of permanent DQs in which waivers aren't issued.

Other than that, I don't think there's any successful trick. Best of luck...