How much time will I have as a doc...really?

[mac61]

---

Members don't see this ad.

As I begin my second year as a medical student, I keep hearing the same addage: "Enjoy the time you have now, because you'll never have time again." Sure enough, everyone says the second year is harder than first (true so far), and the third harder than the second, internship than fourth year, residency...ad nauseum.

I hear this so much that I am starting to believe it, until I see how much time physicians, most of whom I assume (we know what assumptions do) are now in civilian practice (which I hear takes up more of your life than the slackers on active duty complain about), take to post thier unlimited knowlege on a STUDENT forum.

So...really....is it that bad? I know I'm putting off the stuff I should be doing when I come here to figure out how bad I really screwed up by committing myself to military medicine, but I can't imagine that real live attending physicians manage to squeeze it in, let alone post on almost all of the current forums...daily...and have time to write books, etc. on top of all of the stress that SDN brings!!!!! AMAZING!!!!!!

Personally, I'd rather spend time with my family or other such activities that people who make such outrageous sums of money as former military physicians make can afford. I still however have to kill time under the guise of studying, and can only dream of having enough time to trash my former jobs on a silly forum.

So, if I will eventually have enough time someday, thanks for keeping the dream alive. Your time is my entertainment.

If not, stop screwing with us and get a life! Saving the world from all of the incompetent beaurocrats and untrained physicians to whom you are clearly superior is a much more noble cause than keeping people out of the military and/or telling those of us who are locked in how bad our lives will get.

Thanks.

 

[island doc]

Rob,

You're a USUHS alumn, we'll let you handle this one.

 

[MedicalCorpse]

Yes, you will have more time.

Sorry about the whelp crack. It was rude and presumptuous...and I try to limit myself to one or the other per post.

Late night posting quality diminishes with age, it seems.
😴

Good luck with USU and your military medical career.

--
Rob

 

[mac61]

We wouldn't post if we didn't care. We have been there, many of us, drinking from the water fountain on the second floor of the LRC at 2200, cramming desperately for the pharm test at 0 Dark 30 in the A.M., buying stale burritos from the machines near the MS-I carrels, asking ourselves: "Are we doing the right thing with our lives?"



When you are a twenty-something MS-II, everything seems to come (pun intended) with exclamation points appended. Testosterone (or estrogen) will do this. After 15 years, you will mellow out, yet your intellect will remain. You will either remain in the military, or you won't. We as a nation will either fight China and Iran, or we won't. Much of this is out of your control. You must decide what is in your control, and maximize your contentment within this zone.

I met my wife while at USU. We had two handicapped kids (born at WRAMC and WHMC, respectively), whom I love dearly. Our third kid is a blessing beyond reckoning (http://www.notbob.com/arthurjumps.mpg). I will always wonder whether our second son could have been helped more if the military hadn't seen autistic kids as unissued baggage unworthy of significant early intervention.



I worked harder during my final 5 years on active duty than I do now, in private practice as an anesthesiologist. It's hard to explain what it's like NOT to have to leave the O.R. with patients you care for under anesthesia to pee in a cup. It's hard to explain what it's like not to be subject to a recall exercise at 0500 on a day when you know you'll be in the hospital past midnight. It's hard to explain what it's like to be free from the rigid hierarchy of the military, which placed nurses, pharmacists, and glorified housekeepers over doctors.

You say "trash" and "silly". When I was in your shoes as an MS-II (1987), I might have said the same things. "When I was a child, I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things." ‑ 1 Corinthians 13:11 in the Xtian bible. When you "grow up" in medicine, you will acquire the capability to discern between "trash" and "criticize", between "silly" and "vital". Until then, enjoy the warm, squishy uterus which is USUHS. It would not be unreasonable for you to beseech your Deity of Choice (TM) for a radical change to U.S. military medicine before you have to join the ranks of Real World Players after residency. May your prayer find a listening ear.



You will eventually have enough time someday. I am honored to be here to provide entertainment to you, O munificent, worthy One.



If telling you the truth is considered "screwing with you", then consider yourself screwed with. Deal. If "saving the world from all of the incompetent beaurocrats (sic)" seems to be a dishonorable mission, perhaps you should reconsider your underlying assumptions regarding honor. If the water being splashed in your face is too cold and, well, wet, perhaps it isn't real, after all.
Keep telling yourself that until you graduate from residency and have worked for a decade as an attending physician in what is left of U.S. military medicine. Enjoy being commanded by nurses, pharmacists, PAs, and the dude who cleans the john, because physicians above you won't speak out or resign, in order to protect their precious retirement pay and benefits.

Then post back here and apologize for your presumption, whelp.

No offense intended, of course.

P.S. The coffee stand in the middle of the hallway outside lecture halls C and D (under the F-16) is the best thing that happened to the military between 1990 and 2000. Really. (cackling) In the old days, we had to chew on dry Maxwell House (R) coffee grounds to stay awake during SFOS.

--
R. Carlton Jones, M.D.
Ex-LtCol, USAF, MC
Ex-Assistant Professor of Anesthesiology, USUHS
etc.
http://www.medicalcorpse.com

Nemo Me Impune Lacessit: It's Not Just For Breakfast Anymore

Ah, the wisdom of the old.

You could have just replied with a "Yes, you will some day have the time.", but instead you have beseeched your readers with more knowlege. 91 posts in less than 30 days, quite a lot of knowlege to sift through, but we will remain vigilant.

I hope that someday I will be old enough to tell someone to grow up in one sentence and then make an inappropriate sexual pun in another, all the while assuming that you respond to someone that you seem to know. Ahhh, the tools of the geriatric are not to be underestimated: somehow you figured out that I am twenty-something (wrong, however a good excuse to "criticize" USUHS); that I have never been out of the womb of USUHS (wrong yet again, but another great opportunity to point out a "vital" organ such as the uterus); that I don't know what stoicism is (wrong again, but I prefer your typical cynicism); and that I think fighting ineptitude in not honorable (plain failure to grasp syntax, comes with age I hear).

On a lighter note: Sorry to hear that military health care didn't provide adequate care for your children, truly. If it makes you feel any better, in my 14+ years of military experience I knew better, thus my son is treated by an oncologist at The Johns Hopkins. Absolutely no reflection on the Army physicians, just the system that I know will probably not provide adequate care. (This paragraph was inserted to imply that I am not jaded by military medicine, or blind to the fact that it is broken. It is also providing a glimpse into the idea that people go to USUHS for different reasons, not all of which are money and blind patriotism, which may have been the case in the "pre-war" days before WW Gulf I).

In the mean time, O heralded One, I shall continue to watch for your 100th post in August, at which time I will face South and grabs some porceline (sic) since you won't give us a break and stop hijacking every thread in the forum (thought I'd clear that syntax up, though hijacking is a pretty big word....crank up the font.)

Oh yeah....

I don't drink coffee. Whelp. (I'm not sure what that means, but I have some 16th century literature that will probably give me some context. One more reason to procrastinate. I "presume" it's a compliment.)

No offense taken or intended...of course.

 

[AF M4]

I've recently gotten a taste of how the military works - travel vouchers that take three submissions to correct because they came pre-printed wrong, being shorted on active duty pay, told to fly back for an interview on my own dime after being on a rotation for a month because they only have scheduled certain interview days (wish they'd told me this when I scheduled my ADT - could have easily pushed it back a week)...I've only been on a month and every day I see half a dozen things that are so dumb that they could only happen in government work.

My response? Enh. I'm not going to get stressed out about it - all it's gonna do is shorten my lifespan and the amount of time I'll have when I get out. CT scanner down for "terminal cleaning" again? The third night in a row? Or are the techs just taking a nap? Whatever. So I'm draining a Bartholin's cyst down in the ER and there are no Word catheters in the hospital? Sigh, why am I not surprised? Fine, give me a pediatric foley and I'll improvise (yes, this did happen). Give things a couple more years and you'll have orthopedists putting femurs back together with duct tape and baling wire, and cardiologists treating MIs with half a bottle of aspirin and a couple sparking wires that they just ripped from the lamp above the bed. It's gonna get hectic, and they're going to keep cutting the budget to see just how far things can go before they utterly collapse.

So things are screwed up in the military. The civilian medical world isn't in great shape either. The match sucks this year, but there are worse things in life besides being locked into a job that pays $55,000 a year during your 20s. (Repeat serenity prayer here)

 

[USAFdoc]

I've recently gotten a taste of how the military works - travel vouchers that take three submissions to correct because they came pre-printed wrong, being shorted on active duty pay, told to fly back for an interview on my own dime after being on a rotation for a month because they only have scheduled certain interview days (wish they'd told me this when I scheduled my ADT - could have easily pushed it back a week)...I've only been on a month and every day I see half a dozen things that are so dumb that they could only happen in government work.

My response? Enh. I'm not going to get stressed out about it - all it's gonna do is shorten my lifespan and the amount of time I'll have when I get out. CT scanner down for "terminal cleaning" again? The third night in a row? Or are the techs just taking a nap? Whatever. So I'm draining a Bartholin's cyst down in the ER and there are no Word catheters in the hospital? Sigh, why am I not surprised? Fine, give me a pediatric foley and I'll improvise (yes, this did happen). Give things a couple more years and you'll have orthopedists putting femurs back together with duct tape and baling wire, and cardiologists treating MIs with half a bottle of aspirin and a couple sparking wires that they just ripped from the lamp above the bed. It's gonna get hectic, and they're going to keep cutting the budget to see just how far things can go before they utterly collapse.

So things are screwed up in the military. The civilian medical world isn't in great shape either. The match sucks this year, but there are worse things in life besides being locked into a job that pays $55,000 a year during your 20s. (Repeat serenity prayer here)

if you can serve your time as a doc active duty military stress free; wow, that (and you) would be awesome. My concern however might be that in order to do that you are either 1) Dr Phils brother or 2) do not give a crap about anything or 3) almost comatose.

And just saying things are "screwed up" really dillutes reality. The details are what is needed. As a military physician, I was not asking to get off early to meet my afternoon tee time, or I need a new leather sofa in the doctors lounge (which doesn't exist). No, there were very BASIC things WRONG, things wrong that DO NOT happen in the civilian world probably ever. Yes, civilian medicine has its challenges, but military medicine is in a league of it's own (unless perhaps you invite 3rd world countries to play). I copied just a few things I have never,and likely never will see as a civilian FP:

1) soldiers/pts going 20 years without ever having their high blood pressure treated.(20+ years of appts, 39 for 39 abn high BPs in chart) noted as I did the guys sep physical.
2) increases in patient panel sizes from 700 up to 3000+
3) no charts available when you see patients.
4) 31 yo man status post stroke; meds refilled for 2-3 years without ever being seen. Last BP in his chart 248/148!
5) patients having their PCM (family doc) changed 5 times in one year
6) admin techs shredding and burning labs results rather than filing them
7) 20 foot high stack of results/papers waiting to be filed. A year later, still waiting.
8) Novice PAs unsupervised

So, I hope things are changed for the better by the time the current med students hit the front lines. And if it does change, it will probably be because somebody OUTSIDE the chain of COMMAND with some authority finally got a whiff of todays military medicine aroma.

 

[former military]

As a doctor you are going to get the worst health care. In the AF we have a PHA- which is a yearl "exam" to see if you are fit to fight. The exam, in my case, consisted of an airman handing me a pen to fill out a questionnaire, review of systems, and weighing me. I can't remember if they took my blood pressure. It really pissed me off originally that I never saw a doctor and that I was supposed to be a valuable commodity. The reality of it was the AF was making sure they could deploy me not if I was healthy. You need to be your own health care advocate. They should likely give all the physicians all a paxil rx with about 120 refills when they step foot in the hospital because it is stressful especially if you care. When you are undermanned in the clinic and taking call every night or every other night it is difficult to go to the mandatory 3x per week workouts. You don't sleep right, eat right, or exercise right and you can turn into the hamster running on the military medicine wheel. I survived a surgical residency "back in the days" before the 80 hr work week and actually found it more stressful as a staff. So hopefully you can keep it in perspective but it is very difficult sometimes.

 

[MedicalCorpse]

inappropriate

This gets my vote for the most overused word in today's military.

"Dr. Jones inappropriately tried to make a PG-13 joke among adults."

"Dr. Jones inappropriately documented on the patient's record true problems with the care the system was providing."

"Dr. Jones inappropriately spoke with a surgeon equal in rank to him regarding Dr. Jones' concerns re: patient safety."

"Dr. E. inappropriately refused to kill a patient, despite being urged (and nearly ordered) to do so by functionaries without a clinical clue."

"Dr. E. inappropriately screamed for blood using naughty words when a patient was bleeding to death, given that the OR nurse, who had assured him the blood was in the refrigerator, had lied."

"Dr. P. inappropriately insisted on placing an a-line in a 2 year old after induction prior to nephrectomy, against the wishes of the arrogant pediatric surgeon, who insisted that he would lose no blood during the case."

"Inappropriate" is a chilling word that smacks of two things: fascism and puritanism. Only the State (or your Commander) can determine what is "appropriate"; e.g., I was reprimanded for inappropriately charting true things that made the hospital look bad, and which opened up "risk management" concerns for the hospital. "Inappropriate" is a subjective standard which masquerades as objective reality. I almost never hear this word in the civilian world; I heard it nearly every day in the military.

Thus, I must take exception to the use of "inappropriate" in this context; a better term would be "in poor taste" (no pun intended).

--
Rob
Non hijackerus threadus sum

 

[former military]

My favorite tricks and Comments to anesthesia
1)Why are/aren't you putting an A-line/central line in my patient?
2)You are just cancelling my case so that when I re-list it somebody else has to do his anesthesia and assume the risk aren't you?
3)Why is it that the person preop'ing the patients anesthesia the same as the person doing the case?- or, put another way.... "was the preop two weeks in advance not enough time to identify the need for(echo, or stress thallium or pulmonary consult)?
4) When you guys get out of the military you won't have as much Anesthesia F around time
5) This case will take less than an hour
6) This case will take less than 5 minutes... why don't you mask them?
7) Are you an anesthesiologist or a CRNA?
8) I like you anesthesiologists better than the CRNAs ...you are better
9) I like you CRNAs better than the ologists... you are more practical
10) You have to go to the desert again?
11) Why don't you guys practice your spinals on the Optho cases
12) That EEG numeric display number says he isn't asleep enough ..that is why he is moving
13) That EEG numeric display says you can extubate him now
14) That patient is screaming extubate me damn it... Is that criterion to pull his tube.. the twenty second head shake?
15) You can convert my type and screen to type and cross if you want to waste the blood I guess...
16) On your way to the random urine check drink a couple of lattes... it helps with the stage fright....
17) Why is your boss a nurse? Why is my boss a nurse, (or pharmacist, physical therapist, respiratory therapist, ekg technician, etc.)?
18) Please don't lose the patient's airway and kill him.. I don't want to have another all day Saturday "safety day" to attend. - I don't want to make AF times!
19) Do you start tough IVs for the ward nurses?
20) Transfer the patient to the bed? Don't we have orderlies that do that?
21) Why do you call it your OR when it is really my OR?
22) You are not going to write me up for eating beef jerky at the scrub sinks again
23) This bloody pile of lap sponges doesn't count against blood loss... just look in the sucker pail for the real amount.
24) Deploy again? Why don't you just get/stay pregnant?
25) Deploy again? (males) Why don't you just get (asthma/kidney stones/nut pain/orthopedic malady of the day/plantar fasciitis/epilepsy/chronic fatigue syndrom/fibromyalgia)?
26) Do you sass the surgeons at your moonlighting job like you do here?

Seriously, military anesthesiologists do a great job and were one of the bright spots of operating in the military. thank you

 

[R-Me-Doc]

I hear this so much that I am starting to believe it, until I see how much time physicians, most of whom I assume (we know what assumptions do) are now in civilian practice (which I hear takes up more of your life than the slackers on active duty complain about), take to post thier unlimited knowlege on a STUDENT forum.
. . .
Personally, I'd rather spend time with my family or other such activities that people who make such outrageous sums of money as former military physicians make can afford. I still however have to kill time under the guise of studying, and can only dream of having enough time to trash my former jobs on a silly forum.
. . .
If not, stop screwing with us and get a life! Saving the world from all of the incompetent beaurocrats and untrained physicians to whom you are clearly superior is a much more noble cause than keeping people out of the military and/or telling those of us who are locked in how bad our lives will get.

Thanks.

So, does Doc Jones seem to have an axe or two to grind? Yes

Does he have a few Axis 2 and maybe Axis 1 diagnoses (OCD? narcissistic?) Probably 😱

Does he appear to have way too much time on his hands? Uh huh. 😀

Was he probably generally viewed as a malcontent, squeaky wheel troublemaker at his various assignments? Undoubtedly. 😡

Is he being a pain in the a$$ by metastasizing himself and his book ads into every single thread on this forum? Definitely. 😴

BUT, I can also tell you, having spent my time in the Army, that in his own dramatics, over-the-top and self-aggrandizing way, HE IS TELLING YOU HOW IT REALLY IS!!!!

I have many of my own examples of absolutely everything he mentions: poor equipment, inadequate staffing, time-wasting trainings, nonclinical or minimally competent clinical "leaders" dictating policy to physicians, etc, etc, etc.

If you choose to ignore or discount what he is saying, so be it, but you do so at your own risk. Asking someone to go away and not make their opinion known because it just isn't what you want to hear is, um, gee, more or less how we got involved in this whole Iraq deal, but that's obviously a whole different thread . . .

As for his posting on a "student" forum, well, if your only source of knowledge regarding military medicine is going to be other 2nd year med students, I think that pretty much speaks for itself.

Pay very close attention to the negative posts on this board . . . they all contain far more than just a grain of truth. Of course, you will ultimately make your own decision, and allow me to be the first to say that I will respect whatever it is; we're just giving you info to allow an informed decision.

X-RMD

 

[Galo]

As I begin my second year as a medical student, I keep hearing the same addage: "Enjoy the time you have now, because you'll never have time again." Sure enough, everyone says the second year is harder than first (true so far), and the third harder than the second, internship than fourth year, residency...ad nauseum.

I hear this so much that I am starting to believe it, until I see how much time physicians, most of whom I assume (we know what assumptions do) are now in civilian practice (which I hear takes up more of your life than the slackers on active duty complain about), take to post thier unlimited knowlege on a STUDENT forum.

So...really....is it that bad? I know I'm putting off the stuff I should be doing when I come here to figure out how bad I really screwed up by committing myself to military medicine, but I can't imagine that real live attending physicians manage to squeeze it in, let alone post on almost all of the current forums...daily...and have time to write books, etc. on top of all of the stress that SDN brings!!!!! AMAZING!!!!!!

Personally, I'd rather spend time with my family or other such activities that people who make such outrageous sums of money as former military physicians make can afford. I still however have to kill time under the guise of studying, and can only dream of having enough time to trash my former jobs on a silly forum.

So, if I will eventually have enough time someday, thanks for keeping the dream alive. Your time is my entertainment.

If not, stop screwing with us and get a life! Saving the world from all of the incompetent beaurocrats and untrained physicians to whom you are clearly superior is a much more noble cause than keeping people out of the military and/or telling those of us who are locked in how bad our lives will get.

Thanks.

Once again, the all knowing medical student with prior military service telling us old fuddy duddies we should be spending our money and enjoying our free time while military medicine is being slaughtered along with the most deserving patiets we know.

As it is a free country, if you do not like what we have to say, screw off, and go become as good a doctor as you can be, so that when you get into what's left of the military system you can think back on how much of assh**(e you were to be contradicting something you had not yet experienced fully enough to understand it. Or, you may think nothing is wrong, in which case you will be a physician who does not care about medicine, and thus a military officer first and foremost.

What none of you med students, who defend military medicine with little to no background of being a doc, get is responsibility. You will never understand what that means until you actually have some, and people are impeding your ability to exercise it. In time, you will learn. Unfortunately you will be in a system so screwed up, that hopefully you become frustrated enough to do something, anything. Till then, get off the forum, and go read your books.

See, in between cases I can write a responce, go pee, get a drink, and laugh in amazement at the gall you have to put up such a crap thread.

But the answer is, you will find the time to do the things that are important to you. 10-30 minutes a day trying to educate people from not making the mistakes we made, is time well spent for me.

 

[mac61]

Once again, the all knowing medical student with prior military service telling us old fuddy duddies we should be spending our money and enjoying our free time while military medicine is being slaughtered along with the most deserving patiets we know.

As it is a free country, if you do not like what we have to say, screw off, and go become as good a doctor as you can be, so that when you get into what's left of the military system you can think back on how much of assh**(e you were to be contradicting something you had not yet experienced fully enough to understand it. Or, you may think nothing is wrong, in which case you will be a physician who does not care about medicine, and thus a military officer first and foremost.

What none of you med students, who defend military medicine with little to no background of being a doc, get is responsibility. You will never understand what that means until you actually have some, and people are impeding your ability to exercise it. In time, you will learn. Unfortunately you will be in a system so screwed up, that hopefully you become frustrated enough to do something, anything. Till then, get off the forum, and go read your books.

See, in between cases I can write a responce, go pee, get a drink, and laugh in amazement at the gall you have to put up such a crap thread.

But the answer is, you will find the time to do the things that are important to you. 10-30 minutes a day trying to educate people from not making the mistakes we made, is time well spent for me.

Thanks for the candid response.

For the record: I have never blindly defended military medicine, or implied undying support for the system that most of the senior docs in this forum are educating us about. I do not pretend to know more than anyone on this forum, nor do I pretend to know what I have gotten myself into. I am the struggling med student with 3 kids hoping to survive and pick up some knowlege on the way, which I am barely doing. Someday I hope I will help more than I harm, which seems a bit daunting at this moment.

I do find your cause a noble one, however the "metastatic" nature of your message has turned this thread into a near useless forum for those of us who are locked into the system.

This thread was initiated with a pointed satirical message, which was probably a little childish and "inappropriate", however the message was not entirely in jest.

We medical students are no doubt inundated with how "things will be" and most of the outlook is grey at best; a situation that is amplified in military medicine. A glimpse of hope that our lives will have some resemblance of normal life (burning time on "vital" forums) outside of the 100 hours of thankless work performed in a broken system that will consume our very being, not to include deployments, SGTs time, PT, inspections, EDREs, etc. is a welcome idea.

In the mean time I will continue to learn from the words of experience in stead of Robbin's Pathophysiology, because I am a chronic master of time management. I only hope that I can waste my time reading a thread on bad OER bullets and actually read bad OER bullets instead of how much the military is broken.

My sincere apologies to those whom I have offended, particularly Dr. Jones, who I must say responded much more eloquently than I expected (and I definitely laugh at his site/book on more than one occassion).

 

[MedicalCorpse]

Does he have a few Axis 2 and maybe Axis 1 diagnoses (OCD? narcissistic?) Probably 😱

You're just jealous because the voices in my head don't speak to you. 😛

Now, excuse me, I have to go check to see if all of my doors are locked and
the gas burners are off...

--
R

 

[R-Me-Doc]

You're just jealous because the voices in my head don't speak to you. 😛


--
R

As long as the voices in your head aren't speaking ABOUT me, I think I am safe.

Keep up the voice crying in the wilderness thing . . . eventually maybe the powers that be will catch on . . .

X-RMD

 

[concernedspouse]

Seriously. Aren't we all in this together? Military medicine is broken, but so is civilian medicine. I've experienced more than I would like to of both. The grass is always greener... we have friends right now who are currently in a life threatening situation due to the negligence and laziness of non-military doctors. I've experienced top hospitals in our country, small military clinics and small suburban hospitals. All have impressed me at times and frightened me at others. It all comes down to people and systems. It depends on the particulars of each circumstance and I truly hope that ALL adminstrators and doctor's continue to see their particular need for improvement.

In my opinion, ALL OF YOU need to get back to treating the patient and studying more. It certainly would make me rest easier to know that MY doctors were putting their energy into fixing situations rather than just venting about them. You are entitled, of course...but, perhaps there are more contstructive means of discussion than clever insults, attacks and puns???

I won't bother you any more. But, to my spouse: Get Back To Work sweetie. They aren't worth your time. Your patients and family (now and in the future) are.

 

[former military]

I guess the same could have been said about women's rights and civil rights reform advocates. "Shut up and work hard, stop complaining... everything will be as it should".

 

[chopper]

Seriously. Aren't we all in this together? Military medicine is broken, but so is civilian medicine. .

Seriously. Treat a sprained ankle and chest pain the same. Aren't they both just sicknesses?

By trying to 'normalize' problems to be the same thing, you oversimplify a complex problem.

 

[USAFdoc]

Seriously. Aren't we all in this together?

Yes, we are.

Military medicine is broken

Yes, it is

but so is civilian medicine.

Not nearly as broken as the military.

I've experienced more than I would like to of both. The grass is always greener... we have friends right now who are currently in a life threatening situation due to the negligence and laziness of non-military doctors. I've experienced top hospitals in our country, small military clinics and small suburban hospitals. All have impressed me at times and frightened me at others. It all comes down to people and systems.

Yes, and the "military system" is broken at best, reckless at worst.

It depends on the particulars of each circumstance and I truly hope that ALL adminstrators and doctor's continue to see their particular need for improvement.

In my opinion, ALL OF YOU need to get back to treating the patient and studying more.

I spend plenty of time studying and treating patients, and now as a civilian physician, have some authority to ensure that happens in a timely manner and with excellence.

It certainly would make me rest easier to know that MY doctors were putting their energy into fixing situations rather than just venting about them. You are entitled, of course...but, perhaps there are more contstructive means of discussion than clever insults, attacks and puns???

I won't bother you any more. But, to my spouse: Get Back To Work sweetie. They aren't worth your time.

Nice to know that you think that I am not worth your time, still, I think my fellow officers still doing thier best in a broken military system and the troops and families they serve ARE worth my time. If that is this forum, or my presentations to congress, or publications, or suggestions routed through my chain of command; I will continue to speak out against what is a poor healthcare system. You may get back to "sweetie" and go ahead and berate physicians you do not even know and ignore military healthcare problems you have very limited first hand knowledge about

.

 

[MedicalCorpse]

Seriously. In my opinion, ALL OF YOU need to get back to treating the patient and studying more. It certainly would make me rest easier to know that MY doctors were putting their energy into fixing situations rather than just venting about them.

"Harcourt!

Harcourt Fenton Mudd!

(sniff)

Have you been drinking again?

You lazy, stinking, good for nothing..."

"Stella, shut UP!"

..."thing...thing...thing..."

--STTOS, "I Mudd"
http://en.wikipedia.org/wiki/I,_Mudd

Re: her hubby...

Mr. T. says:

"I pity the fool!"

--
R

Calling a 20 yard penalty and 1st down for
internet nagging of non-husbands above
and beyond the call of spousehood.

 

[7by11thenout]

My favorite tricks and Comments to anesthesia
1)Why are/aren't you putting an A-line/central line in my patient?
2)You are just cancelling my case so that when I re-list it somebody else has to do his anesthesia and assume the risk aren't you?
3)Why is it that the person preop'ing the patients anesthesia the same as the person doing the case?- or, put another way.... "was the preop two weeks in advance not enough time to identify the need for(echo, or stress thallium or pulmonary consult)?
4) When you guys get out of the military you won't have as much Anesthesia F around time
5) This case will take less than an hour
6) This case will take less than 5 minutes... why don't you mask them?
7) Are you an anesthesiologist or a CRNA?
8) I like you anesthesiologists better than the CRNAs ...you are better
9) I like you CRNAs better than the ologists... you are more practical
10) You have to go to the desert again?
11) Why don't you guys practice your spinals on the Optho cases
12) That EEG numeric display number says he isn't asleep enough ..that is why he is moving
13) That EEG numeric display says you can extubate him now
14) That patient is screaming extubate me damn it... Is that criterion to pull his tube.. the twenty second head shake?
15) You can convert my type and screen to type and cross if you want to waste the blood I guess...
16) On your way to the random urine check drink a couple of lattes... it helps with the stage fright....
17) Why is your boss a nurse? Why is my boss a nurse, (or pharmacist, physical therapist, respiratory therapist, ekg technician, etc.)?
18) Please don't lose the patient's airway and kill him.. I don't want to have another all day Saturday "safety day" to attend. - I don't want to make AF times!
19) Do you start tough IVs for the ward nurses?
20) Transfer the patient to the bed? Don't we have orderlies that do that?
21) Why do you call it your OR when it is really my OR?
22) You are not going to write me up for eating beef jerky at the scrub sinks again
23) This bloody pile of lap sponges doesn't count against blood loss... just look in the sucker pail for the real amount.
24) Deploy again? Why don't you just get/stay pregnant?
25) Deploy again? (males) Why don't you just get (asthma/kidney stones/nut pain/orthopedic malady of the day/plantar fasciitis/epilepsy/chronic fatigue syndrom/fibromyalgia)?
26) Do you sass the surgeons at your moonlighting job like you do here?

Seriously, military anesthesiologists do a great job and were one of the bright spots of operating in the military. thank you

We loved you too, that is why we always tried to put epidurals in your prostatectomies since you loved that soo much 🙂 That is why we did spinals to cause urinary retention so you would be stuck sending your patients home with a foley and seeing them later for a fill - and - pull... See I did remember something from my internship urology rotation. I had a great senior resident - I think you know him well.

We do miss you your replacement is well.., just ask your former urologist if your haven't already talked with him...

 

[former military]

I have to like anyone fatter, dumber, and uglier than I am... but I can always lose weight, get smarter and improve my looks... he has to stay that way....

 

[MeganRose]

I've recently gotten a taste of how the military works - travel vouchers that take three submissions to correct because they came pre-printed wrong, being shorted on active duty pay, told to fly back for an interview on my own dime after being on a rotation for a month because they only have scheduled certain interview days (wish they'd told me this when I scheduled my ADT - could have easily pushed it back a week)...I've only been on a month and every day I see half a dozen things that are so dumb that they could only happen in government work.
(Repeat serenity prayer here)

I;m a 4th yr, AFHPSP and I've been on active duty since 14AUG06 and just realized that I'm not getting paid at an AD rate. Even more annoying is the fact that I tried to call DFAS today and they were closed. Silly me, I forgot that every holiday somehow gets extended into a four day weekend with "training days" Got love the military...

 

[MedicalCorpse]

I;m a 4th yr, AFHPSP and I've been on active duty since 14AUG06 and just realized that I'm not getting paid at an AD rate. Even more annoying is the fact that I tried to call DFAS today and they were closed. Silly me, I forgot that every holiday somehow gets extended into a four day weekend with "training days" Got love the military...

A Visual Guide to Service Before Self:

http://www.medicalcorpse.com/minimum.jpg

http://www.medicalcorpse.com/customerservice.jpg

http://www.medicalcorpse.com/gallery/comp down.jpg

http://www.medicalcorpse.com/gallery/security forces laziness.jpg

http://www.medicalcorpse.com/gallery/tuition ass.jpg

http://www.medicalcorpse.com/gallery/mpf self b4 service.jpg

Get used to the second Air Force Core Value...Self Before Service, because we're minimum manned due to Sheer Poor Planning at HQ USAF, so, instead of working 12-18 hour days like the docs at the hospital are forced to do, we'll just turn out the lights (literally!) at Finance at Andrews after 12 noon, and only allow non-scheduled walk-ins between 1000-1100 on Tuesdays.

Never forget the third Core Value, which devolves from the first and Second: Mediocrity In All We Do.

You should remember the first Air Force Core Value from my site:

http://www.medicalcorpse.com/shutup.html

--
Rob
http://www.medicalcorpse.com

 

[former military]

I thought one of the core values was... "what ever i need to do to retire comes before job description and above and beyond the call of duty"

 

[MedicalCorpse]

I thought one of the core values was... "what ever i need to do to retire comes before job description and above and beyond the call of duty"

Zackly.

Oh, you were expecting a more long-winded philippic from me.

O.K.

The very physicians who should be standing up and speaking out to fix military medicine are the ones who are neutered and spayed by their feckless fear of jeopardizing their precious military retirements. The senior LtCols and Cols in public positions of power (Specialty Consultants, Residency Directors, Squadron Commanders, and SG/HQ Staff) possess bully pulpits from which they could, if they weren't pusillanimous pukes, purvey puissant PowerPoint presentations promoting pressing preparations to prevent premature putrefaction of patient protection personnel, policies, and protocols. Instead, they sit on their Outlook inbox-enhanced @sses, and coast their way to retirement by following the First and Only Prime Directive of Military Officers: If you value your career, shut up, don't make waves, and allow people (patients, soldiers, whatever) to die due to improper planning, preparation, and prioritization which YOU could have accomplished, if and only if you had thanatotically desired to commit career self-immolation.

There, now wasn't that more satisfying, in a V for Vendetta sort of way, than a mere duosyllabic "Zackly"?

--
Rob
http://www.medicalcorpse.com