Physician Retention

[midn]

This is kind of an aside, but I was wondering if anyone had an article talking about military physician frustrations and how this is effecting retention. The reason I ask is that I am writing my term paper for Leadership and Management (stupid ROTC class) and the topic of my paper is "Leadership with Minimal Coercion" (I would have preferred to write about military medicine altogether, but there are very few resources about the health of military medicine since the issue has been somewhat hushed up). At one point I talk about the usual issue I have read here concerning overbearing O6 nurses giving commands beyond their medical knowledge and how this is causing doctors to become dissatisfied with their jobs and leaving. In my roughdraft, the CDR asked that I cite a source for this statement. Of course, I really doubt I could cite this forum without loosing credibility.

I tried googling, but I mostly came up with nothing I really wanted. I'm sure you folks have something in mind. It doesn't necessarily have to be about the O6 nurses, just something about the loss of physicians due to job dissatisfaction.

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[MedicalCorpse]

I tried googling, but I mostly came up with nothing I really wanted. I'm sure you folks have something in mind. It doesn't necessarily have to be about the O6 nurses, just something about the loss of physicians due to job dissatisfaction.

O.K., here are a few links for you:

http://www.rense.com/politics6/whathap.htm
http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=18464
http://www.usmedicine.com/article.cfm?articleID=152&issueID=23
http://www.usmedicine.com/column.cfm?columnID=16&issueID=12 (Notice Dr. Koenig's black eyes...presumably from being beaten up by administration goons)
http://www.medicalcorpse.com/MG_Scotti_responds.html (involuntary recall to active duty from retirement for life being one of the primary reasons for physicians to leave with only a few years left until retirement)
http://www.medicalcorpse.com/mmcexcerpt.htmlhttp://www.medicalcorpse.com/mmcexcerpt.htmlhttp://www.medicalcorpse.com/mmcexcerpt.html
http://www.medicalcorpse.com/ADSCincreased.html
http://www.medicalcorpse.com/editorials.html

From which I quote:

[FONT=Arial, Helvetica]14) It's Retention, Stupid! .[FONT=Arial, Helvetica]Do something-anything-- to retain good clinical physicians (and nurses) in military service. Like Dilbert , the surest way to recognize the best and brightest military physicians is to look at the long list of those who have left in disgust. When I told my Commanders that I intended to leave the Air Force after 15 years toward retirement, the only response the Air Force Personnel Center gave was: "He's lying. No one leaves after putting in that much time. We have him by the gonads" (or words to that effect). I retorted that this was an excellent way to insure retention of Harvard-educated, board-certified physicians in wartime-critical specialties: impugn their honor and integrity. No one in the chain of command EVER asked me to come to his or her office to reconsider my decision to leave the Air Force as a senior Lieutenant Colonel. When I wrote down a detailed list of my grievances and concerns (similar to this one, but with far more acronyms) at the behest of the hospital Chief Physician (SGH) in November, 2003, nothing ever happened. Poof! It went into the magical black hole of the military circular file reserved for all honest suggestions for process improvement...the same massive singularity that sucks in and destroys the results of the interminable Workplace Climate Surveys sent out (and ignored) year after year. Given this lack of retention of good doctors, who stays in? That's right, the bad and mediocre doctors who could not make it on the outside, because their clinical skills have atrophied to the point of uselessness after years of getting bedsores on their bottoms from doing e-mail, attending meetings, and typing Letters of Reprimand instead of treating patients. After addressing physician retention, do something to encourage retention of highly trained clinical nurses, who are fleeing the military like proverbial intelligent rats who see the murky and deep depths toward which military nursing is headed. Stop making nurses give up direct patient care to "fly desks" in order to make rank. The best medical and surgical care in the world can be undercut and destroyed by a 2nd lieutenant ward nurse who has no idea that we don't routinely stick arterial lines in the patient's chest, rather than wrist; or who ignores hours of critically-low blood pressure or troubled breathing because their ignorant inexperience prevents them from recognizing dire emergencies..

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Hope this helps. As a former ROTC cadet myself (1981-1985), I hope your essay falls on non-blind eyes.

--
R

 

[midn]

O.K., here are a few links for you:

http://www.rense.com/politics6/whathap.htm
http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=18464
http://www.usmedicine.com/article.cfm?articleID=152&issueID=23
http://www.usmedicine.com/column.cfm?columnID=16&issueID=12 (Notice Dr. Koenig's black eyes...presumably from being beaten up by administration goons)
http://www.medicalcorpse.com/MG_Scotti_responds.html (involuntary recall to active duty from retirement for life being one of the primary reasons for physicians to leave with only a few years left until retirement)
http://www.medicalcorpse.com/mmcexcerpt.htmlhttp://www.medicalcorpse.com/mmcexcerpt.htmlhttp://www.medicalcorpse.com/mmcexcerpt.html
http://www.medicalcorpse.com/ADSCincreased.html
http://www.medicalcorpse.com/editorials.html

From which I quote:

[FONT=Arial, Helvetica]14) It's Retention, Stupid! .[FONT=Arial, Helvetica]Do something-anything-- to retain good clinical physicians (and nurses) in military service. Like Dilbert , the surest way to recognize the best and brightest military physicians is to look at the long list of those who have left in disgust. When I told my Commanders that I intended to leave the Air Force after 15 years toward retirement, the only response the Air Force Personnel Center gave was: "He's lying. No one leaves after putting in that much time. We have him by the gonads" (or words to that effect). I retorted that this was an excellent way to insure retention of Harvard-educated, board-certified physicians in wartime-critical specialties: impugn their honor and integrity. No one in the chain of command EVER asked me to come to his or her office to reconsider my decision to leave the Air Force as a senior Lieutenant Colonel. When I wrote down a detailed list of my grievances and concerns (similar to this one, but with far more acronyms) at the behest of the hospital Chief Physician (SGH) in November, 2003, nothing ever happened. Poof! It went into the magical black hole of the military circular file reserved for all honest suggestions for process improvement...the same massive singularity that sucks in and destroys the results of the interminable Workplace Climate Surveys sent out (and ignored) year after year. Given this lack of retention of good doctors, who stays in? That's right, the bad and mediocre doctors who could not make it on the outside, because their clinical skills have atrophied to the point of uselessness after years of getting bedsores on their bottoms from doing e-mail, attending meetings, and typing Letters of Reprimand instead of treating patients. After addressing physician retention, do something to encourage retention of highly trained clinical nurses, who are fleeing the military like proverbial intelligent rats who see the murky and deep depths toward which military nursing is headed. Stop making nurses give up direct patient care to "fly desks" in order to make rank. The best medical and surgical care in the world can be undercut and destroyed by a 2nd lieutenant ward nurse who has no idea that we don't routinely stick arterial lines in the patient's chest, rather than wrist; or who ignores hours of critically-low blood pressure or troubled breathing because their ignorant inexperience prevents them from recognizing dire emergencies..

------------
Hope this helps. As a former ROTC cadet myself (1981-1985), I hope your essay falls on non-blind eyes.

--
R

Sweet, thanks alot. This will certainly add more punch to my paper.

In regards to yous last statement about falling on non-blind eyes, I think it is largely inevitable. The CDR who teaches the class is a dolt who fails to read into what he teaches by exercising the same ineffective leadership principles that are cited as failures in our material. Nobody seems to listen to research in the Navy unless it supports the status-quo.

The only thing positive that I have gotten out of the class is the doors it has opened for me to use other styles of leadership than just strict adherence to policy. In fact, we had one USMC general come in and talk to us about his experiences that were largely similar to yours (in a different context than medicine). When he was a Colonel at the time, his supervising O7 general was unethically and illegaly court-martialling a subordinate who was speaking up against some of his actions. The COL went to the general and explicitly stated to him that he would be reporting his violations to the O7's superiors. The O7 responded to his legal threat by grabbing him by the collar and screaming at him, then following up with an aggressive letter of reprimand which he literally threw in the COL's face. In the end, the O7 ended up getting kicked out of the USMC and the guy went on to become an O7 himself. Hopefully, my peers and I will follow these assertive behaviors when we are commissioned and bring about the change everyone wants to see.