Military Health Debate goes on?

[Galo]

I'll try again, here, and hopefully this thread does not get derailed by petty idiocy.

This is the last entry made by the moderator Dr. CASSCELLS, Assistant Secretary of Defence for Health Affairs:

I have been extremely impressed that so many of you have chosen to contribute to the Healthy Debate session on Recruitment and Retention. The professional pride in care being provided for our men and women in uniform and their families as I travel around the MHS, including in-theater, is reflected in all of your professional comments. It is more than obvious that you share in the goal to make our system better. I, too, am committed to making a difference in the MHS's efforts to energize and improve the tools at our disposal to let our providers know we appreciate their dedication. I will strive to put better "tools" in the toolbox that can be used for both recruitment and retention. As was noted by one of the participants, this debate session will not resolve the problems, but it has clearly focused on several major issues that need attention. Pay issues are self-evident, but when combined with issues such as support staff needs, increasing the efficiency of AHLTA, focusing on maintaining and developing skills, enabling the provider to continue with patient care despite promotions and personal encouragement to continue service after a commitment is over are all actionable items. Dr Steve Jones, my Principal Deputy and leader of our Managing Human Capital effort, is already starting to work them in earnest. I was heartened by the frequent recommendations that there should be more opportunity for physician input. I have directed our Health.mil Webmaster to continue the debate sessions as an ongoing forum. Please continue to use this forum so that we can all help each other. Dr. Jones will monitor it for ideas and synergies. Once again, I thank everyone who participated in this discussion on Recruitment and Retention. Together we will make a difference!


I guess, I'm much too jaded to have expected much else, and I know despite critical manning issues, the nature of the institution (Milmed) will never change enough to make all the ills we complain about go away completely. Likely based on the AF bandaid, they will throw money at it at first, but that is unlikely to work. Seems as they now want to make it a continual forum, but I doubt there will be much contribution to it.

And the saga rolls on.

A link for those who may be seeing this for the first time:

http://www.health.mil/Debates/Debate.aspx?ID=9&a=1

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[i want out]

I'll try again, here, and hopefully this thread does not get derailed by petty idiocy.

This is the last entry made by the moderator Dr. CASSCELLS, Assistant Secretary of Defence for Health Affairs:

I have been extremely impressed that so many of you have chosen to contribute to the Healthy Debate session on Recruitment and Retention. The professional pride in care being provided for our men and women in uniform and their families as I travel around the MHS, including in-theater, is reflected in all of your professional comments. It is more than obvious that you share in the goal to make our system better. I, too, am committed to making a difference in the MHS's efforts to energize and improve the tools at our disposal to let our providers know we appreciate their dedication. I will strive to put better "tools" in the toolbox that can be used for both recruitment and retention. As was noted by one of the participants, this debate session will not resolve the problems, but it has clearly focused on several major issues that need attention. Pay issues are self-evident, but when combined with issues such as support staff needs, increasing the efficiency of AHLTA, focusing on maintaining and developing skills, enabling the provider to continue with patient care despite promotions and personal encouragement to continue service after a commitment is over are all actionable items. Dr Steve Jones, my Principal Deputy and leader of our Managing Human Capital effort, is already starting to work them in earnest. I was heartened by the frequent recommendations that there should be more opportunity for physician input. I have directed our Health.mil Webmaster to continue the debate sessions as an ongoing forum. Please continue to use this forum so that we can all help each other. Dr. Jones will monitor it for ideas and synergies. Once again, I thank everyone who participated in this discussion on Recruitment and Retention. Together we will make a difference!


I guess, I'm much too jaded to have expected much else, and I know despite critical manning issues, the nature of the institution (Milmed) will never change enough to make all the ills we complain about go away completely. Likely based on the AF bandaid, they will throw money at it at first, but that is unlikely to work. Seems as they now want to make it a continual forum, but I doubt there will be much contribution to it.

And the saga rolls on.

A link for those who may be seeing this for the first time:

http://www.health.mil/Debates/Debate.aspx?ID=9&a=1

this is just DC doublespeak to get people to contribute, and once some of the contributors come out the closet, they will task them with fixing it without ever giving them enough tools to fix anything... and the cycle will continue.

i want out (of IRR)

 

[MilHealth]

Hi!

I am a consultant to Military Health and have been reading your threads.

I was wondering if there was one specific area you could change, what would it be? I know a lot of good seems to be happening in the mental health realm with new study partnerships with NIMH surrounding suicide and PTSD.

Doctors in training and any military health professional are vital to the services. Thank you for all that you do.

 

[dwb8p]

oh god...

 

[BigNavyPedsGuy]

Hi!

I am a consultant to Military Health and have been reading your threads.

I was wondering if there was one specific area you could change, what would it be? I know a lot of good seems to be happening in the mental health realm with new study partnerships with NIMH surrounding suicide and PTSD.

Doctors in training and any military health professional are vital to the services. Thank you for all that you do.

Please forgive our sarcasm. It's hard to know on an internet forum if your a prankster, a troll, someone is legitimately concerned and can help, a recruiter, or someone who's trying to get folks in trouble.

All that being said, most of the threads talk about some general themes of primary care clinicians being overworked/overused and subspecialists not being able to see the volume to keep up their skills.

If I had to pick one thing, that can actually change, I would say start using CPRS, teh VA computer system, for the entire military. That would directly impact the lives of almost every military physician, except those that are operational.

 

[Perrotfish]

I'm still a student, and I'm sure this isn't the biggest thing that needs to change in military medicine, but it's the biggest thing I have experience with: spouses and children of HPSP students should be covered under Tricare (or some other form of health insurance). I just find it really embarassing to see comissioned officers struggling to dig up the cash for their families' basic health care needs. It seems particularly ungrateful when those officers have years of prior service.

 

[IgD]

I know a lot of good seems to be happening in the mental health realm with new study partnerships with NIMH surrounding suicide and PTSD.

I was curious how did you arrive at that conclusion? Do you have any first hand experience in uniform?

 

[Galo]

Hi!

I am a consultant to Military Health and have been reading your threads.

I was wondering if there was one specific area you could change, what would it be? I know a lot of good seems to be happening in the mental health realm with new study partnerships with NIMH surrounding suicide and PTSD.

Doctors in training and any military health professional are vital to the services. Thank you for all that you do.

I too would want to know what your experience is in the military health system. I think a quick read of the MHS survey can give you a pretty good idea of the MANY things that need to be changed.

 

[IgD]

Doctors in training and any military health professional are vital to the services. Thank you for all that you do.

One time I had to go to an officer's call with the Chief of Naval Operations, Admiral Mullen. He gave a speech about how much he hated Navy medicine. He said that it cost him more and more money every year. He said that "pretty soon we will have a medical corps and no Navy". Then he went on to say he'd rather buy bombs and guns and went on to blame retirees for post-retirement medical care expenses.

I almost rolled out of my seat when I heard that!!!

 

[Perrotfish]

One time I had to go to an officer's call with the Chief of Naval Operations, Admiral Mullen. He gave a speech about how much he hated Navy medicine. He said that it cost him more and more money every year. He said that "pretty soon we will have a medical corps and no Navy". Then he went on to say he'd rather buy bombs and guns and went on to blame retirees for post-retirement medical care expenses.

I almost rolled out of my seat when I heard that!!!

I actually sort of agree. I personally think that the VA should have vastly expanded powers and budget to handle 100% of retirement and injury medical benifits, as well as pensions. It's unreasonable to ask the inividual branches of service to set their budgets trying to take potential injuries/retirements into account. I mean I guess retirements you can plan for, but wartime injuries? Our current system basically means every injured Sailor/Marine cuts the Navy's budget and reduces support to healthy servicemen in the field. This, I think, gives the military services too much of an incentive to deny veterans a sufficient disability rating on the basis that the veteran isn't really hurt. This is especially true in the area of mental health, where lasting injuries are so easy to deny.

I remember seeing a report in the washington post that, a few years back, the Army had taken this to it's logical extreme: denying a sufficient diability rating for health care benefits to 95% of applicants being discharged on medical grounds. This is as opposed to 70% in the Navy and Air Force. Something is wrong when a significant number of your veterans are told they aren't hurt enough for medical benifits of a pension, walk across the street to the VA, and are told they are clearly 100% disabled.

Just a medical student's thoughts.

 

[BigNavyPedsGuy]

I actually sort of agree. I personally think that the VA should have vastly expanded powers and budget to handle 100% of retirement and injury medical benifits, as well as pensions. It's unreasonable to ask the inividual branches of service to set their budgets trying to take potential injuries/retirements into account.

What about GME? IM, every surgical specialty needs geriatric exposure. It's where you find your pathology. Just like they couldn't get rid of peds, they can't dump retirees.

 

[notdeadyet]

What about GME? IM, every surgical specialty needs geriatric exposure. It's where you find your pathology. Just like they couldn't get rid of peds, they can't dump retirees.

Agreed. If the vast majority of your patient-base is going to be active duty, you are really going to get a rotten education. You really need the retirees and medically separated if you're ever planning on practicing medicine in the civilian sector.