Milmed Guide to Thrive

[John1513]

brothers and sisters,

Could we please start a thread to help young medical corps officers thrive in Milmed?

Any litttle thing can help. We all know sdn seniors have been posting for years, “ Beware - you have been warned.”

For various reasons and via various routes, new MC officers join every year. True, many GTFO at their ADSO - dismayed and bewildered (albeit forewarned).

However, there may be a cadre who might be naive enough (me) who thinks that maybe they can make a difference if they make it positions of influence.

What if there was a young MC Officer who in his first tour saw things in real time everything that has been forewarned here in SDN? What if that Officer was so viscerally moved that it is a driving force for the rest of his career?

What if there were Surgeon Generals who never forgot their first impressions of Milmed from their first tour?

let me start—


One of the many things that I have learned the hard way is “lead, or be led.”

First impressions are so impactful. First tour - what is a department head? What on earth is a MECC, and a steering committee? What do these things matter, I have patients to see gosh darn it! —- we need to help new MC officers be more equipped to succeed.

New to the fleet physicians already have the “clueless O-3” stigma, but actually being clueless of Milmed life makes it worse. ODS doesn’t go into Milmed at all, so I feel that’s where sdn can fill the void.

Examples of positivity can be see where we have whitecoatinvester and we have CDR Schoeffer at MCcareers. Let’s pour into each other guys!!!!

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[dr zaius]

Thrive or survive?

 

[John1513]

Both, please. Surviving only, just getting by, comes with much heartburn.

 

[DrMetal]

learn to use a computer well, particularly how to navigate around Windows, and Microsoft Products.

Build templates for notes in MS Word and notepad...chart as much as possible in these programs, instead of in AHLTA/Essentris. Whatever specialty you're in, someone has likely created such templates, copy and adjust as needed.

Save often when working on gov't computers.

Don't trust anybody's word....look for things in writing and official documentation (not that that's always solid, but it's better than the crap that comes out of everyone's mouths).

Apply for whatever GME you want.....worst that they can say is 'No', including outservice/deferred stuff

be flexible with your geography, we can't all work and play in San Diego.

develop a good whiskey habit.

 

[HighPriest]

Completely agree with trust no one. Anything you really need done, you absolutely have to do it yourself. Unless you've known someone for years, and/or are personal friends with them outside of work, you can expect that they will put absolutely zero priority on anything you've asked them to do. Process your leave, restock equipment, change your preference cards, do their jobs - don't expect any of that. The earlier you get used to the concept that if someone does something in their job description you're fortunate that they did it, the happier you'll be.

Know how to prioritize what you need, because you'll be doing most of it.

When you delegate work, plan on following up on it frequently and regularly, and don't plan on it getting done on time - delegate it early and tell everyone it's due before it actually is. Only delegate work that won't completely gum up your life if it isn't done.

If you find a federal employee who actually does what their asked efficiently, memorize their name and their face and be very, very kind to them because they're the *(&king angels of the DoD. They could actually survive outside of the institution, but they choose to stay and still never become worthless slugs.

Keep in mind that federal employment is a $#!t filter. All the good water flows through and on to the ocean, and the $#!t stays behind, with only a few exceptions.

Remember that, to the DoD, you're not a doctor. You're a tool. They bought and paid for you so that they could use you for a very specific purpose. They don't care - at all - if you're very good at anything else. If you're a general surgeon, you're a trauma machine. They put in a quarter, and they want trauma widgets out of the machine. It doesn't matter if you're the absolute best bariatric surgeon in the free world. They don't care. They'll watch those skills rot on the vine with complete, emotionless disregard because that's not why they bought you. Also, the MEDCENs exist to house their tools. A toolbox. Not to take care of patients. Taking care of patients is a privilege they allow you to participate in so that you don't shoot yourself in the face, because Congress doesn't like suicide in the DoD. If you get to take care of patients while not deployed, great. If not, that's even better because taking care of people is expensive. They're not in the business of taking care of people, they're in the business of keeping the killing machine they bought up and running. So hop to it, you tool. Also, your skillset should pretty much stay sharp because you're a tool and they're keeping you in their toolbox, so why would you go dull?

Leadership generally means doing the $#!t other people don't want to do so that you can get promoted.

The best thing you can do as a clinician is to be as productive as you can be, and keep your (*&king head down. That way, when the parade of idiots from the command suite comes by, you have some ammunition that you can use to shoo them off. If you're one of the most productive people they have (RVU/FTE), they'll generally leave you alone. When they don't, reminding them that you're one of the most productive people that they have will help to shut them up. Because to your command, the literal only thing that matters are the arbitrary metrics that OTSG hands down, at random, every year. One of them is always RVU/FTE, so you can use that. Most of them are utter nonsense, and not usable.

Make a decision up front whether you want to be a doctor or a soldier/airman/sailor. If you want to be a military guy, don't see a lot of patients, do all of your online training early, show up to events, and offer to take operational positions as often as possible. To the military, a good soldier rubs the right noses, sniffs the right $$es, and pretends they know whats good for everyone else. If you take this path because you really do want to help make things better, don't take it right away, because you're going to burn out really quickly as you realize nothing you do will make a long term difference. At that point, you'll either drown in kool aid or you'll have to go back to your clinical career. If you want to be a good doctor, then right out of residency you need to fight like hell to see and treat patients. As hard as you can, every single day. Because it will be a constant up-stream swim to even begin to approximate the amount of experience your civilian colleagues are getting just by going to work. Push your office staff to see a reasonable number of patients. Fight with the OR nurses to do more than three cases in a day. Fight with the floor nurses to actually take care of your inpatients. Fight with command to get the equipment you need and to moonlight. Now, be smart about it. Don't be a loudmouth idiot. Find out what motivates these people and figure out how to frame what you want as something that's good for them too. It's the only way to make things work. For example, you command only cares about the arbitrary metrics that OTSG hands down, so find out what the metric-du-jour is and explain to them how getting a new liposuction machine will help obtain that goal.

Definitely nurture a good whiskey habit.

GTFO ASAP.

 

[HighPriest]

Oh, yeah, and if you get PCSed to BFE suck it up. But don’t fall for this “it could be worse” BS. It -could- be worse, but it also could be really fantastic, and all you asked for was tolerable. In other words, don’t worry about the grass on the other side of the fence. Maybe it could be browner, maybe it could be greener. Just be a realist and realize what your lawn looks like and figure out how to mow it until you can move.

 

[HighPriest]

Don't trust anybody's word.

Honestly, dude, I had some PTSD with this when I got out. It took me months to realize that I had an unusual and extreme paranoia with regards to trusting people to do what I asked and what their job description includes. Then I finally realized that my office staff generally does what they’re paid to do. Sometimes because they want to, sometimes because they have some pride, sometimes because they just don’t want to get fired. But they usually do it. Without complaining. On time.

 

[Homunculus]

been a busy few months, haven't been able to stop by as much. still in shock gallo returned, lol.

not much to add to from @HighPriest 's post. i could expound a little here or there but the meaty part is accurate. there are some forrest gumps running around out there who get everything they want and things just seem to work out for, but they are few and far between. there are also some good physician leaders out there. but they are also few and far between.

my REFRAD is in a few months and i'll be moving to the reserves. i'll post some musings at some point but the themes won't really be new-- i may touch on a few other items but that's some high yield stuff.

--your friendly neighborhood the light at the end of the tunnel is nearing caveman

 

[TheEarDoc]

Honestly, dude, I had some PTSD with this when I got out. It took me months to realize that I had an unusual and extreme paranoia with regards to trusting people to do what I asked and what their job description includes. Then I finally realized that my office staff generally does what they’re paid to do. Sometimes because they want to, sometimes because they have some pride, sometimes because they just don’t want to get fired. But they usually do it. Without complaining. On time.

Don't work for the VA then because trust me I'm right there with you on the paranoia!

 

[John1513]

Medical conferences clues

Local conferences’ registration fees often can be paid by command if we ask - this comes from Supply pot of money.

For the Q2 years required CME-to-maintain-license conference, that comes from TAD pot of money. Commands are much more strict on TAD money.

Both need the SF182 education conference packet filled out.

You will notice in military life that Supply money is use-it-or-lose it. There are periods of feast and famine.

Hope this helps someone!

 

[AirborneBearcat]

I had a senior attending physician give me a good pearl that I remind myself of frequently.

AHLTA had just gone down for the 3rd time in the same day and it was already nearly 1600 hrs so we knew most of the DoD support staff had already peaced out for the day. There was obvious stress and tension amongst all the physicians, nurses, techs, etc.

He told me, "[AirborneBearcat], it's times like these where I have to remind myself of what is really important. What is the "signal" and what is just the "background noise." The patients are the signal. This (motioning to a frozen AHLTA screen) is just noise. It is nothing. Try your best to not get too frustrated with it. We have the privilege to care for some of the most incredible people in this country. Plus, we don't have to worry about their ability to pay for our services!"

 

[DrMetal]

He told me, "[AirborneBearcat], it's times like these where I have to remind myself of what is really important. What is the "signal" and what is just the "background noise." The patients are the signal. This (motioning to a frozen AHLTA screen) is just noise. It is nothing. Try your best to not get too frustrated with it. We have the privilege to care for some of the most incredible people in this country. Plus, we don't have to worry about their ability to pay for our services!"

This happens quite often. Here's how I combat this:

* Use CHCS to place all of your orders (labs/rads/meds/consults), and do so right away after (or even during an encounter). Yes I know, it sucks using a 30-year old text shell to do your business....but if you get good with it, it's much more reliable (and faster than AHLTA). I like using it, it makes me feel like I'm in War Games.

* With all of your orders in, chart in MS Word (as mentioned above). Upload your note later. Most physicians take 24-72 hours to complete their notes anyway. You're generally ok to do so, unless there's some dire sense of urgency (patient getting sent to ER, or being admitted, etc).

 

[j4pac]

This happens quite often. Here's how I combat this:

* Use CHCS to place all of your orders (labs/rads/meds/consults), and do so right away after (or even during an encounter). Yes I know, it sucks using a 30-year old text shell to do your business....but if you get good with it, it's much more reliable (and faster than AHLTA). I like using it, it makes me feel like I'm in War Games.

* With all of your orders in, chart in MS Word (as mentioned above). Upload your note later. Most physicians take 24-72 hours to complete their notes anyway. You're generally ok to do so, unless there's some dire sense of urgency (patient getting sent to ER, or being admitted, etc).

I use to say screw it and pull out an SF-600 and prescription pad every now and again. I rarely left work without my notes being done...even on AHLTA cluster days

 

[militaryPHYS]

Thanks for starting this thread! I've been following but not commenting to see where our trusted community on SDN took us!

Here are my two cents now that the first year of staff-life is winding down at a small OCONUS MTF.

#1 Focus on your practice first. Make sure you have it streamlined to accommodate for the inevitable AHLTA crashes, windows updates that fail, etc. etc. These things are a well known issue so don't use them as an excuse to berate Milmed. Find a way to make them less of an issue. The Word document pre-typed templates have served me well. If you are at a command that doesn't allow you to "add note" the entire template then set it up so you can copy and paste each section in to the lame check-box requirements. The word document/add-note templates are also great for follow up copy-and pasting to the new encounter. Even easier than "copy-forward"!! I also pre-screen my clinics and sometimes have most of the SPEC notes roughly written before clinic even starts. FTR/Follow ups are copy and pasted and updated, SPECS are pre-written (ish) which means I get a lunch every day and can finish well before 1530 and work out before I have to pick the kids up. My wife is an internist (well known for long-encounters and long notes) but she types her notes during the actual visit in the exam room. She somehow does it where she maintains eye-contact, her patients love her and her notes are done before she leaves the exam room. Figure out a way to make life easy depending on what your duty station throws at you!

On the AHLTA note topic...spend a half a day learning how to code your basic encounters. Once you learn it then your word document copy and paste templates are easily and properly coded and take two-seconds. If you let AHLTA code it for you then you will be severely deficient in RVU's and the bean counters will be upset. But you should also be upset because the real-world codes and you should know how to do it. If you think that just because everything is free in the military means you shouldn't care about coding and RVU's then you're missing the big picture on life and accountability.

#2 If you are surgical then focus on maintaining your skills. Double scrub, book solid indications and don't stretch those indications just to increase your surgical numbers. If you end up with a niche of typical cases then own it even if it sucks. At least you'll be mastering something instead of whining about your low-volume or low-acuity case load (also something well known to MilMed at small MTF's). Insist on TAD/TDY/Conferences/skills labs. Don't get pissed when you are denied. If your case load sucks then read more or watch VuMedi on cases you aren't doing as much as in residency. Changes are coming down the pipeline, but until then we are stuck with what each MTF gives us. You likely can't change much so don't spend your time hating your life. Find ways to feel fulfilled, useful and worth something.

#3 Seek out high-visibility collaterals. Don't just apply to the first one that comes through your inbox. You can align your collaterals with your own self-interests MOST of the time. Also, try to make them align with your main job somehow so you aren't doubling your work (two birds with one stone). Currently READINESS of our fighting force is very high-visibility. Anything that you can justify as improving readiness is likely to make a good block 41 but also you have an opportunity to influence change that is important to BUMED (or DHA) right now. ACCESS TO CARE and patient-centered medicine is high-visibility in MilMED because it is in the civilian world. Work on building your clinic templates to match the current metric of accountability in BUMED to make them happy. Find collaterals that make you feel fulfilled, look great on your fitrep but most importantly help the command accomplish it's current mission based on current conflicts, priorities or CO mission statements.

#4 Be a team player. It doesn't matter if you hate your life and decision to take HPSP/USUHS money...if you make it known you hate your decision and get frustrated by the well-known pitfalls of MilMed then the people who have power over you, and even your corpsman under you, will lose all respect for you and won't help you to even maintain a little bit of happiness in your day to day life. If you stay positive, accept the pitfalls and find ways to lessen their impact, help others succeed, mentor junior officers and enlisted then even if your practice sucks right now, at least you are improving the other areas of your life that matter.

More to follow. Better stop for now

 

[John1513]

I think I figured out AHLTA crashing.

We need to restart/reboot our computer at lunch.

It isn’t about RAM or a newer computer - it is about the server/servers.

AHLTA + outlook + IE open at the same time all day long is apparently too much for the DHA servers to handle.

 

[Perrotfish]

The problem with a guide to thrive is that you need to define what exactly it means to 'thrive' in milimed. What exactly is your goal? Promotion to 0-6? To develop as a physician? Good outcomes for your patients? A good transition to the civilian world? The ability to look back on your accomplishments with pride? Happiness as you slog through your obligation? Obviously we all want all of those things, but the paths to those different goals are different.

If your goal is promotion, my advice would basically be to not worry too much about it. One of the nice things about milimed is that O-4 is an 'all fully qualified' board, meaning if you don't have a single thing in your file you get promoted. To fail to promote you need to fail so spectacularly that your chain of command puts a negative letter in your permanent record. That takes more than just a bad attitude. Stay off FEP, pass your PRTs, and don't get accused of criminal behavior and you promote. Then you get yet another year or two after hitting O-4 where its OK to earn a 'P' on your fitreps. So that 8 years after medical school where you can basically put promotion out of your mind, even if you think the goal is to be the next Surgeon General. Finally if you are 8 years out and still thinking about promotion chances are you won't be looking on internet forums to figure out what to do next, you'll have had many mentors within the military itself who can help you figure out when to do department head/director/whatever. That isn't to say that you can be a dirtbag for 8 years without it haunting you, milimed is a small community, but if you do your work, have good outcomes, stay off of hit lists, and don't make everyone hate you then you don't need to otherwise devote yourself to box checking.

If your goal is to develop as a physician, which should be the top priority for any new residency grad, then you need work. However if you want good outcomes for your patients, and you're at a small command, that usually means arguing against admitting more complex patients because your support staff just doesn't handle enough volume of those patients to guarantee a good outcome. The only way to reconcile the two, if you're a proceduralist/ER physician, is to moonlight. Or do locums. Or mission trips. Or TAD back to a MEDCEN. If you accept the case load at your small hospital you are either hurting your future patients. If you're family/OB/Peds you might get something normal to a full patient load safely, but still look at ways to push yourself in terms of both competence and speed. If at all possible during the first year out of residency try not to take on any administrative role beyond the minor collaterals that get dumped on you, more than any other year that's when you want to focus on your skills.

The other part of promoting good outcomes for your patients is to be willing to tackle any administrative duty that you think is standing between your patients and good care. Take ownership of training programs. Advocate for nurse and RT TAD programs. If you feel like a collateral is important for patient care take a leadership role. A corollary, BTW, is to NOT entangle yourself in collaterals that you don't feel help patient care (they're usually the ones with 'quality' or 'champion' jammed somewhere in the name). There are plenty of nurse corp and MSC O-2 that need those roles to promote, and your time and expertise is needed elsewhere to work on patient care issues. Again, don't worry about the visibility of your collaterals. By the time you need to worry about fitreps, you will need major leadership positions, rather than collaterals.

If you want to be proud, looking back, then do your fair share. Calling out sick should be rare. Accept when its your turn to work Christmas. Work your call schedule. Don't punt patients to (or from) the ER.

Good transition to the civilian world? Mostly this just seems to be about working hard and having good references, but there are a few tricks.
1) Be a USUHS professor. Its a form you need to fill out. That's it. Congratulations, you now have 5 years experience in academic medicine
2) Pick up credentials. The military is good about having formal credential processes for everything from toenail removal to joint injections to allergy clinics. Treat it like a treasure hunt and you will add on skills that a private practice might ultimately want to buy.

Happy during your time? This one's tough, because if it was going to be a good experience they probably wouldn't have paid for your medical school. That being said.
1) Get involved with your community. If you get stuck in the middle of nowhere don't just wander back and forth between your house and the hospital, take the time to see the landscape and meet the people. Pretend you are putting down roots.
2) Do a military thing every year or two. Mountain Medicine. A shooting competition. Chem Warfare school. MCMAP blackbelt school. I've known at least a couple of people who went to jump school for no good reason. If you're a reasonable guy they'll probably let you get at least a few memories out of your time.
3) Do a conference if you're not doing a military thing. They should be giving you TAD about once a year, at least if your willing to do something unfunded. Take advantage of it. There's a good chance they'll even pay for it.

Happiness, like promotion, gets more complex when you get past your first few duty stations and start having the ability to negotiate for cushy or desirable jobs, but early on that would be most of the advice I would have.

 

[armytrainingsir]

Carpe diem.

Look for experiences while on AD that you can't have as a civilian. Embrace and enjoy them, for they are fleeting. Being a civilian doc isn't the end all be all. Medicine, mil and civ, is screwed up. Just in different ways. Don't waste even more of your youth in a holding pattern for 'delayed gratification' that won't be nearly what you think it will be.

 

[Perrotfish]

Carpe diem.

Look for experiences while on AD that you can't have as a civilian. Embrace and enjoy them, for they are fleeting. Being a civilian doc isn't the end all be all. Medicine, mil and civ, is screwed up. Just in different ways. Don't waste even more of your youth in a holding pattern for 'delayed gratification' that won't be nearly what you think it will be.

Are you working in civilian medicine?

 

[militaryPHYS]

The problem with a guide to thrive is that you need to define what exactly it means to 'thrive' in milimed. What exactly is your goal?

All good points in your post. Thanks for putting in the time to write that. Ideally we can strive for all of the goals you listed, but as we are all well-aware, balance is tough to maintain.

 

[sonofva]

I also think that mentorship is very important, buy understand that it is very different than the line guys. The line guys are on a pipeline. PL, Company XO, Company command, battalion staff, batt xo, bc, and so on. They all go by year group, and can all anticipate what comes next, and how they should be progressing, because they all do the same thing by and large.

It is different, at least in the Army. No two MC officers take the same path, because there are infinite options, and you can be put in any one. I mean, a gmo CPT is likely not going to be a Brigade surgeon, but take a few recent residency grads. One can be put as a brigade surg, the other as a SF Batt surg, the third as a residency faculty, and the fourth as an FST Doc. Each of these people needs different guidance, and its not just generic stuff like "this is what you need to succeed in your PL time." On top of that, guidance may change at their next duty assigment. So pick a mentor early. They can keep you from doing some stupid ****. But dont be afraid to switch when your circumstances change.

 

[colbgw02]

How many junior medical corps officers have relevant mentors to look to? I know that the senior people I was around grew up in a vastly different medical corps. Their paradigm was residency --> "utilization" tour --> fellowship --> homestead at MEDCEN --> retirement --> civilian contractor job. Oh, and basically just showing up would get you to O-6. They had precious little meaningful advice to offer when it came to being a brigade surgeon or facing a competitive O-5 promotion board.

 

[HighPriest]

How many junior medical corps officers have relevant mentors to look to? I know that the senior people I was around grew up in a vastly different medical corps. Their paradigm was residency --> "utilization" tour --> fellowship --> homestead at MEDCEN --> retirement --> civilian contractor job. Oh, and basically just showing up would get you to O-6. They had precious little meaningful advice to offer when it came to being a brigade surgeon or facing a competitive O-5 promotion board.

I can tell you what my pool of plausible mentors looked like: O-5/6s who had gone straight through med school-residency-fellowship-MEDCEN. They had never deployed. 20 years, no deployments. They had never taken an operational billet beyond "department head," which did come with some extra paperwork, but it wasn't like they were doing mostly non-clinical. They had spent 20 years with full CME funding, Army-wide didactic courses in our specialty, no requirements for CCC or ILE, not even a whisper of being forced into a brigade surgery billet. None of them had spent any time at an MTF with fewer than a 150 bed capacity. And by the time I was a mid-level resident, most of those guys would regularly remind me that the Army was completely different now and that if they had joined when I joined, they would have left a long time ago.

 

[John1513]

Thank you all! This is such good information. Us junior docs will benefit for years to come

 

[sonofva]

How many junior medical corps officers have relevant mentors to look to? I know that the senior people I was around grew up in a vastly different medical corps. Their paradigm was residency --> "utilization" tour --> fellowship --> homestead at MEDCEN --> retirement --> civilian contractor job. Oh, and basically just showing up would get you to O-6. They had precious little meaningful advice to offer when it came to being a brigade surgeon or facing a competitive O-5 promotion board.

Dude we have an email system in which you can literally contact anyone from pv1 snuff to csm dailey. Figure out what job you want and google until you find out who is currently filling that role, or a graduate from your program from several years ago, or a leader you respect, or whoever you think will be helpful. Then look them up in global, and cold email them. Respectfully introduce yourself and ask if you can run some questions by them. The military is unique in that most people are happy to talk with you about your future plans. This has worked for me, and I have developed great relationships with both line and medical officers ranking from MAJ to GO. The worst they will say is " I dont have time for you."

 

[colbgw02]

Dude we have an email system in which you can literally contact anyone from pv1 snuff to csm dailey. Figure out what job you want and google until you find out who is currently filling that role, or a graduate from your program from several years ago, or a leader you respect, or whoever you think will be helpful. Then look them up in global, and cold email them. Respectfully introduce yourself and ask if you can run some questions by them. The military is unique in that most people are happy to talk with you about your future plans. This has worked for me, and I have developed great relationships with both line and medical officers ranking from MAJ to GO. The worst they will say is " I dont have time for you."

Pretty tough to have a mentor over email, but that's only part of the point. The other part is that the person in that job, you know, the one you'd have me email, got to that position via a route no longer available to me.

 

[sonofva]

Pretty tough to have a mentor over email, but that's only part of the point. The other part is that the person in that job, you know, the one you'd have me email, got to that position via a route no longer available to me.

Have a bad attitude all you like, but this has worked well for me. Start with emails, send your resume, then talk on the phone, then if they are somewhat local meet for lunch. I get that its not perfect. But i have developed relationships with people who are able to offer somewhat timely advice, call in favors, or at least an lead on someone else to talk with. Its easy and doesnt cost anything. Just got to reach out and do it, or dont... your career man.

 

[colbgw02]

Have a bad attitude all you like, but this has worked well for me. Start with emails, send your resume, then talk on the phone, then if they are somewhat local meet for lunch. I get that its not perfect. But i have developed relationships with people who are able to offer somewhat timely advice, call in favors, or at least an lead on someone else to talk with. Its easy and doesnt cost anything. Just got to reach out and do it, or dont... your career man.

What bad attitude? I asked a question in hopes of spurring discussion about the availability of mentors because my mentor's career arc had no relevancy to mine, an experience echoed by @HighPriest. Your proposed work-around was to cold contact strangers. That very well may be a source of good information and developing contacts, but we were talking about mentorship - not networking and fact finding. I guess you and I have different concepts of what a mentor is.

 

[sonofva]

What bad attitude? I asked a question in hopes of spurring discussion about the availability of mentors because my mentor's career arc had no relevancy to mine, an experience echoed by @HighPriest. Your proposed work-around was to cold contact strangers. That very well may be a source of good information and developing contacts, but we were talking about mentorship - not networking and fact finding. I guess you and I have different concepts of what a mentor is.

What is your concept of a mentor? These are people with great experience that I can have frequent discussions with and get guidance from about how to succeed in my current position, to plan for the future, and bounce ideas off whenever I need. Just because I didnt meet them in the traditional way doesnt make them less of mentors.

 

[j4pac]

What is your concept of a mentor? These are people with great experience that I can have frequent discussions with and get guidance from about how to succeed in my current position, to plan for the future, and bounce ideas off whenever I need. Just because I didnt meet them in the traditional way doesnt make them less of mentors.

I’m with you. SDN has been an excellent mentorship program for me even though I have met only a few of the people on this forum. You have to do what you have to do...and sometimes e-mentoring is the best we’ve got. Though not perfect can provide a wealth of knowledge.

 

[armytrainingsir]

Are you working in civilian medicine?

Yes

AD for a decade, huge break in service, now in the reserves.

 

[DD214_DOC]

My best advice would be to give up trying to make sense of things demanded of you. I went too far into the rabbit hole only to discover the very metrics we are, “judged”, on are completely inaccurate. The, “system”, relies on an excessive number of decision makers who never communicate with each other and each having their own agenda. You will be given tasks that conflict with each other. You will be required to meet the same deadline with the same timeframe to work for several taskers, and be left having to choose which one or two you will actually meet the suspense for. Prioritizing and planning ahead to get things done is usually an enormous waste of time, because you will be handed last-minute taskers with short suspenses that interrupt your planned schedule.

I think this captures the experience pretty well: My only real task each day is to decide who all to piss off and whose turn it is to make happy by completing the task. You survive my making sure this is never the same person more than twice in a row.

Oh, and nobody actually cares about the quality of care you’re providing. Seriously. There are literally zero core outcome measures related to quality care and positive outcomes. See lots of patients as soon as you possibly can after they were referred and you’ll be the golden boy/girl for your MTF. Don’t worry too much about what you actually do at these appointments. Nothing proves how awesome of a clinician someone is better than lots of RVUs and a great ATC average.

Enough bitter sarcasm for now.

 

[militaryPHYS]

See lots of patients as soon as you possibly can after they were referred and you’ll be the golden boy/girl for your MTF.

Don't forget about signing your notes within 72 hours! God forbid you forget about a T-Con or a routine follow up note and it will be marked as a delinquent encounter on every single PAR or OPPE you get until you PCS.