Military VIrus/Cancer as virulent as ever

[Galo]

Well,

I have to say when I first read this it was with surprise to say the least.

I suspect embers from our epic disagreements may lie there, and there is no intention on my part to fan them.

What surprises me the most is that for the first time we seem to be in agreement. I think this is the first post by A1 that I have seen with any condemnation of the system. Now granted this is my first post in ???a year or more, (i'm sure there is a way to check that), so I have not kept up or tried to look up what he has posted. Was that scathing assessment a thread or a post on this forum? I am also in agreement with, and I have stated it multiple times including in this thread, that there are excellent people in the system, and that it is an honor to serve our military. However, I think those excellent people are never enough to make up for the *****s that are part of the malignancy not only military medicine, but in the system as a whole.

I started this thread after reading about the F-22 pilot and his ordeal. There were also other pilot's whose careers were ruined from the Anthrax vaccine debacle. To me they are just examples of how a hierarchy like the military which rewards longevity with power regardless of merit, is a flawed system. I, like many others, experienced these flaws as particularly dysfunctional in the medical field where physicians are treated as soldiers, and not physicians.

I will wholeheartedly once again disagree with A1 on the fact that the Decline of Military Medicine, (I think my first thread), started back WAY more than 3-5 yrs ago. Not to nitpick, but for subspecialist, a majority of the problems started when Tricare took our older population out of the system and sent them to the outside. Of this there are multiple opinions by at the time surgeons in command who documented this as a huge problem. I had at one time included in this forum the "TrainWreck" power point presentation authored by the then consultant to the AF Surgeon General, and often get requests to pass it on. The problem was compounded by accepting non-physicians to be in command of physicians, as well as weak inept attempts to modernize primary care at the expense of subspecialties. I think it was called PCO....Primary Care Optimization.

I believe that signing on today, without knowing the information that is available about the system, is fraught with disappointment that turns into despair if one does not have the correct expectations of a system that is designed for its benefit only, and not that of the individual who wants to practice medicine in a modern environment.

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[HighPriest]

Here's yet another option to consider, rather than the military, to pay off your student debt:

http://lasvegas.cbslocal.com/2014/0...oning-off-virginity-highest-bidder-at-550000/

 

[mitchconnie]

I'll jump on the nostagia bandwagon for Memorial Day and post for the first time in years. It's interesting to see that some of the old super angry/super positive posters have mellowed a bit. Disappointing to see that the military medicine is still just as difficult as when I was in.

I left the military five years ago after 13 years on active duty, and I can tell you from personal experience that the grass really is greener on the other side. I'm amazed by pro-military posters who talk about about how dysfunctional and difficult civilian medicine is. I have never seen anything in my civilian practice that was anywhere close to the level of dysfunction that was routine in the .mil. While there is no utopia, there are just so many more options available after you get out, and if you can't find something that works, then you aren't looking very hard.

Don't want to run a business and want a limited time committment? Work for the VA. Sure it's still military-style bureaucracy, but you'll be making twice the money for no more work and you can leave anytime if they piss you off too much. Don't want to work for the government, but want a stable financial package? Go with a hospital-employed or multispecialty group position. Want to teach and write, but don't care so much about an enormous income? Go with a University Hospital position--and get this...people will actually value the fact the you teach, write and publish! It's amazing.

Personally, after I got out of the Air Force, I went with an option that is probably the closest thing to military medicine in the civilian world--a big University Medical System. I still deal with some irrelevant metrics (publication numbers), too many nurses in management, people chasing promotions at the expense of patient care, etc. So it's certainly not perfect, but the thing is, I really like what I'm doing clinically and I'm rewarded very well for working hard and doing a good job. I'm seeing an incredibly high volume of high-acuity cases every single week--aorto-duodenal fistula, acute mesenteric ischemia, thoraco-abdominal aneurysms, weird vascular tumors. Every day it's something new and bizarre: seeing things that I never saw in my entire military career at a low-volume, low acuity hospital. I feel like my surgical skills have grown exponentially since leaving the military because I just do so many more cases on so much sicker patients. I did 28 surgical cases last week--a lot, but really not crazy busy. In the Air Force, I would do that kind of volume in 6-8 weeks. There is just no way to develop and maintain high-end surgical skills in the current military environment.

Sometimes I still get pissed off at management, and whine and complain about things, but the difference is that I can do something about it. A couple years ago I was really unhappy with my contract--didn't think my hard work was being compensated appropriately--so I went out and interviewed in what turned out to be a great job market. I found some other attractive options and then went back to my current employer and re-negotiated. They gave in a little, I gave in a little, and everyone was happy. Keeping a physician satified was important to them, and I felt valued. Nothing compared to the total impotence of working in a military medical center.

The only thing I remember fondly from my time in the .mil is some of the great people I met and worked with--mostly a bunch of young, well-trained, idealistic guys trying their best to make it work in a broken system. But otherwise, it was just miserable. No matter how crazy my current practice is, I'll think back to my time in the Air Force and just thank God that I made it out with my marriage, my career, and my sanity intact.

Good luck to everyone who is still in--it can only get better!

 

[sonofva]

I don't think the Army really ever lied to you about this (except maybe recruiters, but your crazy if you listen to them anyway). I've always been told the order of precedence is:

1) God
2) army
3) family

... Nowhere in that list is career. If no one told you this/you didn't believe them, I feel sorry for you.

 

[pgg]

I've always been told the order of precedence is:

1) God
2) army
3) family

I thought it was Unit, Corps, God, Country. It's what LCPL Dawson told me, anyway.