I will never forget the most unbelievable patient encounter I have ever had anywhere. I was working alone as an AF GMO in the ER in the early morning hours one day when a young mother brought in her two young previously healthy children and signed them in as patients. Upon triage where there vital signs were normal, the chief complaint was that the children needed a medical check. Given the fact that we were bound by EMTALA/AF Policy to see anyone for anything anytime, we obliged. With bleary eyes and a tired brain, I entered the exam room and asked this young mother what problems her children were having and her answer was NONE!! Incredibly, she went on to tell me that their family was leaving to go on vacation later that day and she just wanted them "checked out" to make sure that they would not get sick while on vacation!!! Nothing like that has even happened to me since, and I am convinced that such a thing would only happen within the context of MTF medical practice where everything is scott free. Furthermore this "free" environment, fosters a lack of gratitude on the part of patients. In my current civilian position, I am continuously receiving written and verbal expressions of gratitude and appreciation from patients, it is obvious that they value and appreciate the care they receive, but as I look back on my military medical experience all I seem to recall patients doing was constantly belly aching and complaining about this, that or whatever. I'll never forget the vice-commander of the medical group telling me once that patient complaints there were just a part of doing business!! For an organization that is so money oriented, I just cannot understand why service fees have not been instituted in MTF's.