Military Medicine: Fire. Aim. Ready.

[narcusprince]

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Is the assumption that all Navy orthopedic docs are a part of and responsible for this? I was never in the Navy nor was I an Ortho doc, but I don’t know militaryphys from anyone else on the forum. Maybe I’m the one being naive but it seems inappropriate to make serious assumptions about his character based on his specialty and service. Maybe you know him personally?

I don’t know him personally. But I do know the community of docs. I know the lifer types in the community. And they buddy covered many many more things then just this incident. Again I can only make my assumption based on common demographics and behaviors.

 

[militaryPHYS]

Yeah, not sure how to respond to that.

I went from agreeing and high fiving @HighPriest for his leashes metaphor because that few paragraphs is the perfect description of how life in MilMed can go.

Then it seemed like @narcusprince is trying to get me cancelled with loosely directed false accusations.

More leash metaphors would be great.

 

[narcusprince]

I stated my story due in part to truly disturbing behavior. I hope your one or the good ones who would report behavior like this and prioritize patient safety. Their were some very good orthopedic surgeons this incidence of gross negligence that lead to harm really turned my stomach on accountability. Again militaryphys I don’t know who you are.

 

[militaryPHYS]

I think we can all say we’ve seen lack of accountability, failure to meet best practice recommendations and even down right bad decisions that could lead to patient harm. But that is in and out of military practice and cross specialty.

But applying loose generalizations to move the needle on here doesn’t land well.

I don’t feel a strong need to respond directly. I will say that I am fully engaged with the surgical quality/safety community to help guide improvement both in and out of the military as there is a strong relationship with the ACS. For people who see a problem and want to help impact change there are always avenues of attack out there.

 

[narcusprince]

Military Phys generalizations are the basis for discrimination. As someone who has seen the rolling lists of IG complaints those that are minorities and females bear the brunt of the punishments where good ole boys get slaps on wrists and promotions. I can not encourage minorities or for that fact females to join the Navy. I cannot speak for the other branches. I would say let the good ole boys drive the ships.

 

[militaryPHYS]

Military Phys generalizations are the basis for discrimination. As someone who has seen the rolling lists of IG complaints those that are minorities and females bear the brunt of the punishments where good ole boys get slaps on wrists and promotions. I can not encourage minorities or for that fact females to join the Navy. I cannot speak for the other branches. I would say let the good ole boys drive the ships.

So it is bad to generalize for minority groups but OK to generalize for the majority groups? Not sure that makes sense but Ok.

I enlisted over 20 years ago. I agree that the tribalism existed and still persists to an extent but the overall movement has been in a positive direction, thanks to people like @Res Rehab

My current triad consists of 2 women and 1 minority. Not a single “good ole boy” as you describe them.

The voice of every person in the military today is louder and has more impact than ever before. Still room to grow? Sure, but we are moving in the right direction. Not sure I would ever advocate for limiting opportunity for minority groups, underserved populations, or any other community that is otherwise well informed and interested in joining. Preying on them via recruiters is horrendous and I’m sure still happening but that’s not what we do here. Nobody is recruiting, just informing. We are providing our own current experiences and information to those who seek it…or at least that’s what I do.

 

[MedicalCorpse]

I am not a mod. I have no power here in this forum.

As the Original Poster, however, I would humbly ask that people please attack the real enemy we face: a military medical system that endangers our troops, their families, and our honored retirees, and not each other.

I am not criticizing or calling out anyone. I am just asking for civility.

I know I am not perfect, and have not always practiced this virtue I am preaching. For that, I am sorry. My only explanation (not excuse) is that I am still angry after all of these years that the problems I clearly identified and wrote about in 2006 after leaving the military have not only not been fixed, they have, for the most part, gotten worse.

Please let us channel this anger and frustration into productive actions and words to improve the status quo, for the benefit of our nation and the world.

So mote it be.

Thanks.

 

[narcusprince]

Corpse, one thing is very clear the problems we all faced are different. The problems currently are very different then the static problems of my time. The issues you faced in the Air Force were very different from my issues with military medicine. I hope for one Militaryphys is one of the change agents and says in the twilight of his career I have been lucky who can I make this environment better for. I have never served with a more intelligent group of doctors then my time in the Navy especially my last 3 years. The major problems I saw in my practice were sociopathic individuals whom had never been sufficiently challenged and redirected and unfortunately these sociopaths fit a certain demographic. I would always say to myself if I did half the things these individuals did I would be in handcuffs. Thats my mindset justice was not equal penalties for minorities were far greater then their counterparts.

 

[MedicalCorpse]

The major problems I saw in my practice were sociopathic individuals whom had never been sufficiently challenged and redirected and unfortunately these sociopaths fit a certain demographic. I would always say to myself if I did half the things these individuals did I would be in handcuffs. Thats my mindset justice was not equal penalties for minorities were far greater then their counterparts.

Narcus, my friend and fellow anesthesiologist, I cannot comment on that, given my own melanin-challenged ancestry.

However, as I have said here for years, everyone in the military, and especially military "medicine", is a potential victim of weaponized tribalism and cronyism, enforced by the legacy Uniform Code of Military Justice (UCMJ), regardless of your genetics.

I believe you and ResRehab 100% that non-white people are routinely prejudiced against.

Harvard refused even to give my Chinese-American son an interview when he was applying for college, despite his amazing grades at an elite public STEM school, excellent test scores, extra-curricular activities, and legacy status (from me), because Harvard (as the lawsuit stated) discriminates against Asian-Americans as part of its "subjective rating", which objectively scores Asians at the bottom, leading to their disproportionate rejections, regardless of qualifications. I am glad he ended up attending and graduating summa cum laude from a far better school that provided my young scholar a much warmer, more supportive and nurturing environment than I ever experienced in the cold, harsh, sink-or-swim environment of Cambridge from 1981-1985.

I guess I am trying to say that just being European-American with diplomas from an Ivy League college, USU, and a military residency are NOT sufficient to shield you from unjust, evil reprisals for just doing your job by, as you put it, the sociopaths that are routinely chosen to be leaders in the U.S. military as a result of both their complete inability to function in the civilian world and their continued possession of a body temp above room temperature.

I will defer to you, ResRehab, and others to document how much WORSE it can be for those who are minorities in uniform, because I was clearly a "majority" victim who was still unable to escape the trash bin that many (perhaps not all, MilitaryPhys) competent and ethical physicians are unceremoniously tossed into by this corrupt system to this day.

PS Of course, our experiences as anesthesiologist outcasts cannot even be imagined by those who are seen by command and themselves as the Golden Children of milmed...more on that theme shortly...

 

[narcusprince]

Narcus, my friend and fellow anesthesiologist, I cannot comment on that, given my own melanin-challenged ancestry.

However, as I have said here for years, everyone in the military, and especially military "medicine", is a potential victim of weaponized tribalism and cronyism, enforced by the legacy Uniform Code of Military Justice (UCMJ), regardless of your genetics.

I believe you and ResRehab 100% that non-white people are routinely prejudiced against.

Harvard refused even to give my Chinese-American son an interview when he was applying for college, despite his amazing grades at an elite public STEM school, excellent test scores, extra-curricular activities, and legacy status (from me), because Harvard (as the lawsuit stated) discriminates against Asian-Americans as part of its "subjective rating", which objectively scores Asians at the bottom, leading to their disproportionate rejections, regardless of qualifications. I am glad he ended up attending and graduating summa cum laude from a far better school that provided my young scholar a much warmer, more supportive and nurturing environment than I ever experienced in the cold, harsh, sink-or-swim environment of Cambridge from 1981-1985.

I guess I am trying to say that just being European-American with diplomas from an Ivy League college, USU, and a military residency are NOT sufficient to shield you from unjust, evil reprisals for just doing your job by, as you put it, the sociopaths that are routinely chosen to be leaders in the U.S. military as a result of both their complete inability to function in the civilian world and their continued possession of a body temp above room temperature.

I will defer to you, ResRehab, and others to document how much WORSE it can be for those who are minorities in uniform, because I was clearly a "majority" victim who was still unable to escape the trash bin that many (perhaps not all, MilitaryPhys) competent and ethical physicians are unceremoniously tossed into by this corrupt system to this day.

PS Of course, our experiences as anesthesiologist outcasts cannot even be imagined by those who are seen by command and themselves as the Golden Children of milmed...more on that theme shortly...

I will say this. The anesthesiologist in my final department I felt was the best example of diversity. Sure it was not perfect but we had Ivy League, Military trained, civilian trained docs of all races and colors and genders. Our community at Large had a lot of diversity.

 

[militaryPHYS]

I would humbly ask that people please attack the real enemy we face: a military medical system that endangers our troops, their families, and our honored retirees

This is false. This contributor's experiences are real and, as presented in his other posts, are his described examples of horrendous leadership, lack of character and downright criminal behavior that he experienced during the early 2000's as an anesthesiologist in the Air Force. Even though we cannot currently verify, we should take him at his word and heed his warnings based off of his experience. However, they are not generalizable to the entire current Milmed system. The current Milmed has evolved, plus-sized, down-sized, right-sized over the last 20 years to a system which is far from perfect but continues to add checks and balances to hold people accountable and strive for improvement in medical care, equity/inclusion amongst other things. But that is just my experience currently serving in the Navy.

Whether or not Milmed is the right choice (in my opinion) has little to do with these accusations and more to do with one's willingness to serve regardless of them being a physician or not, their acceptance of a complete lack of autonomy in practice and future living location, plus the risk of military deployments at anytime and to anywhere whether you agree with the conflict or not.

Although...few are probably still reading this thread and probably best that we move on

 

[armytrainingsir]

Yeah, the Navy is sooooo racist. 😗

Navy, Marines May Reinstate Promotion Board Photos After Removal Impacted Diversity

The Navy and Marine Corps could reinstate service photos in promotion and selection boards after the removal of photos adversely impacted diversity goals — the opposite of the Defense Department’s intent when it barred the use of photos in promotion boards last year. In July 2020, then-Defense...

coffeeordie.com

 

[MedicalCorpse]

I hope (you're) not the one who thought it was more appropriate to get your teeth cleaned while you had a patient on the table…..

I am not a mod. (I) have no power here in this forum.

As the Original Poster, however, I would humbly ask that people please attack the real enemy we face: a military medical system that endangers our troops, their families, and our honored retirees, and not each other.

I am not criticizing or calling out anyone. I am just asking for civility...

This is false. This contributor's experiences are real and, as presented in his other posts, are his described examples of horrendous leadership, lack of character and downright criminal behavior that he experienced during the early 2000's as an anesthesiologist in the Air Force. Even though we cannot currently verify, we should take him at his word and heed his warnings based off of his experience.

Dude, I was standing up to defend you from what seemed to be a personal accusation questioning your honor and character.

Where did you get from the words that I wrote that I was belittling anyone's experiences in military medicine?

It's as if I said, "Grass is green." and you responded, "Stop demeaning my opinion about which car is best, heretic!"

It is a known fact that bizarre and hateful things, including racism, tribalism, unjust reprimands, sexual assault, and other vile actions regularly occur in a system (the entire U.S. military) which only punishes and holds accountable those who aren't the Chosen Ones of the inbred hierarchy. Nothing I wrote in my post said otherwise.

During my anesthesiology residency at Wilford Hall, one of our staff pediatric surgeons constantly lorded himself over everyone he met as if he were a deity incarnate, because he considered himself to be superior to all of us as a member of an "elite" group of surgeons in the Air Force. One night, he stopped performing major abdominal surgery on a child and took all his residents and medical students into the break room so they could enjoy the dinner that he had ordered.

I have never seen a person as red as my chief resident (Hi, Mary!) was when I came in to relieve her that evening. She was outraged that she was forced to monitor the vital signs of a young man with his belly cut open without any surgery being performed on him. We let our attending know about this ongoing travesty, and he did go in to talk to the surgeon, but it was all just laughed off, because anesthesiologists are at the bottom of the Great Chain of Being (Scala Naturae) in the military, below even minerals. The surgery team finished eating before returning to the O.R.

I never heard one word that hinted that he was ever punished for this by the Air Force.

Sadly, that level of arrogance and hubris (and, dare I say, karma) led to his death and that of his children when the private plane he was piloting flew into a Texas thunderstorm and crashed.

In any case, getting back to your astoundingly inappropriate response to me ("This is false."), if we (all of us) cannot understand each other, how can we continue a civil discourse in this forum? If you don't understand the words that are coming out of my mind, please ask me for clarification in the future before firing off a proverbial broadside in the wrong direction with the wrong shot. Thanks in advance.

PS You may be proud of your checks and balances and the current accountability status in the Navy, but look in the mirror, dude. You are a Golden Child who is needed by the Navy far more than you need the Navy, given that your earning power is 5X greater in the civilian world (at least). Most of all, you haven't been in long enough for your clinical skills to decay and rot like all the O-6 "providers" you see wandering around outside the operating room thinking about their next e-mail. This leads to my next thread, already in process...

 

[militaryPHYS]

Attacking MilMed as an “enemy” isn’t the purpose of the forum that @SDN created.

We are very open about the negative side of MilMed. Many on here highlight those. Very few discuss some of the positives. Regardless, purpose is to provide information to each other and prospective MilMeds to make a well informed decision.

 

[MedicalCorpse]

Attacking MilMed as an “enemy” isn’t the purpose of the forum that @SDN created.

We are very open about the negative side of MilMed. Many on here highlight those. Very few discuss some of the positives. Regardless, purpose is to provide information to each other and prospective MilMeds to make a well informed decision.

What you think you mean by "MilMed" is not the same as what I said, now is it?

Quick quiz: what is the subject of the following: "A military medical system that endangers our troops."

Hint: it's neither "military" nor "medical".

This isn't Reed-Kellogg, but here we go:

Subject: System
--Adjective: military
--Adjective: medical
Verb: Endangers
Direct Object: Troops
--Adjective: our

The system I grew up in from 1981 to about 1998 (at Travis; earlier or later elsewhere), wherein physicians were in charge, and funding and staffing were adequate to accomplish our mission, was murdered in cold blood by the military leadership across all branches under what was called the Objective Medical Group in the Air Force, and similar initiatives in all services.

Between outsourcing garrison care to civilian insurance companies (Tri-To-Get-Care); bulldozing major medical centers across the country; downsizing the remaining Military Treatment Facilities (MTF) to the point of mission failure; putting non-physicians in command of doctors; failure to train and retain enough military physicians to avoid needing to hire civilian contractors at double or triple the cost; and intentionally replacing anesthesiologists with independently-practicing CRNAs, family physicians with PAs and NPs, etc.; the SYSTEM of providing quality, timely, local, and free MEDICAL care to our troops and their families by experienced physicians has been shattered. The two decades since I left have seen the dissolution of military medicine qua medicine, in favor of "health care by cheaper and less educated people when you can even get an appointment at the MTF at all", with the coup de grâce being the ripping of military health care from the military services to the civilian-run, underfunded, bureaucratic abomination which is DHA.

“The Matrix is a system, Neo. That system is our enemy. But when you're inside, you look around, what do you see? Businessmen, teachers, lawyers, carpenters. The very minds of the people we are trying to save. But until we do, these people are still a part of that system and that makes them our enemy. You have to understand, most of these people are not ready to be unplugged. And many of them are so inured, so hopelessly dependent on the system, that they will fight to protect it."

Morpheus, The Matrix

I would never consider the U.S. military an enemy. I am a loyal, patriotic, disabled American veteran who remains proud of the service I gave to my country for so many years.

It's the system that needs to be reformed, revitalized, and reborn through the leadership of medical students and physicians who will stand up and say, "This is not working. This is now how physicians should treat patients. This is not how physicians should be treated: subject to reprimands by non-doctor commanders with far less education and knowledge. We need to fix this while we still can, before we fall off the tightrope we are walking into the next big war without a functional medical safety net for our troops."

I understand that you seem to be "inured" by your status as a godlike orthopedic surgeon bestride the globe of military health care like a reverse Atlas. You can't foresee being replaced by mid-level providers with half of your knowledge and skill.

The first time you have an orthopedic PA refuse to listen to your clinical instructions, you will begin to understand what military anesthesiologists have been going through for the past quarter century.

It is inevitable that you remain "hopelessly dependent on the system" while on active duty. One small example: if you ever said anything negative about your commanders online and they found out, you would be in deep trouble under the UCMJ.

I suffered the same legal restrictions on my freedom of speech while in uniform. Now that I have left, my mind and voice are free, as everyone here has witnessed (for better or worse) since 2006.

I appreciate your perspective, MilPhys, as a physician still serving our country on active duty. I hope that you realize that, in my own way, I am trying to serve our great nation by speaking out for a return to military medicine led by military physicians instead of whatever you wish to call the agonally-breathing System today, which in no way, shape or form is actually "Military Medicine" at all, now is it?

Yes, it will take money, years, hard work, and more money, but, as a retired USAF brigadier general wrote to me:

"First class medical care is not cost effective..You get exactly what you pay for..
Freedom is also not cost effective
Try living without it..."

Moving forward, let us all strive to continue to provide quality information to prospective medical students regarding what experiences they can truthfully expect as a military physician in 2024 and beyond: the good, the bad, and the just plain ugly.

Peace.

 

[Baron S]

Attacking MilMed as an “enemy” isn’t the purpose of the forum that @SDN created.

We are very open about the negative side of MilMed. Many on here highlight those. Very few discuss some of the positives. Regardless, purpose is to provide information to each other and prospective MilMeds to make a well informed decision.

Is the "both sides" argument a good one when the vast majority of docs have a really, really bad time and a few have a decent or good time?

 

[Gastrapathy]

If we are trying to destroy military medicine faster than it is destroying itself then for what purpose? To right a wrong done to us?

[edited to remove "you" as the question was more for the group]

So you agree that military medicine is destroying itself? The answer to your question is that saving milmed shouldn't be anyone's purpose. This is a student centered site and they are the focus. The young naive students with a desire to serve their country, fear of debt and a false belief that military medicine is acceptable are the audience. We aren't saving military medicine, we're saving them. I would encourage any future prospective student to read all of @militaryPHYS's posts from that perspective. Pay attention to the ones that object to the complaints on the basis of the fact that people should have known better. In today's world, I wholeheartedly agree. If you read this, you're on SDN and you have been informed of the truth. If you wish it away because you don't want it to be true, thats on you. Once you sign up, serve honorably and don't duck your turn to deploy.

 

[militaryPHYS]

Nobody said anything about saving it. We don’t have to. It will always be here because it serves a very specific purpose that nobody cares about until we are in the next conflict. An all reserve force will never happen.

[edited to remove anything about me for your and my benefit]

 

[orbitsurgMD]

Nobody said anything about saving it. We don’t have to. It will always be here because it serves a very specific purpose that nobody cares about until we are in the next conflict. An all reserve force will never happen.

[edited to remove anything about me for your and my benefit]

I beg to differ. An all-reserve force is nearly what all our major allies have. Medical care is basic primary care and the rest gets referred to the civilian government-supported sector. You would not exist there as a Navy personnel asset, and neither would your hospital.

 

[militaryPHYS]

I beg to differ. An all-reserve force is nearly what all our major allies have. Medical care is basic primary care and the rest gets referred to the civilian government-supported sector. You would not exist there as a Navy personnel asset, and neither would your hospital.

This is simply false and has become a poorly understood yet often deployed concept here on SDN.

Military Medicine Worldwide

It all comes down to size and power. The ratio of active to reserve medical assets is determined by the size of their force and the size of the military medical system (which is also based on size and worldwide operational demand). Our largest closest ally (France) has about 270k active duty. The US has about 1.3 mil active duty.

Even though our largest closest ally has 20% of the size of our military, they too have 2 military teaching hospitals and 4 other military hospitals. They even opened a military medical school in 2011. Guess how many foreign military bases they have with military hospitals that other allies utilize during peace and wartime engagements?

As you mentioned, what they do well is balance the active vs. reserve medical force and even more importantly the coordination of military/civilian partnerships of their home military hospitals. That doesn't mean that they are all reservists. The found the balance...or at least have a better balance than we do.

This is what drives me bananas because the reason DHA was created was to do this exact thing: FIND THE RIGHT BALANCE. Right size, standardize, become more efficient as a joint military medical force to provide/maintain high quality care at home during peacetime with the right mix of active/reserve forces to maintain our global requirements. We are slowly moving in the direction you all keep advocating for. A larger reserve force, more civilian partnerships, higher volume and more complex care for those physicians who are active duty and in peacetime holding pattern. But we will never be all reserve. There is no way based on our size and global demand to maintain foreign assets for our use and allied country use. So let's focus on ways that we can move further towards the right balance rather than just simply saying we need to be all reserve.

 

[militaryPHYS]

Retired French Military Orthopedic Surgeons’ Opinions on Their Careers

ABSTRACTIntroduction. Owing to their professional and personal experiences, retired military orthopedic surgeons’ views of their careers are a unique sourc

academic.oup.com

Active duty French orthopedic surgeons. Let me know if the data and responses in this paper sound familiar.

 

[afteranesthesia]

This is simply false and has become a poorly understood yet often deployed concept here on SDN.

Military Medicine Worldwide

It all comes down to size and power. The ratio of active to reserve medical assets is determined by the size of their force and the size of the military medical system (which is also based on size and worldwide operational demand). Our largest closest ally (France) has about 270k active duty. The US has about 1.3 mil active duty.

Even though our largest closest ally has 20% of the size of our military, they too have 2 military teaching hospitals and 4 other military hospitals. They even opened a military medical school in 2011. Guess how many foreign military bases they have with military hospitals that other allies utilize during peace and wartime engagements?

As you mentioned, what they do well is balance the active vs. reserve medical force and even more importantly the coordination of military/civilian partnerships of their home military hospitals. That doesn't mean that they are all reservists. The found the balance...or at least have a better balance than we do.

This is what drives me bananas because the reason DHA was created was to do this exact thing: FIND THE RIGHT BALANCE. Right size, standardize, become more efficient as a joint military medical force to provide/maintain high quality care at home during peacetime with the right mix of active/reserve forces to maintain our global requirements. We are slowly moving in the direction you all keep advocating for. A larger reserve force, more civilian partnerships, higher volume and more complex care for those physicians who are active duty and in peacetime holding pattern. But we will never be all reserve. There is no way based on our size and global demand to maintain foreign assets for our use and allied country use. So let's focus on ways that we can move further towards the right balance rather than just simply saying we need to be all reserve.

Wow...you have drunk the Koolaid so hard, dude. Did you just defend DHA? Can't take anything else you say seriously, then.

 

[militaryPHYS]

Wow...you have drunk the Koolaid so hard, dude. Did you just defend DHA? Can't take anything else you say seriously, then.

If your private hospital is taken over by a health system and not everyone leaves, those that stay are wrong to work within the new system they are faced with?

DHA can’t be escaped if one is to serve in military medicine. It is part of the equation now so we all need to understand how to manage/solve problems with DHA involved.

 

[DOswag]

If your private hospital is taken over by a health system and not everyone leaves, those that stay are wrong to work within the new system they are faced with?

DHA can’t be escaped if one is to serve in military medicine. It is part of the equation now so we all need to understand how to manage/solve problems with DHA involved.

You must just be an eternal optimist military PHYS. DHA when I was still in was making everyone's lives miserable with the only hope being, get out as soon as you can because DHA is just now getting started... Glad I separated a year ago and am on the other side where, if someone like DHA takes over a company, I can go wherever I want to get away from that garbage. This is a negative to the milmed but again, you remaining positive during this is impressive.

 

[militaryPHYS]

Not having much of a choice also helps. My wife could have left 2 years ago. I have no plans to leave when payback done. Probably back overseas after these orders. Current 5 year plan is to stay to 20 (24.75 if I get there) but who knows what will happen between now and then.

Glad you are enjoying life after the transition. Keep us posted on how things are going.

 

[afteranesthesia]

If your private hospital is taken over by a health system and not everyone leaves, those that stay are wrong to work within the new system they are faced with?

DHA can’t be escaped if one is to serve in military medicine. It is part of the equation now so we all need to understand how to manage/solve problems with DHA involved.

I'm so glad I left the military. I can't be around your type. It's mentally exhausting, and I require a higher dose of my SNRI to function.

 

[afteranesthesia]

Not having much of a choice also helps. My wife could have left 2 years ago. I have no plans to leave when payback done. Probably back overseas after these orders. Current 5 year plan is to stay to 20 (24.75 if I get there) but who knows what will happen between now and then.

Glad you are enjoying life after the transition. Keep us posted on how things are going.

You're an orthopod? Why on earth do you stay in when you could make so much more $$$$ on the outside PLUS have control of your schedule, life, where you live? And not work for an organization that operates like DHA? I truly don't understand. Literally, read your "disclaimer" on your posts. Guess what - I don't have to put that. I don't have to care or worry about Uncle Sam anymore. It's liberating. Freeing. I can take any job I want. Quit any job I want. Move anywhere in the country. In the world. Why stay imprisoned for 3-4 X less money too? It's mind-befuddling to me.

 

[militaryPHYS]

You're an orthopod? Why on earth do you stay in when you could make so much more $$$$ on the outside PLUS have control of your schedule, life, where you live? And not work for an organization that operates like DHA? I truly don't understand. Literally, read your "disclaimer" on your posts. Guess what - I don't have to put that. I don't have to care or worry about Uncle Sam anymore. It's liberating. Freeing. I can take any job I want. Quit any job I want. Move anywhere in the country. In the world. Why stay imprisoned for 3-4 X less money too? It's mind-befuddling to me.

Incredible that two people can be so different yet both necessary in this world. I am glad that you found a happier place that you enjoy.

 

[afteranesthesia]

Still waiting for your answer on why you want to make less money, be told where to live and work under DHA when the military absolutely doesn't value you at all? Truly always wondered this about the lifers....why. And WHY?

 

[militaryPHYS]

Wife and I combined already make more than enough for our family’s lifestyle. We’ve been “told” to live in DC, Virginia, Japan, San Diego. Will likely request Europe next for another overseas adventure.

I currently do feel valued..at least enough. I feel valued in other areas of my life and those areas matter much more. But I have also found purpose in certain priorities that the Military values so easier to negotiate for what we want and also helps me feel valued for it…but that could change quickly.

Does that answer your question?

 

[Baron S]

It doesn't matter what DHA does so long as the culture of milmed is that docs are doing MA work and support staff cap you at 8 patients/day and lose their minds or file a union complaint if you try to add one on.

 

[afteranesthesia]

Wife and I combined already make more than enough for our family’s lifestyle. We’ve been “told” to live in DC, Virginia, Japan, San Diego. Will likely request Europe next for another overseas adventure.

I currently do feel valued..at least enough. I feel valued in other areas of my life and those areas matter much more. But I have also found purpose in certain priorities that the Military values so easier to negotiate for what we want and also helps me feel valued for it…but that could change quickly.

Does that answer your question?

You could work less, have more autonomy and not be told to live anywhere (even places you like) outside the military, but some people like the structure I guess and the much reduced pay etc. I am subspecialized and literally had to work all of my leave days in order to keep up my subspecialty. I take it that isn't your problem. It didn't work for me, and I didn't like where I lived. My command was constantly taking away ODE, and that greatly affected my morale and mental health, because it jeopardized my longterm ability to provide for my family practicing something I spent a lot of time becoming an expert in and have another board certification in. We are not the same, but I guess I'm glad SOMEONE is happy in the military. People like you are few and far between. And I think it's really important people consider this before they sign the dotted line. You have NO IDEA what sort of doctor or life you might have a zillion years after you sign that contract.

 

[DOswag]

You could work less, have more autonomy and not be told to live anywhere (even places you like) outside the military, but some people like the structure I guess and the much reduced pay etc. I am subspecialized and literally had to work all of my leave days in order to keep up my subspecialty. I take it that isn't your problem. It didn't work for me, and I didn't like where I lived. My command was constantly taking away ODE, and that greatly affected my morale and mental health, because it jeopardized my longterm ability to provide for my family practicing something I spent a lot of time becoming an expert in and have another board certification in. We are not the same, but I guess I'm glad SOMEONE is happy in the military. People like you are few and far between. And I think it's really important people consider this before they sign the dotted line. You have NO IDEA what sort of doctor or life you might have a zillion years after you sign that contract.

That's a big one, beyond the atrocities of milmed, that is so hard to comprehend when you're premed looking at HPSP or other options and incredibly hard to convey to youngsters when you're on the other side of it. So much changes in your life in med school, residency, as well as changes in medical fields/specialties, changes in the global political climate, that occur during this time while you still owe X number of years to the military after you complete your training.