Galo

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Dr GeddyLee said:
I showed this forum to a radiologist I work with that got out of his airforce just two years ago and it gave him a good chuckle. He really enjoyed his stint in the service and advised me what is said here is typical of the internet where the unhappy people complain the most and make the situation sound far worse than it is.

So, I'm in no position to comment on the issue and am only offering a second-hand opinion, but it is true that not every military doc feels the same way.
The radiologists at Offutt when from 4-2 with no change in volume of films or reading expectations. One of them almost got divorced because of the stress it added for almost a year before they were able to work out a deal and sent radiology stuff out. At Wright Patt, one of the department of defence's only specially trained neurointerventional radiologist was deprived of his ability to practice at the univ of Cincy where he was able to do more neurointerventional in a weekend, than he did at our base in a month. They cut everybody's ability to moonlight. They hired a BOZO for 400,000/yr. He had been fired from his previous job for alleged sexual harrasment. Every radiologist in that department was unhappy. One left with 15 yrs active duty time. He felt like the life was being squeezed from him, and he had been a line officer before going to med school. All these guys were dedicated and hard working, and all hated the system that they recognized was a piece of crap. So maybe your radiologist was just doing his bare minimum and when it came time to get out he did.

Not all physicians in the military are concerned enought to post here. Many do not know about this forum, do not care, do not see the ability to enact change. There may be multiple other reasons. The fact remains that the few of us who do care bring multiple experiences over long periods of time from all branches of medicine, and we know military medicine is in the toilet. We care about our soldiers and want them to have as close to the best medical care as possible. That is not happening now. Unfortunately the best we can see, is letting the system get to the point of failure before something is recognized by the beurocrats who run the system. But look at the VA system. I feel very little hope, but will continue to try to educate others about what to expect when becoming a military physician.
 

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militarymd said:
Sounds like the typical Navy nurse corp rah, rah, rah, speech from someone who writes point papers, but don't know how to put an IV in.
It's an accepted leadership statement - "Don't come to me with a problem unless you have a solution". Our medical director in the ED where I was a resident (coincidentally, 9 years as Navy FS, and got rotary-wing qualified (although, sorry, don't know which aircraft) while in - but left while the leaving was good) taught me that, and I respected him enough that I always had my ducks in line when I presented an issue to him. He's an active EP and the residents - to a person - preferred working with him. Despite the admin activities, he retains his technical skill.
 

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Galo said:
The radiologists at Offutt when from 4-2 with no change in volume of films or reading expectations. One of them almost got divorced because of the stress it added for almost a year before they were able to work out a deal and sent radiology stuff out. At Wright Patt, one of the department of defence's only specially trained neurointerventional radiologist was deprived of his ability to practice at the univ of Cincy where he was able to do more neurointerventional in a weekend, than he did at our base in a month. They cut everybody's ability to moonlight. They hired a BOZO for 400,000/yr. He had been fired from his previous job for alleged sexual harrasment. Every radiologist in that department was unhappy. One left with 15 yrs active duty time. He felt like the life was being squeezed from him, and he had been a line officer before going to med school. All these guys were dedicated and hard working, and all hated the system that they recognized was a piece of crap. So maybe your radiologist was just doing his bare minimum and when it came time to get out he did.
Good examples, although different military facilities vary significantly. The radiologists at the last med cen I worked at had a fairly cushy case load. Plus they rarely got deployed. So overall their morale was much higher then the FP docs. The FP docs were getting deployed right and left, and then overworked when they got back home b/c so much of their staff was deployed at any given time. They did finally start hiring more and more civilian contractors though, so that helped things out.
 
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Mirror Form said:
Good examples, although different military facilities vary significantly. The radiologists at the last med cen I worked at had a fairly cushy case load. Plus they rarely got deployed. So overall their morale was much higher then the FP docs. The FP docs were getting deployed right and left, and then overworked when they got back home b/c so much of their staff was deployed at any given time. They did finally start hiring more and more civilian contractors though, so that helped things out.

I had a good friend at Offutt; FP docs there were running at 15% manning many days. More with less only goes so far. Kinda like the career length of todays military FPs.
 
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IgD said:
Today I heard someone comment on leadership: Never give criticism without providing an alternative solution that is validated, viable, sustainable and flexible. See the problem is that you guys give criticism that is not constructive. The end result of such misdirected criticism is your leadership and credibility are undermined.

I think DogFaceMedic is calling you guys on this.

As far as my background, I've posted on it before. You may want to read the forum a little more closely.
IgD: concise and accurate analysis.

There are many problems, but there are some solutions. No solution is perfect or complete, but we can work at them while we are serving in uniform. Regardless, our soldiers (sailors, marines, coasties) still need medical care and their needs are not served by non-existent or incompetent health care.

The guesses about my background, naivete, experiences, medical licenses, inferiority complexes, etc.. provided me with heartfelt enjoyment -- and, inaccurate.

Fishing was good, children had a good time, still ate hamburgers -- sadly, back to the real world.
 

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DogFaceMedic said:
IgD: concise and accurate analysis.

There are many problems, but there are some solutions. No solution is perfect or complete, but we can work at them while we are serving in uniform. Regardless, our soldiers (sailors, marines, coasties) still need medical care and their needs are not served by non-existent or incompetent health care.

The guesses about my background, naivete, experiences, medical licenses, inferiority complexes, etc.. provided me with heartfelt enjoyment -- and, inaccurate.
I never expected/expect perfection. Manning a clinic a little better than 20% would be a start though. Having a chart when the patient is there does not seem unreasonable.

Yes, our soldiers and retirees (and their families) all deserve the best healthcare. What the goverment has purposely DESIGNED for the current military healthcare system to function is shameful. As officers and physicians, we all have to decide what price we will pay to do a job. I was willing to deploy, work 300+ hours, go to war, get 50% the pay I could get as a civilian.................I was NOT willing to play part in a healthcare system that placed my patients at unnecc risk, and one that has removed the physician from have some measure to ensure quality care for the patients (ie. 100% responsibility with zero% authority).

Call me crazy, but i doubt the USAF will find many physicians willing to work in that system. It is all very sad. :oops:
 

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DogFaceMedic said:
IgD: concise and accurate analysis.

There are many problems, but there are some solutions.
Yep, wasn't your solution to send all doctors to basic training? Seriously though, what are your solutions? So far none of your posts have even touched on any the problems we've been discussing here (perhaps b/c you don't understand them?).

BTW, I'm not even one of the hardcore anti-military medicine people on this forum. When pre-meds ask me about HPSP I don't scare them off. But to hear naive people like yourself lecturing us with some second grade level idealism is annoying. Especially since none of your posts have really addressed any of the issues. Your broken record of "the soldiers need us" isn't what's being debated, nor is it what needs fixing.

DogFaceMedic said:
The guesses about my background, naivete, experiences, medical licenses, inferiority complexes, etc.. provided me with heartfelt enjoyment -- and, inaccurate.
And you dodge the question once again. It's not like it takes a genius to figure out that you aren't a military physician. And if your experience was worth mentioning then you would have mentioned it.
 
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Mirror Form said:
Yep, wasn't your solution to send all doctors to basic training? Seriously though, what are your solutions? So far none of your posts have even touched on any the problems we've been discussing here (perhaps b/c you don't understand them?).

BTW, I'm not even one of the hardcore anti-military medicine people on this forum. When pre-meds ask me about HPSP I don't scare them off. But to hear naive people like yourself lecturing us with some second grade level idealism is annoying. Especially since none of your posts have really addressed any of the issues. Your broken record of "the soldiers need us" isn't what's being debated, nor is it what needs fixing.



And you dodge the question once again. It's not like it takes a genius to figure out that you aren't a military physician. And if your experience was worth mentioning then you would have mentioned it.
The tenor of discussion on this web over the last year or so seems to have improved, but perhaps not enough. (It was the contemptful derision of the enlisted Americans that made me sign on to this forum and defend them.) It is a bit of a joke, but everyone going to basic training has a point - Plato recommended it for everyone who wanted to vote -- but that is off topic.

I have several suggestions, but I am reluctant to initiate suggestions then be promptly castigated as a naif. I had hoped to initiate a good dialogue first.

I had thought about sharing my experiences, but the vitriolic insults when I first joined made me decide against it. If I say I did this or that, then someone responds, "Oh, you think you had it tough. I had to walk ten miles to residency in the snow and blistering heat." "Oh yeah! Our senior resident murdered us every night before resuscitating us." "Oh yeah! we had to get up an hour before we went to sleep...." (I plagiarized just a little from Monty Python, which may date me.) Then the point is lost under who has the biggest.....self-assessment.

My misjudgement may have been that the tenor was improved enough to initiate a good discussion. IgD maybe right that this verges on the "broken doctor" forum.

I will continue to work to be a part of the solution, rather than the problem as long as I serve.

And, to those who served and suffered under the bureaucratic nonsense: thanks for providing good care to those who deserve it. Really, no hidden agendas.

I'll let someone else start a new threat on pragmatic solutions, because I am now a target. Adding to another thread seems pointless because it gets buried under the rants.
 

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DogFaceMedic said:
The tenor of discussion on this web over the last year or so seems to have improved, but perhaps not enough. (It was the contemptful derision of the enlisted Americans that made me sign on to this forum and defend them.) It is a bit of a joke, but everyone going to basic training has a point - Plato recommended it for everyone who wanted to vote -- but that is off topic.
Plato recommended this where, exactly? If you are going to cite classics, then do so with accuracy, please. And please explain the relevance to military medicine, if you can. I could use a laugh.

DogFaceMedic said:
I have several suggestions, but I am reluctant to initiate suggestions then be promptly castigated as a naif. I had hoped to initiate a good dialogue first.
Yeah, right. It was for our benefit entirely.

DogFaceMedic said:
I had thought about sharing my experiences, but the vitriolic insults when I first joined made me decide against it. If I say I did this or that, then someone responds, "Oh, you think you had it tough. I had to walk ten miles to residency in the snow and blistering heat." "Oh yeah! Our senior resident murdered us every night before resuscitating us." "Oh yeah! we had to get up an hour before we went to sleep...." (I plagiarized just a little from Monty Python, which may date me.) Then the point is lost under who has the biggest.....self-assessment.
Not so fast. Don't say you have experience and ideas, but then back off saying you don't want to share them, and then blame others for your reluctance. That especially makes you look lame.

DogFaceMedic said:
My misjudgement may have been that the tenor was improved enough to initiate a good discussion. IgD maybe right that this verges on the "broken doctor" forum.
Very convincing. So far, you have played exactly the same card as IgD, suggesting you have important and relevant "experience" but providing no specifics. Then you try to slam the posters who do cite their experience, in detail, by referring to them as "broken doctors". I call B.S.on you, just as I do with that charlatan IgD.

DogFaceMedic said:
I will continue to work to be a part of the solution, rather than the problem as long as I serve.
Doing what, exactly?

DogFaceMedic said:
And, to those who served and suffered under the bureaucratic nonsense: thanks for providing good care to those who deserve it. Really, no hidden agendas.
If you mean that, then stop hiding your experiences and credentials.

DogFaceMedic said:
I'll let someone else start a new threat on pragmatic solutions, because I am now a target.
B.S. on you there.

DogFaceMedic said:
Adding to another thread seems pointless because it gets buried under the rants.
And B.S., again. You are a troll, plain and simple.
 
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Well, all the negative attacks is precisely my point about my reluctance to engage just to experience irrationale vitriol. The ER forum is much better, with greater maturity.

And for Plato: in "The Republic" he did not suggest basic training as such. Rather, he advocated willingness to defend the "polis" as a precursor to participation in politics. Those not willing to defend it, should not have a say in poltiical discourse.

I think it was PandaBear that responded to the whining about how tough medicine is by suggesting Infantry was a harder job. (Of course, someone will then conclude that I do not know how tough medicine is.)
 

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DogFaceMedic said:
I will continue to work to be a part of the solution, rather than the problem as long as I serve.

And, to those who served and suffered under the bureaucratic nonsense: thanks for providing good care to those who deserve it. Really, no hidden agendas.

I wish there were solutions to the DEEP pile of crap that military medicine now finds itself in. The solution is NOT just keep your mouth shut, look straight ahead, and work hard. Those are all admirable traits at times, but they will lead to the continuence of the same problems we have now.

Although I wish things were different, I really do not believe our military leadership has in thier character, what it will take to right the ship. What they do have is MICROMANAGING, PROMOTION, METRICS and other things that do nothing to help the doctor care for the patient, in fact they frequently hinder that relationship and put care at risk. :mad:
 

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DogFaceMedic said:
Well, all the negative attacks is precisely my point about my reluctance to engage just to experience irrationale vitriol......

They are simply calling you out.....I raise the BS flag also.
 

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DogFaceMedic said:
Well, all the negative attacks is precisely my point about my reluctance to engage just to experience irrationale vitriol. The ER forum is much better, with greater maturity.

And for Plato: in "The Republic" he did not suggest basic training as such. Rather, he advocated willingness to defend the "polis" as a precursor to participation in politics. Those not willing to defend it, should not have a say in poltiical discourse.

I think it was PandaBear that responded to the whining about how tough medicine is by suggesting Infantry was a harder job. (Of course, someone will then conclude that I do not know how tough medicine is.)
Change your avatar. Use this.
 

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USAFdoc said:
I wish there were solutions to the DEEP pile of crap that military medicine now finds itself in. The solution is NOT just keep your mouth shut, look straight ahead, and work hard. Those are all admirable traits at times, but they will lead to the continuence of the same problems we have now.

Although I wish things were different, I really do not believe our military leadership has in thier character, what it will take to right the ship. What they do have is MICROMANAGING, PROMOTION, METRICS and other things that do nothing to help the doctor care for the patient, in fact they frequently hinder that relationship and put care at risk. :mad:
USAF Doc is right. I have seen far too much crap passing as leadership to the detriment of what matters. It iriitates me no end and I want to find solutions. Sorry for the blunt response, militarymd, I have a short temper sometimes.

It is not all darkenss and evil; I have worked for very good CDRs and NCOs, medical and line units - and I am watching Band of Brothers. But, I have had the misfortune of being under many morons.

As is no secret we can fight back by doing the right thing by our patients and using our medical authority to push back.

At higher levels, we obviously need less clip board nurses. The quickest way to get rid of them is force them to pull shifts on the floor -- they retire or transfer when pressed to perform.

And, the IG and congressional reps can help fight some battles. If you worry about a reprimand, they can't for upholding your medical judgement. Anyway, what are they going to do, kick us out. I'm taking their money and experience and trying to do the right thing by my soldiers (and dependents, retirees, airmen, marines, sailors, etc...)
 
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