Military Docs are leaving!

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BomberDoc said:
Sorry, Ed. So after such shoddy treatment, are you planning on staying in past your commitment?
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You must have forgotten some of my earlier posts. There's no way I will stay in. If they offered me $1,000,000 for an extra year, I'd get out. I'd reimburse the army for every penny it spent on me ($200,000?) and work without pay just to get out 1 year earlier.

The deployment? It was to be expected and I'm only marginally upset about it. I just want to get control of my life (and give it to my wife where it belongs!).

Please forgive my rant; baseball season just started and my wife sent me Bobble-Head Man, but he was injured in the mail. He has a fractured mandible and mastoid -- I don't know if he's going to make it.

Ed
 
edmadison said:
You must have forgotten some of my earlier posts. There's no way I will stay in. If they offered me $1,000,000 for an extra year, I'd get out. I'd reimburse the army for every penny it spent on me ($200,000?) and work without pay just to get out 1 year earlier.

Ed
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Go Army!

counting the days.......
 
Founder said:
What are everyone's opinions on civilian doctors who contract with the military? I get the impression from posts that many military doctors would consider those civilians "poor" or "inadequate" where they look to the military as a last resort. Is this accurate?
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Not in my experience ... and most of us hear the same conjecture put forth regarding active duty physicians. "Why would any doctor with a bit of talent want to work for the military?" If one buys everything one reads on this forum, one might get the impression that everyone even tangentially associated with military medicine is "poor" or "inadequate" ... which is clearly not the case.

Our civilian contractors aren't FMGs speaking broken English, incompetently stumbling from one sentinel event to another. On the whole (recognizing the bounds of my limited experience and perspective) our contractors seem to be as capable as any physicians I've encountered at outside rotations. Their positions are not jobs of last resort. I'm not familiar with the details of their contracts, but I get the feeling that most are quite happy with the no-weekend no-call lifestyle, the relatively slower pace compared to churn & burn private practice, and their salaries - which seem to be reasonably competitive for the area and the hours.

One of the criticisms of military GME is the relatively junior high turnover staff. Contractors who stick around year after year, and who don't deploy, are beneficial to a residency. I'm told the RRC views them favorably. As a resident, I'm never disappointed to find myself assigned to work with one.

sethco said:
I buy into the theory that when they finally stop meeting 100% of the available HPSP participants, the effects won't be felt until 4 years later, when everybody is getting out of med school
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I think we're all watching, with great interest, to see how the heavily GMO-dependent Navy handles the last couple years of HPSP shortfalls and continued poor retention. The GMO pipeline is a couple years away from being half-empty.
 
PGG: That is good to hear. Personally it seemed like a bunch of mixed messages being presented here.

From the "I'm the best physician in da world!" posts it seems like anyone in military medicine (who doesn't hate military medicine and perpetually regrets HPSP/USUHS) is either a sucker, too crappy to get a job on the outside, or there due to nepotism and power tripping.
 
Founder said:
PGG: That is good to hear. Personally it seemed like a bunch of mixed messages being presented here.

From the "I'm the best physician in da world!" posts it seems like anyone in military medicine (who doesn't hate military medicine and perpetually regrets HPSP/USUHS) is either a sucker, too crappy to get a job on the outside, or there due to nepotism and power tripping.
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Not necessarily, but there is a lot of truth to something I heard here for the first time recently. Military docs are either:

1) In training
2) In payback or
3) Incompetent.

I know of only a few exceptions.
 
ActiveDutyMD said:
Not necessarily, but there is a lot of truth to something I heard here for the first time recently. Military docs are either:

1) In training
2) In payback or
3) Incompetent.

I know of only a few exceptions.
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Those are the only three I've ever known. The third type is usually management. The other two are just counting down the days until they can get out.
 
BomberDoc said:
Those are the only three I've ever known. The third type is usually management. The other two are just counting down the days until they can get out.
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I certainly can't comment about your experiences, but I can tell you that at least until recently, there were many decent army pediatricians that did not meet those three criteria. I imagine that this is because military pediatricians make as much or even more than civilians and may have better hours. On the other hand, I do wonder every time I see a senior dermatologist, radiologist or orthopod what's wrong with them.....

Ed
 
Not in my experience ... and most of us hear the same conjecture put forth regarding active duty physicians. "Why would any doctor with a bit of talent want to work for the military?" If one buys everything one reads on this forum, one might get the impression that everyone even tangentially associated with military medicine is "poor" or "inadequate" ... which is clearly not the case.

Our civilian contractors aren't FMGs speaking broken English, incompetently stumbling from one sentinel event to another. On the whole (recognizing the bounds of my limited experience and perspective) our contractors seem to be as capable as any physicians I've encountered at outside rotations.
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I wish that my experience with contract help were so rosy. I think that the quality of the contractors depends heavily on the funding and competence of the contract agency, and in many cases both are poor, attracting bottom-of-the-barrel types.

In two instances, military facilities that I have been associated with have hired surgical subspecialists who were (I know this sounds made up, but it's not) LEGALLY BLIND. In one case a sky-high mortality rate was the tip-off, and in the other, someone noticed that his wife was driving him to work every day because he could not qualify for a driver's license. I have personally had to repair life-threatening damage inflicted on patients by contract ED staff who were subsequently fired for gross malpractice. Granted, this is all anecdotal, but the anecdotes go on...and on...and on.

The best contractors, in my opinion, tend to be younger docs who have just left the military and want a stable income for a relatively short period while transitioning to private practice. My other observation is that the Army funds its contracts very well, almost to the point where it's a scam, while the Air Force tries to nickel-and-dime the contractors and they get what they pay for.
 
ActiveDutyMD said:
Not necessarily, but there is a lot of truth to something I heard here for the first time recently. Military docs are either:

1) In training
2) In payback or
3) Incompetent.

I know of only a few exceptions.
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Your observation of incompetency of senior active duty physician based on??

Prior to joining the military medicine I question the both competency and motives of senior military physicians. We tend to judge that competent doctors are motivated by pure economics.

While I am not planning to serve beyond my obligation I have been impressed by dedication and competency of my senior physicians thus far.
 
haujun said:
Your observation of incompetency of senior active duty physician based on??

Prior to joining the military medicine I question the both competency and motives of senior military physicians. We tend to judge that competent doctors are motivated by pure economics.

While I am not planning to serve beyond my obligation I have been impressed by dedication and competency of my senior physicians thus far.
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My experience with incompetent senior military physicians was first hand, and I have documented it before on this forum.

I remember earlier you were a fervent defender of military medicine, but now you are saying that you will not stay beyond your commitment. Could you explain why the change of heart?? What have you seen or experienced as a resident, (a much more potentially comforting experience than being the attending in charge), that makes you say you will get out as soon as you can?

Thanks
 
Galo said:
My experience with incompetent senior military physicians was first hand, and I have documented it before on this forum.

I remember earlier you were a fervent defender of military medicine, but now you are saying that you will not stay beyond your commitment. Could you explain why the change of heart?? What have you seen or experienced as a resident, (a much more potentially comforting experience than being the attending in charge), that makes you say you will get out as soon as you can?

Thanks
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I know your experiences along with others who left the service going on 3 years? (USAF DOC, MiltaryMD etc...) and it was my intention to obtain more current experieces from CURRENT military active duty physicians.

I never wrote on my previous posts that I will stay beyond obligations.

However I did write in my earlier posts that many military physicians enjoyed their tour and left the service to obtain the civilian jobs (more stable without deployments, moving etc). This so called negative aspect (if you call it) has nothing to do with military medicine, but this aspect is a part of general sacrifice that is expected from any soldier.

I will continue to write my experiences when I become attending in few months and when I leave I hope to continue to do so to encourage future medical students to take advantage of HPSP.
 
What is wrong with fullfilling your obligation and getting out to do other things?

Do you assume that people only get out because they hated their time in the service?
 
elderjack21 said:
What is wrong with fullfilling your obligation and getting out to do other things?

Do you assume that people only get out because they hated their time in the service?
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Well said. This is a classic problem with the cheerleaders out there. Once you join, they think you MUST stay for a career. To do anything less than 20 years is treason. That kind of thinking is pure bulls#it. People age and mature. Situations and circumstances change. Relationships and families happen. Priorities shift. This is natural. Sometimes it leads people who enjoy military service to look elsewhere. This holier-than-thou "I'm more of a patriot because I'm staying in and you're not" crap is ridiculous.
 
haujun said:
I know your experiences along with others who left the service going on 3 years? (USAF DOC, MiltaryMD etc...) and it was my intention to obtain more current experieces from CURRENT military active duty physicians.

I never wrote on my previous posts that I will stay beyond obligations.

However I did write in my earlier posts that many military physicians enjoyed their tour and left the service to obtain the civilian jobs (more stable without deployments, moving etc). This so called negative aspect (if you call it) has nothing to do with military medicine, but this aspect is a part of general sacrifice that is expected from any soldier.

I will continue to write my experiences when I become attending in few months and when I leave I hope to continue to do so to encourage future medical students to take advantage of HPSP.
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OK, fine, but that still does not answer my question.

Is it stability, not deploying, not moving?? All perfectly understable. You say that about other physicians who left, what about you specifically. What is it about it that you already know you'll be leaving?
 
BomberDoc said:
Well said. This is a classic problem with the cheerleaders out there. Once you join, they think you MUST stay for a career. To do anything less than 20 years is treason. That kind of thinking is pure bulls#it. People age and mature. Situations and circumstances change. Relationships and families happen. Priorities shift. This is natural. Sometimes it leads people who enjoy military service to look elsewhere. This holier-than-thou "I'm more of a patriot because I'm staying in and you're not" crap is ridiculous.
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This seems kind of like a mixed signal though. I want to get as much information as I can and get all points of view (as I don't know since I've never been exposed to milmed like many here for years and years as a doctor) but the constant negativity is basically the same thing, just opposite.

Sometimes it seems that unless you are getting out and pursuing a civilian career than the person staying in is staying because they re incompetent or lazy or power tripping.

While constant cheerleading serves no good purpose since nothing is perfect, doesn't constant negativity serve no purpose since milmed is not a totally negative experience?

To me and I am sure others reading who are confused as who to believe, both the constant cheerleaders but the constantly negative people seem to come off as arrogant "I am the best doctor in the world" type of people.
 
Tired said:
Who says this? I don't see many posts along these lines.
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Typically this kind of nonsense comes from senior officers who stupidly figure that since the military worked out well for them that it must work out for everybody. These are the people who get horribly offended when someone states that they are getting out. In my limited experience, they also go out of their way to punish those who are leaving. That is a pretty deeply ingrained way of thinking in the military. Give the s#itty job to the guy who is leaving because he is already a lost cause and pissing him off won't do any harm. This is why you should never tell anybody above you that you are just doing your payback and getting out ASAP.
 
Tired said:
Must be something you see operationally. Our attendings who get out (2 or 3 this year) get awards and parties.
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It could be a function of operational medicine. I've only been at one base and as such, have very little knowledge of what goes on in other places. As always, take me as just one data point... a very angry and disgruntled data point. Of course I didn't choose to go operational. I applied for AF residency a few times. The AF decided that 25-30% of us need to stay in these crappy GMO billets because nobody wants to do it. Actually now I'm glad that I didn't get selected for a military residency. The thought of spending another 8 years as a slave to this organization nauseates me. As William Wallace said while being disemboweled, "FREEDOM!"
 
BomberDoc said:
I've only been at one base and as such, have very little knowledge of what goes on in other places. As always, take me as just one data point... a very angry and disgruntled data point.
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This is the most accurate and honest post you have ever written.
 
haujun said:
I know your experiences along with others who left the service going on 3 years? (USAF DOC, MiltaryMD etc...) and it was my intention to obtain more current experieces from CURRENT military active duty physicians.

I never wrote on my previous posts that I will stay beyond obligations.

However I did write in my earlier posts that many military physicians enjoyed their tour and left the service to obtain the civilian jobs (more stable without deployments, moving etc). This so called negative aspect (if you call it) has nothing to do with military medicine, but this aspect is a part of general sacrifice that is expected from any soldier.

I will continue to write my experiences when I become attending in few months and when I leave I hope to continue to do so to encourage future medical students to take advantage of HPSP.
Click to expand...

Totally on target. There are definite upsides to service as a military doctor which counterbalance many of the negatives. Service implies some degree of personal sacrifice. I don't know anyone who has been negative or punative towards anyone getting out after their obligation is met.
 
a1qwerty55 said:
I don't know anyone who has been negative or punative towards anyone getting out after their obligation is met.
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I didn't see anyone punished, but there is a definite shift in the way you you are viewed/and or treated once you put in your papers to get out (at least on the non-medical side of the house).

It is more human nature than anything else though. Once someone has committed themselves to a career in their speciality, they have to believe that their choice was the best choice, otherwise they wouldn't have chosen it right? They just have to overcome the fact that what is best for them isn't always best for everyone else.

That said, I let everyone know I was getting out to attend medical school. Most of them thought that was an equally honorable thing to do.

Life changes, people get out for many reasons, most of them are good reasons. There are many who would go back in as well (maybe not as many who wouldn't go back in though 🙂

If you have served even for a short time in the military you have already served your country more than the vast majority of people out there, so good on you, even if you get out after your initial obligation.
 
a1qwerty55 said:
Totally on target. There are definite upsides to service as a military doctor which counterbalance many of the negatives. Service implies some degree of personal sacrifice. I don't know anyone who has been negative or punative towards anyone getting out after their obligation is met.
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Those who have dropped papers to get out will be treated differently. They should not be treated poorly, but with limited resourses, will a command send them to an expensive CME conference? No. They should get 30 days terminal leave if they have it on the books, they should get the standard 10 days house hunting, they should not be deployed for the last 3 months of their time on active duty.

elderjack21 said:
I didn't see anyone punished, but there is a definite shift in the way you you are viewed/and or treated once you put in your papers to get out (at least on the non-medical side of the house).

That said, I let everyone know I was getting out to attend medical school. Most of them thought that was an equally honorable thing to do.

Life changes, people get out for many reasons, most of them are good reasons. There are many who would go back in as well (maybe not as many who wouldn't go back in though 🙂

If you have served even for a short time in the military you have already served your country more than the vast majority of people out there, so good on you, even if you get out after your initial obligation.
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Most who take HPSP do not retire. I don't think it is reasonable to expect them to do so. As long as you payback your time, no one should look down upon your decision to get out.
 
NavyFP said:
Those who have dropped papers to get out will be treated differently. They should not be treated poorly, but with limited resourses, will a command send them to an expensive CME conference? No. They should get 30 days terminal leave if they have it on the books, they should get the standard 10 days house hunting, they should not be deployed for the last 3 months of their time on active duty.
Click to expand...

I didn't get punished per se when I got out to go to medical school, but I was told that despite being my reporting senior's number one LT I would not be getting the EP since the other guy who wasn't getting out "needed it more." When I explained that I would be back in via HPSP, my skipper said that "the medical corps doesn't care about non-medical corps FITREPS." 🙄

I don't know if an MP instead of an EP will make a difference, but I was fairly annoyed since I thought a FITREP was based on performance, not plans to stay in.
 
BlueIsis said:
I didn't get punished per se when I got out to go to medical school, but I was told that despite being my reporting senior's number one LT I would not be getting the EP since the other guy who wasn't getting out "needed it more." When I explained that I would be back in via HPSP, my skipper said that "the medical corps doesn't care about non-medical corps FITREPS." 🙄

I don't know if an MP instead of an EP will make a difference, but I was fairly annoyed since I thought a FITREP was based on performance, not plans to stay in.
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I have seen CDR's go both ways on this issue. Some will give the best rating to the guy who is getting ready to go in front of the promotion board, even if he/she isn't the best one they rate.

When I got out there will 12 other (0-3) captain's that the BC senior rated, he ranked me 1 of 12, even though it was my REFRAD evaluation and he knew there was a chance I wouldn't come back in. I was fine with a decent rating, but he chose to write me up a great one. I am near certain that my evals in a different branch will have no impact on my medical promotions (if I go back in). Plus...everyone gets promoted!

Now...for the army at least, it doesn't matter so much where you are ranked in respect to other LTs or CPTs since they have done away with the Senior Rater giving a set number of "top blocks" for the CPTs and LTs they rate. Once you are a MAJ it becomes more important to be "top blocked."
 
BlueIsis said:
I didn't get punished per se when I got out to go to medical school, but I was told that despite being my reporting senior's number one LT I would not be getting the EP since the other guy who wasn't getting out "needed it more." When I explained that I would be back in via HPSP, my skipper said that "the medical corps doesn't care about non-medical corps FITREPS." 🙄

I don't know if an MP instead of an EP will make a difference, but I was fairly annoyed since I thought a FITREP was based on performance, not plans to stay in.
Click to expand...

That is a regular occurance.
 
NavyFP said:
Most who take HPSP do not retire. I don't think it is reasonable to expect them to do so. As long as you payback your time, no one should look down upon your decision to get out.
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Actually, my clinic director (O-6) and three other senior medical officers at my command constantly congratulate me on my decision to separate. They all know that doing 20 years in the Medical Corps is just not a good deal anymore. I am so ready ot GTFO an finally start my residency...
 
Pretty good article in Esquire magazine this month.

After reading it, nobody on here really has anything to kvetch about.
 
alpha62 said:
http://www.esquire.com/features/things-that-carried-him

Very sobering. Reality check, put perspective on all our lives, egos, and ambitions.
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Lt. John R. Hudson, M.D. - A medical doctor who reluctantly went to a Navy scholarship to fund his last two years of medical school because he could not afford it anymore, was killed in the bombing. He had tried unsuccessfully to save SSgt. Soifert just days earlier.

JAMA does a column called "A Piece of My Mind" that had a letter from a woman that sounded almost like it could have been written by someone who was getting ready to divorce their spouse because they were never home.

then at the end you find out that LT Hudson was whom she was writing it about.
He was a USN physician killed in the Marine barracks bombing of 1983.

I still want out (of IRR)
 
another sobering publication. National Defense University Occasional Paper on Iraq.

We've all got to just stop feeding these clowns in charge with more manpower. Soldiers are the only ones with the power to stop this insanity.
 
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