Love-hate relationship

[IgD]

---

Members do not see this ad.

My relationship with military medicine is so confusing. I love the institution of the military and the people that make it up. There I times I feel really excited and pumped up like I'm making a difference. On the other hand there is a lot of instability, politics, lack of trust and autonomy/control. There are so many mixed messages. It's like an abusive relationship. Do you feel this way at all? I'm curious if you had any regrets about leaving.

 

[Galo]

My relationship with military medicine is so confusing. I love the institution of the military and the people that make it up. There I times I feel really excited and pumped up like I'm making a difference. On the other hand there is a lot of instability, politics, lack of trust and autonomy/control. There are so many mixed messages. It's like an abusive relationship. Do you feel this way at all? I'm curious if you had any regrets about leaving.

I'm really sorry to hear your description. Unfortunately I think it's how a majority of physicians feel. I wanted to be in the Air Force since I was a child. I loved the romantic idea of war, flying, etc. Even as an adult as I made the desicion to be a physician, I thought and felt it would be a great place to practice medicine. Unfortunately alot of the situations you describe seemed to overwhelm or dampen the satisfaction I got from taking care of very deserving people.

I also remember your unbridled enthusiasm at the prospect of being a miltiary physician. This severe letdown is one reason I continue to tell people my experience. Its good, (and bad), to see that as enthusiastic as you were (are), and as much as you seem to take it upon yourself to give the most excellent care you can, you still find sometimes insurmountable walls of BS that impede you doing your job the best you can.

Hand in there, and bide your time. Make the best of it, make associations with local places of excellence, keep good track of your medical record, stay under the radar, take care of patients.

Best of luck

 

[NavyFP]

My relationship with military medicine is so confusing. I love the institution of the military and the people that make it up. There I times I feel really excited and pumped up like I'm making a difference. On the other hand there is a lot of instability, politics, lack of trust and autonomy/control. There are so many mixed messages. It's like an abusive relationship. Do you feel this way at all? I'm curious if you had any regrets about leaving.

Your not alone. Even those of us who are pro-military recognize the system is not perfect. As with any large organization it has its issues. it is a balance between good days and bad. Are there more good than bad? Do you still believe in the mission? That is the key. If the answer is no, time to go. You have served your time and I salute you. If not, stay. The truism is that if you don't like the policy now.... Wait a bit, it will change.

 

[BomberDoc]

Love the military. Love the Air Force. Love the mission. Love flying. Love dropping bombs. Love killing bad guys. Love helping good guys.

HATE the medgroup politics. HAAAAAATE the nurses that think their silver oak leaves give them the right to overrule doctors. HATE the lies and doubletalk. HATE that admin and meetings are more important than patient care.

Despite the good things, the bad things massively outweigh and overshadow the good. Would not do it again knowing what I know now. Wish somebody had told me the truth so many years ago.

 

[350011]

That's another thing I've been wondering: to what extent can support staff (esp. nurses) throw their weight around when they out-rank you, despite their obvious lack of a medical license?

 

[orbitsurgMD]

That's another thing I've been wondering: to what extent can support staff (esp. nurses) throw their weight around when they out-rank you, despite their obvious lack of a medical license?

At its best, the nurse corps understands its role in mission support and makes best efforts to support doctors and others in patient care. When things run this way, NC can be a pleasure to work with.

At its worst, the nurse corps becomes a self-regarding and self-serving force within the patient care and administrative structure and devotes its energies to destructive agendas that undermine the mission and demoralize others who have jobs to do. Using superior rank to undermine professional status ("I am a major, captain (and doctor), and I disagree with your medical plan and won't do as you request") is only one of many behaviors that serve these ends.

I found both in my military experience. The rank structure can significantly enable and reinforce those nurses inclined toward negative and mission-inhibiting behaviors.

 

[73BARMYPgsp]

At its best, the nurse corps understands its role in mission support and makes best efforts to support doctors and others in patient care. When things run this way, NC can be a pleasure to work with.

At its worst, the nurse corps becomes a self-regarding and self-serving force within the patient care and administrative structure and devotes its energies to destructive agendas that undermine the mission and demoralize others who have jobs to do. Using superior rank to undermine professional status ("I am a major, captain (and doctor), and I disagree with your medical plan and won't do as you request") is only one of many behaviors that serve these ends.

I found both in my military experience. The rank structure can significantly enable and reinforce those nurses inclined toward negative and mission-inhibiting behaviors.

Why doesn't credential supercede rank? Like in a tactical situation when the person in the leadership "slot" may actually be a CPL with some SGT's in his squad. He is still in charge. This is a serious (not rhetorical) question, by the way. Can that kind of structure be implemented?

I am used to that kind of set up, coming from the enlisted side.

 

[DiveMD]

I am on the same boat guys. It is not the Navy what I dislike; it's the f-ing medical system and the people who run it. I cannot stand another second under the command of some nurse or MSC type a-hole. I am not expecting any special treatment for being a doctor; but have you ever seen a civilian institution in which doctors do not have assigned parking space/area? I have to compete every single morning with hundreds of corpsmen and civilians for a spot. And guess what? If I don't get there on time…THEY CAN'T START THE F-ING CLINICS!!!!

I WANT OUT NOW!!!!

 

[dry dre]

I am not expecting any special treatment for being a doctor; but have you ever seen a civilian institution in which doctors do not have assigned parking space/area? I have to compete every single morning with hundreds of corpsmen and civilians for a spot.

This is about the lamest complaint about milmed that I've ever heard. I mean please. Maybe you're having an exceptionally bad week?

 

[BomberDoc]

This is about the lamest complaint about milmed that I've ever heard. I mean please. Maybe you're having an exceptionally bad week?

It is the fact that something so simple that could be beneficial to physician morale is ignored. Previous commander at my medgroup used to canvass the patient parking lot for cars belonging to medical staff and she would give out LORs if you parked there. The staff lot, naturally, is farther away and too small to accommodate everybody that works there. This was brought up several times and was consistently shot down. Of course the commanders have reserved spaces right next to the building so its all good since their convenience is taken care of.

 

[The White Coat Investor]

It is the fact that something so simple that could be beneficial to physician morale is ignored. Previous commander at my medgroup used to canvass the patient parking lot for cars belonging to medical staff and she would give out LORs if you parked there. The staff lot, naturally, is farther away and too small to accommodate everybody that works there. This was brought up several times and was consistently shot down. Of course the commanders have reserved spaces right next to the building so its all good since their convenience is taken care of.

At least you had a staff lot. They asked us to park at the BX and walk over. A dedicated parking spot is nice, but I can live without that one if I could get a few other things, like paid on time or paid my full salary without having to sign on for more time (the last-year ISP gotcha) or an active duty nurse with more than 4 years of nursing experience who still does bedside nursing. (You're a captain now, here's your clipboard and welcome to the coven.)

 

[USAFdoc]

My relationship with military medicine is so confusing. I love the institution of the military and the people that make it up. There I times I feel really excited and pumped up like I'm making a difference. On the other hand there is a lot of instability, politics, lack of trust and autonomy/control. There are so many mixed messages. It's like an abusive relationship. Do you feel this way at all? I'm curious if you had any regrets about leaving.

do I miss it for the POSITIVE things you mentioned. YES
am I absolutely certain I did the right thing by me, by my family, and on the principle of the matter (if given the choice, don't volunteer to work for an organization that most of the time really could care less about good medicine and care of patients and staff as long as their IMAGE and METRICS are maintained).

NO REGRETS in leaving. MANY REGRETS in signing. Thank GOD that is behind me now.

 

[fetch]

My relationship with military medicine is so confusing. I love the institution of the military and the people that make it up. There I times I feel really excited and pumped up like I'm making a difference. On the other hand there is a lot of instability, politics, lack of trust and autonomy/control. There are so many mixed messages. It's like an abusive relationship. Do you feel this way at all? I'm curious if you had any regrets about leaving.

From what I'm learning here and experienced personally, I think any profession that demands autonomous thinking/behavior from its members to begin with has a confusing relationship with the military. Conflict seems like it should be expected. When I read instances of you all being placed in positions where what is inherently medically right/wrong is ignored/over-ruled by a non-MD, you have my empathy. I don't know what I would do if while in the military someone else tried to dictate how I practice. Probably be court-marshalled is what. Thankfully, while our Corps sets us up for many failures and frustrations, that super critical one is not amongst them.

One of the questions I ponder is how different are the instablity, politics, lack of trust, etceteras, really when compared to non-independent civilian practice? For us, there is actually little difference unless you are working autonomously as owner or partner; then you get to decide everything, down to one-ply or two-ply... But once you have an organization/company involved and their administrators - well, administrators are administrators the whole world round. I can cite numerous examples of colleagues in positions where company/organizational boards control/dictate hospital policy and past a certain point, it never ends happily. If your Corps doesn't slog all its own administrative tasks, someone has to, and it sounds like the decision was made to delegate it to the NC for good or bad.

Another that comes to mind may seem frivolous to you all since I am admittedly ignorant of the Medical Corps history but I can't help but wonder. Why are nurses even Officers to begin with? Why aren't they part of the Warrant Officer Corps? The definition fits even if it would screw with the USAF's current structure. Seems to me this would eliminate a lot of the structure and organization issues CO's/FO's are reporting. I mean no disrespect to nurses and lord knows I understand understaffing/shortages issues in today's military, but wouldn't it avoid them being able to usurp a freaking doctor's patient care decisions by the mere power of rank alone?

 

[PharmD2MD]

Another that comes to mind may seem frivolous to you all since I am admittedly ignorant of the Medical Corps history but I can't help but wonder. Why are nurses even Officers to begin with? Why aren't they part of the Warrant Officer Corps? The definition fits even if it would screw with the USAF's current structure. Seems to me this would eliminate a lot of the structure and organization issues CO's/FO's are reporting. I mean no disrespect to nurses and lord knows I understand understaffing/shortages issues in today's military, but wouldn't it avoid them being able to usurp a freaking doctor's patient care decisions by the mere power of rank alone?

Oh crap. Now you've done it. I don't think too many nurses frequent this corner of SDN, but they always seem to come out of the woodwork to invade and disrupt physician/med student forums when someone drops a bomb like this.

 

[PharmD2MD]

.

 

[FNU LNU]

Actually, I think this is a brilliant idea. When I was in the Marine Corps I had the privilege of working with a ton of CWOs. They were mostly good leaders and all technical experts in their field. They were given significant autonomy within their own area, but ulitmately reported to a regular officer. This solution would allow for nurses to be promoted without ever creating a situation where they outrank a doctor.

Not to totally hijack this thread, but I would love advise on how to assure good patient care when a higher-ranking nurse is refusing to follow your instructions. Thanks.

 

[IlDestriero]

.

 

[DiveMD]

It is the fact that something so simple that could be beneficial to physician morale is ignored. Previous commander at my medgroup used to canvass the patient parking lot for cars belonging to medical staff and she would give out LORs if you parked there. The staff lot, naturally, is farther away and too small to accommodate everybody that works there. This was brought up several times and was consistently shot down. Of course the commanders have reserved spaces right next to the building so its all good since their convenience is taken care of.

This is exactly my point. I am tired of watching all these administrators in my command walk in @ 0830 in civilian attire and sipping Starbucks after parking in their reserved spots located right in front of my office.

This is about the lamest complaint about milmed that I've ever heard. I mean please. Maybe you're having an exceptionally bad week?

Lame complaint? What about morale and common sense? Also, who is actually producing their precious RVU's?