Some questions/concerns . . .
1. Straight through training and discontinuation of GMO tours
Sounds like this isn't going to happen, entirely. The number of GMO tours may get reduced (especially the # of "unsupervised" ones), but they're probably not going away completely. GMOs are a unique facet of milmed, and if people have great heartache about them, then they probably shouldn't join. Hopefully the quality and professional experiences of the GMO jobs will increase (cool things like humanitarian missions, real wartime trauma experiences, etc etc).
2. Bonuses paid by the month instead of annually (no raise just simplified pay system)
sounds reasonable enough. also, i'd advocate a significant increase in bonus's and specialty pays, to help bring milmed salaries more on par with the civi world.
3. 360 degree evaluation for promotion: 1) traditional political/subjective evaluation 2) patient evaluation 3) peer/subordinate evaluation
There are parts of the Navy (at least) that have implemented these '360' evaluations. However, the senior rater is still your boss, and he/she still signs the bottom line and has the ultimate authority over the content of your fitrep/eval. The problem with the 360 approach is that it is difficult to standardize the evals and of course there's a ton of subjectiveness that goes into it.
Just outta curiosity, in the civi world, how are medical professionals 'evaluated' and promoted, say within a hospital ranking structure?
4. Better respect for professional boundaries. Professional standing trumps rank.
I think here you're talking about the complaint of having nurses and MSC's acting as your boss, or dictating policy that affects patient care, right?
I don't think you have a problem with a nurse or MSC telling you what to do, you have a problem with an
incompetent nurse or MSC telling you what to do, and telling you to do something that you know is not right nor professional, correct?
Again, i'll ask for a comparison with the civi world. You have plenty of situs out there where MPHs, nurses, MBAs, JDs even are calling some important shots that affect patient healthcare. So how do civi physicians deal with an MBA telling him/her what to do, or making policy that affects how the MD treats a patient?
5. Replacement of AHLTA with VISTA with one system for both DoD and VA
i don't know anything about either system, sounds like each system is very huge and complicated. I'm not sure merging them would be such a great idea. Maybe all that needs to created is a strong line of communication between the two systems, so you can toggle from one database to the other with no loss of data.