Navy Medicine

[militarymd]

I don't think I ever told this story, so I figure I would give island doc and USAFdoc a run for their money.

My wife and I did our residencies about 200 miles apart while on active duty in the Navy. So when our residencies finished up, we figured that we would get stationed together. We figure there are plenty of duty stations in the Navy where you need both an anesthesiologist and an internist.

Well, after many months of being told we would be together at various locations around the world (the detailer kept changing his mind)....while we continued to just say "ok, we're ready to go"...our detailers finally give us Guantanamo....a hardship tour...co-located for 3 years.

As a new anesthesia grad....3 years in a place where you do maybe one case a week is a killer. Normal length of tour there is 1 year.

I told my detailer that sending me there for 3 years (no one else ever stayed that long) was professionally unreasonable.

The a s s told me fine. I could go for one year by myself. I said ok, but then the a s s proceeds to tell me that they need to move my wife to a location that would be next to impossible for me to visit during my year in sunny cuba.

I asked them why they needed to move my wife, they said that this other duty station had a "critical" need for internists that they couldn't fill.

It was a ******* i n g lie. I had a friend who asked to go there (that same day) and was told that there was no billet there. I brought this up in my conversation with the detailer, ....guess what the ******* h e a d did??? He hung up....that's right, a Captain in the Navy got caught in a lie and hung up on me and proceeds to refuse to take my calls.

I left a message saying that they could do what ever they wanted, and that if my marriage stayed together, we would find a way to get back together.

They ultimately left my wife where she was, and I was able to visit her 4 times during my year in Cuba.

They Navy is filled with dishonest, lying bastards who have rank and can make your life miserable.

---

Members don't see this ad.

 

[Monty Python]

It was a ******* i n g lie. I had a friend who asked to go there (that same day) and was told that there was no billet there. I brought this up in my conversation with the detailer, ....guess what the ******* h e a d did??? He hung up....that's right, a Captain in the Navy got caught in a lie and hung up on me and proceeds to refuse to take my calls.

.

Try this simple tactic, which has successfully worked for me several times.

Concisely and objectively record the events in a letter to your US Senator.

Senator John Smith
United States Senate
Washington DC 20510

If you don't want to return to the well too many times, also use your Congressman.

Honorable Mary Jones
US House of Representatives
Washington DC 20515

Amazing how fast things happen when you send that letter.

 

[island doc]

Never trust any military medical officer in the rank of O-5 or above.

 

[IgD]

If anything, this is a lesson on how not to interact with a detailer. In other words, you told the detailer "I'm too good for this position". The detailer thought "Who does this guy think he is? I'll show him". You asked for special treatment and you got it.

Remember that after residency you are expected to perform a utilization tour in an undesirable location.

Did you really find Cuba to be a hardship? I heard its a family friendly tropical paradise. In your defense, three years does sound long. I thought that accompanied tours there generally were 2 years while unaccompanied tours were 1.

 

[island doc]

Sounds like you were the first "detainee" there.

 

[militarymd]

If anything, this is a lesson on how not to interact with a detailer. In other words, you told the detailer "I'm too good for this position". The detailer thought "Who does this guy think he is? I'll show him". You asked for special treatment and you got it.

Remember that after residency you are expected to perform a utilization tour in an undesirable location.

Did you really find Cuba to be a hardship? I heard its a family friendly tropical paradise. In your defense, three years does sound long. I thought that accompanied tours there generally were 2 years while unaccompanied tours were 1.

EXCUSE ME??? Did you read my post? The ******* ing lying bastards jerked my wife and I around for months, telling us you'll go here, you'll go there, never making up their mind.

At every turn, we said "that's great, we're ready to move"....UNTIL they pulled the 3 years in CUBA S hit. Talk about letting your skills wither.

For the average career Navy physician who has no skills and is O-6 bound..letting your skills wither is not a big deal, but I AM A DOCTOR, and so is my wife.

The detailer was trying to fill a hard to fill billet for 3 years (historically and every time since Cuba is a one year billet WITH YOUR FAMILY)... the F uck H ead was looking for a medal..."I filled Cuba for 3 years with an anesthesiologist and an Internist"

And when I said I would take it up my A ss alone, they started lying!!!!

F uck the Navy!!! I'm glad I'm out.

I hope Navy Medicine sinks and rots on the bottom of the ocean.

I hope the government will learn its lesson with the piece of s hit organization that is BUMED, and replace it with a civilian run organization.

They need to learn if they want quality, they need to pay for it....Civilians all the way.

 

[island doc]

Sounds like you were a tortured "detainee".

 

[militarymd]

Did you really find Cuba to be a hardship? I heard its a family friendly tropical paradise.

On call 24/7 for the year.....some paradise

 

[Monty Python]

EXCUSE ME??? Did you read my post? The ******* ing lying bastards jerked my wife and I around for months, telling us you'll go here, you'll go there, never making up their mind.

At every turn, we said "that's great, we're ready to move"....UNTIL they pulled the 3 years in CUBA S hit. Talk about letting your skills wither.

For the average career Navy physician who has no skills and is O-6 bound..letting your skills wither is not a big deal, but I AM A DOCTOR, and so is my wife.

The detailer was trying to fill a hard to fill billet for 3 years (historically and every time since Cuba is a one year billet WITH YOUR FAMILY)... the F uck H ead was looking for a medal..."I filled Cuba for 3 years with an anesthesiologist and an Internist"

And when I said I would take it up my A ss alone, they started lying!!!!

F uck the Navy!!! I'm glad I'm out.

I hope Navy Medicine sinks and rots on the bottom of the ocean.

I hope the government will learn its lesson with the piece of s hit organization that is BUMED, and replace it with a civilian run organization.

They need to learn if they want quality, they need to pay for it....Civilians all the way.

I realize this is after-the-fact, but did you try running your situation by Capt. Scott Trezza, specialty advisor?

 

[militarymd]

I realize this is after-the-fact, but did you try running your situation by Capt. Scott Trezza, specialty advisor?

This was before Trezza...and he was a piece of S hit. I wouldn't piss on him if he were on fire.

 

[Globus P]

EXCUSE ME??? Did you read my post? The ******* ing lying bastards jerked my wife and I around for months, telling us you'll go here, you'll go there, never making up their mind.

At every turn, we said "that's great, we're ready to move"....UNTIL they pulled the 3 years in CUBA S hit. Talk about letting your skills wither.

For the average career Navy physician who has no skills and is O-6 bound..letting your skills wither is not a big deal, but I AM A DOCTOR, and so is my wife.

The detailer was trying to fill a hard to fill billet for 3 years (historically and every time since Cuba is a one year billet WITH YOUR FAMILY)... the F uck H ead was looking for a medal..."I filled Cuba for 3 years with an anesthesiologist and an Internist"

And when I said I would take it up my A ss alone, they started lying!!!!

F uck the Navy!!! I'm glad I'm out.

I hope Navy Medicine sinks and rots on the bottom of the ocean.

I hope the government will learn its lesson with the piece of s hit organization that is BUMED, and replace it with a civilian run organization.

They need to learn if they want quality, they need to pay for it....Civilians all the way.

Your professionalism in using so many 4 letter words is a testament to your impressive command of our English language.

You are taking a nose-dive with your recent posts, just let it go and move on.

 

[militarymd]

Your professionalism in using so many 4 letter words is a testament to your impressive command of our English language.

You are taking a nose-dive with your recent posts, just let it go and move on.

All this happened in 1996, almost 10 years ago. Even to this day, the thought of these people (detailer, specialty advisor) and their behavior brings my blood to a boil.

When I meet people and they ask me about my experience in the military, these memories make my face turn red with anger.

My personal memories and thoughts of these events are meant for those who are thinking about Navy medicine....not for those committed.

Does anyone want a life experience that will bring such emotions (and 4 letter words) to the surface ....almost 10 years after the fact????

I have moved on....my life is incredible right now....more money than I can imagine, better work environment than I can imagine, but the memories of Navy senior officers bring out the 4 letter words in my vocabulary.

 

[IgD]

EXCUSE ME??? Did you read my post? The ******* ing lying bastards jerked my wife and I around for months, telling us you'll go here, you'll go there, never making up their mind.

I can imagine the frustration you had. However, you were a borg just like everyone else-a junior one at that. You it was a mistake to ask for special treatment especially fresh out of residency when everyone gets a utilization tour. When you did, it backfired in the worst possible way. Had you even been to Cuba before? Whining about a duty station is another strike. I wonder if the detailer had been to Cuba before. He might have been insulted.

The other lesson here is you need to learn how to be flexible to have a successful career in the military. Things change on a day to day basis if not moment to moment. If the CO of a ship dies suddenly from a MI, someone else has to get uprooted to replace the billet. Chances are that someone might be you. You are setting yourself up for a hard fall if you are betting the farm on a guaranteed billet.

 

[GMO2003]

All this happened in 1996, almost 10 years ago. Even to this day, the thought of these people (detailer, specialty advisor) and their behavior brings my blood to a boil.

When I meet people and they ask me about my experience in the military, these memories make my face turn red with anger.

My personal memories and thoughts of these events are meant for those who are thinking about Navy medicine....not for those committed.

Does anyone want a life experience that will bring such emotions (and 4 letter words) to the surface ....almost 10 years after the fact????

I have moved on....my life is incredible right now....more money than I can imagine, better work environment than I can imagine, but the memories of Navy senior officers bring out the 4 letter words in my vocabulary.

MilitaryMD,

I have read almost every post of yours and can almost visualize the intensity in your verbage. I have also had the benefit of reading much of wha Islandoc has to say about military medicine as well. I can say for a fact that I am glad that my time is also coming to an end. I am looking to the future and a civlian residency and I could not be happier.

Guys..it would be great to someday catch up with you in person so we could have a beer and just chill...how about we all convene at Islandoc's island paradise and hook up with some binkini clad natives

 

[island doc]

I can empathize wholeheartedly. Even though my experiences were quite some time ago also, to this day I am still furious over the fact that I was forced into the position of practicing solo emergency medicine (running codes, intubating asthmatics, burn victims, mva's, head trauma, MI's, etc....) after only a transitional year internship....it was horrible. The AFMS is grossly negligent and irresponsible. The Federal Tort Claims Act should be repealed, thus stripping them of that protection and exposing them to the medical malpractice liability they so richly deserve.

 

[Globus P]

All this happened in 1996, almost 10 years ago. Even to this day, the thought of these people (detailer, specialty advisor) and their behavior brings my blood to a boil.

When I meet people and they ask me about my experience in the military, these memories make my face turn red with anger.

My personal memories and thoughts of these events are meant for those who are thinking about Navy medicine....not for those committed.

Does anyone want a life experience that will bring such emotions (and 4 letter words) to the surface ....almost 10 years after the fact????

I have moved on....my life is incredible right now....more money than I can imagine, better work environment than I can imagine, but the memories of Navy senior officers bring out the 4 letter words in my vocabulary.

I know what you mean, I too have a short list of topics experienced thus far in my 14 year Navy career I must not discuss or else my face turns red and I start getting angry again.
I was an officer detailer at the Navy Personnel Command before med school. Fortunately in the office/community I worked, the detailers were very honest and were great examples of what detailers should be. I walked up to the medical corps detailing office and I found the detailers less impressive than I expected. Most, if not all, were Medical Service Corps officers, not even physicians, but medical administrators. I found that disappointing, but as a doc I sure wouldn't want to be taken out of the hospital and put at a detailing desk.

 

[USAFdoc]

I know what you mean, I too have a short list of topics experienced thus far in my 14 year Navy career I must not discuss or else my face turns red and I start getting angry again.
I was an officer detailer at the Navy Personnel Command before med school. Fortunately in the office/community I worked, the detailers were very honest and were great examples of what detailers should be. I walked up to the medical corps detailing office and I found the detailers less impressive than I expected. Most, if not all, were Medical Service Corps officers, not even physicians, but medical administrators. I found that disappointing, but as a doc I sure wouldn't want to be taken out of the hospital and put at a detailing desk.

I have a 6 year enlisted NON medical career to balance against my somewhat short-lived (1 term) USAF medical career......and the USAF hands down wins the worst organization award. Not a week would go by in which admin didn't come up with some new twist on how to drag down a clinic deeper into the slime. One of my favorites was when they had stamps made in which we were to stamp each of our progress notes (this stamp said "I have read and agree and understand the above..or something similar to that)...anyways, we were to stamp each progress note and then have every patient read the progress note for that days visit. Can you say completely CLUELESS! Even if you did have each progress note done by the end of the visit (which you don't), could you imagine the lost time waiting for your patient to read and sign the note and then ask any questions about the visit and note? UNBELEIVABLE.....but TRUE. Needless to say all the physicians disobeyed that direct order.

 

[militarymd]

IgD,
Your posts get more and more ridiculous. Your MINDLESS defense of Navy medicine makes me, and probably all the readers here, suspect you to be a plant from BUMED to spew forth more lies to help a rotten system.

When you did, it backfired in the worst possible way. Had you even been to Cuba before? Whining about a duty station is another strike. I wonder if the detailer had been to Cuba before. He might have been insulted.

DO YOU KNOW HOW TO READ? DID YOU READ MY POST? My wife and I agreed to everything for months on end.

Special Treatment????? What is special about asking for what everyone else before me got???? and afterwards????

Have you ever been on call for 24/7 for a year. What are you? A GMO where half your decisions don't make a hill's beans worth of difference?

My immediate availability means life and death for people under my care....24/7 for a year....try that on for size.

I'm sure the detailer was there....doing what everyone else there was doing...boozing it up everynight and going out doinng water sports every weekend with their family.

I was stuck there for 24/7 for a year by myself ON CALL.

 

[militarymd]

MilitaryMD,

I have read almost every post of yours and can almost visualize the intensity in your verbage. I have also had the benefit of reading much of wha Islandoc has to say about military medicine as well. I can say for a fact that I am glad that my time is also coming to an end. I am looking to the future and a civlian residency and I could not be happier.

Guys..it would be great to someday catch up with you in person so we could have a beer and just chill...how about we all convene at Islandoc's island paradise and hook up with some binkini clad natives

Good luck. After military service, practice practice is a cakewalk unless you're incompetent, like a lot of career military MDs.

 

[militarymd]

The other lesson here is you need to learn how to be flexible to have a successful career in the military. Things change on a day to day basis if not moment to moment. If the CO of a ship dies suddenly from a MI, someone else has to get uprooted to replace the billet. Chances are that someone might be you.

You think that is any different in the civilian world??? You are dilusional.

 

[USAFdoc]

Good luck. After military service, practice practice is a cakewalk unless you're incompetent, like a lot of career military MDs.

I tend to refer to my current civilian job as my "sea of tranquility" as compared to the complete daily chaos that was my USAF med clinic. But "cake walk" works too.

 

[GMO2003]

Good luck. After military service, practice practice is a cakewalk unless you're incompetent, like a lot of career military MDs.

I'm not there yet, MMD...however, another year as a GMO will make anyone go crazy...I do my best by reading everyday...and reading each month's issue of AAFP...nonetheless, I cannot wait to continue with residency in the specialty of my choice...I actually enjoyed the years of primary care...however, I am not going to disillusion myself to thinking I gave the dependents and some of the retirees with multiple, chronic, medical problems the same level of care that a board certified family practice doc could do...sure the majority of primary care is straight forward...however, all it takes is missing that 5-10% that could harm a patient

 

[island doc]

I'm not there yet, MMD...however, another year as a GMO will make anyone go crazy...I do my best by reading everyday...and reading each month's issue of AAFP...nonetheless, I cannot wait to continue with residency in the specialty of my choice...I actually enjoyed the years of primary care...however, I am not going to disillusion myself to thinking I gave the dependents and some of the retirees with multiple, chronic, medical problems the same level of care that a board certified family practice doc could do...sure the majority of primary care is straight forward...however, all it takes is missing that 5-10% that could harm a patient

I know exactly how you are feeling. I was there not all that long ago. All I can say is just hang in there. Words cannot describe the orgasmic ecstasy you will feel when you walk out of that military clinic for the last time, and drive off base for the last time. Just look forward to seeing that place in your rear view mirror.

 

[IgD]

We should change the name of this thread to "truth hurts". What you did was to move your queen right in front of an enemy knight without seeing it. On the next turn the knight took your queen and you slammed all the pieces on the floor.

I can see from your reponses that you are very upset. I know where you are coming from. I've experienced the stresses of being detailed first hand. My point here is not to throw salt on your wounds but to point out a possible lesson to be learned (for you and for other people in the military medical system).

IgD,
Your posts get more and more ridiculous. Your MINDLESS defense of Navy medicine makes me, and probably all the readers here, suspect you to be a plant from BUMED to spew forth more lies to help a rotten system...

 

[USAFdoc]

We should change the name of this thread to "truth hurts". What you did was to move your queen right in front of an enemy knight without seeing it. On the next turn the knight took your queen and you slammed all the pieces on the floor.

I can see from your reponses that you are very upset. I know where you are coming from. I've experienced the stresses of being detailed first hand. My point here is not to throw salt on your wounds but to point out a possible lesson to be learned (for you and for other people in the military medical system).

Some people (not to mention any names) DESERVE to be in the current sham of a health care system that is called military medicine. I know of at least one. I feel bad for all the other docs and the patients stuck in that system, but I know know of one person that deserves what lies ahead.......I hope you (he knows who he is) end up in the same USAF primary clinic that has chased 100% of the docs out for 15 years running.

 

[IgD]

I hope you (he knows who he is) end up in the same USAF primary clinic that has chased 100% of the docs out for 15 years running.

I'm confused about something USAFDoc. If an organization has a 100% loss rate of its members over a 15 year period how many members would remain? How can an organization that has been around for 100 years or more have a 100% loss rate and still survive? It seems impossible.

 

[GMO2003]

I know exactly how you are feeling. I was there not all that long ago. All I can say is just hang in there. Words cannot describe the orgasmic ecstasy you will feel when you walk out of that military clinic for the last time, and drive off base for the last time. Just look forward to seeing that place in your rear view mirror.

Islandoc...I really do hope that I can look you up the next time I find myself in the islands..my wife really wants to go...it'll be a little while longer...but it'll give me something to look forward to...it seems that everytime I read your posts I see myself in your writings...in other words I feel that I am living through what you endured from years passed...I guess I take comfort and have some catharsis in that respect...rock on and keep living the dream

 

[USAFdoc]

I'm confused about something USAFDoc. If an organization has a 100% loss rate of its members over a 15 year period how many members would remain? How can an organization that has been around for 100 years or more have a 100% loss rate and still survive? It seems impossible.

why is it that even the most basic things slip past you?

everyone leaves (civilians quit, military separate) and everyone is replaced with brand new people. New HPSP-ers right out of residency, new PAs out of PA school, new nurses etc.......like stated before in other threads...every single nurse that worked there when I arrived had quit by the time I left as well; every single military doc had left active duty, 7 of 8 civilian docs had quit etc..........replaced with new people eventually, sometimes with up to a year delay to fill those spots...that is one reason we were running on 20% manning most weeks.

 

[IgD]

why is it that even the most basic things slip past you?

Don't quit your day job USAFDoc. Leave manpower issues to the pros.

 

[USAFdoc]

Don't quit your day job USAFDoc. Leave manpower issues to the pros.

believe me, I won't be quitting this job. Again, being in a place that places at least some importance on safety of patient care counts for something to me.

As for you, please don't quit your day job either, that ensures me that you and me won't be working side by side. Nothing personal, but you seem lost.

As for manpower issues; that is out of our hands. The SG has dibs on those calls and too bad there is no such thing as instant replay in his world because he "blew the call" and is losing the game for everyone.

God Bless the USAF and those docs and staff doing the 12+ hrs a day.
Hang in there guys, DOS commeth.

 

[USAFdoc]

Don't quit your day job USAFDoc. Leave manpower issues to the pros.

I appologize, sincerely, for degrading you. You may not beleive this but I am on your side and want Mil Med to be what it should be, and it IS possible, but major changes need to happen for even the chance of success (USAF Primary Care anyways).

You seem to have a knack of irritating docs because of your blind "acceptance" of a broken system. If you were a nurse and at your nursing school/hospital you witnessed 1st hand numerous instances of compromised patient care, cheating, lying, impropper treatment of co-workers etc....................you would find it very frustrating and rude if I labeled all you concerns as WAH!

I hope you find your mil med career to be wonderful and rewarding. It certainly will not be easy, but that was never my concern. In my USAF career I saw and heard things that should NEVER EVER happen, things that do not happen elsewhere. To you that may be WAH. If that is the case, thank GOD you are not my advocate, not my doc.

 

[IgD]

I appologize, sincerely, for degrading you. You may not beleive this but I am on your side and want Mil Med to be what it should be, and it IS possible, but major changes need to happen for even the chance of success (USAF Primary Care anyways).

You seem to have a knack of irritating docs because of your blind "acceptance" of a broken system. If you were a nurse and at your nursing school/hospital you witnessed 1st hand numerous instances of compromised patient care, cheating, lying, impropper treatment of co-workers etc....................you would find it very frustrating and rude if I labeled all you concerns as WAH!

I hope you find your mil med career to be wonderful and rewarding. It certainly will not be easy, but that was never my concern. In my USAF career I saw and heard things that should NEVER EVER happen, things that do not happen elsewhere. To you that may be WAH. If that is the case, thank GOD you are not my advocate, not my doc.

I don't accept the system blindly. In fact I'm a rugged individualist and question everything. What I do try to do is understand the system and work within the system to improve medical care. Instead of getting angry I try to figure out a way to get things done. Losing your cool just makes you look foolish and makes you ineffective. Regardless of your practice you have to recommend a treatment to your patient based on constraints of the system and ability to pay for services. You need to use the same logic in the military. Is it even possible to change the system?

Believe me I appreciate some of the things you say but at the same time those problems are everywhere. Have you ever worked at a VA hospital or at a busy metro hospital for example? I've seen everything you mentioned above civilian hospitals. Every system has its problems.

 

[Croooz]

I don't accept the system blindly. In fact I'm a rugged individualist and question everything. What I do try to do is understand the system and work within the system to improve medical care. Instead of getting angry I try to figure out a way to get things done. Losing your cool just makes you look foolish and makes you ineffective. Regardless of your practice you have to recommend a treatment to your patient based on constraints of the system and ability to pay for services. You need to use the same logic in the military. Is it even possible to change the system?

Believe me I appreciate some of the things you say but at the same time those problems are everywhere. Have you ever worked at a VA hospital or at a busy metro hospital for example? I've seen everything you mentioned above civilian hospitals. Every system has its problems.

This thread began with the abuse and lies of the detailers. We aren't talking about a broken military medical system but now even the detailers have issues. How is this comparable to the civilian sector? As a civilian you are your own "detailer". This isn't a matter of getting a patient treated but about where you will work. If the standard is a 1 year tour then why send someone there for 3 years? In Oki, the tours are 1 year unaccompanied and 3 years accompanied. Perhaps this is what the detailer was trying to pull?

Regardless of why, this is not a civilian side problem. You work where you choose to as a civilian. There aren't hard ship tours or unaccompanied tours there are jobs where you decide if you can deal with whatever the system has to offer. If you can't or choose not to then pack your toys and play elsewhere......how is that even equal to the military? In the military, you have some choices but are not free. Worst yet, your choices are limited even further because of lies, deceit, vendettas, or "the needs of the Navy"

BTW, if every year there are new people coming into an organization who are obligated to be there for the next 4-10 years the organization will never cease to exist. Navy medicine will be tight during the next decade. 60-70% of HPSP's are going unfilled and this will make for a tough time during the next decade of Navy medicine. Mandatory STOP/LOSS. Wait and see.

 

[militarymd]

Reading this story of mine...made me mad again...at the detailer and specialty advisor.....I still remember their names.....they better prey I never run into them in a dark alley.