Political Climate

[AubreyMaturin]

I have read, in other threads, people mention the current political "climate" in regards to miltary medicine. One of my interviewers for USUHS (Army) said that the Navy was going to sub contract much of its medical labor. What does this mean exactly, "sub-contract?" What are the consquences of the current administration's policies? How will this affect our future as HPSP and USUHS grads?

It seems that less people means less competition for residencies, but not if their are less residncies available as well.

I am interested in conjecture and opinions, but please back up with facts.

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[edmadison]

The impact of the subcontracting will mean that those who are active duty will have a much greater chance of being deployed. Then, when you complete your active duty committment and go IRR you will have a much greater chance of being pulled back to AD. As for residency slots, the Navy is already eliminating those.

Ed

 

[militarymd]

"sub-contracting" means that instead of having an active duty physician on staff at a military hospital, you just "contract" for a service from physicians available around that particular base.

Tricare is supposed to allow members to seek "any physician" in the area that they want....Unfortunately Tricare re-imbursements are relatively low, so many physicians won't take tricare.

Many of the established surgeons that I work with will not take Tricare because the reimbursements are so low. One group that I work with now have rescinded that policy in light of our current war.

 

[rotatores]

As for residency slots, the Navy is already eliminating those.

Actually...just half of the peds spots...but don't worry...they Army will soon catch on.

 

[AubreyMaturin]

I am curious to know how many Navy residency applicatns exhist in a given year; USUHS, HPSP, returning GMOs combined. Does anyone know how many there are? According to the GME website, there are only 221 total residency spots availible, and less than 10% of applicatns get a defferal to civilian residencies. These numbers would actually speak more of the competitiveness overall.

 

[Neuronix]

My predictions are that non-combat essential residencies will be slashed and the needed jobs will be given to civilian contractors in the USA. The remaining military personell will have greater restrictions on the type of residency or the type of job they will perform (i.e. trained in one thing, used as FP). Meanwhile, billet selection will get even worse, as it's easier to fill the billets that aren't in the middle of nowhere. Since civilians are not deployable, the fewer military docs will be deployed more frequently. I believe this will happen to more than just the Navy.

No facts here other than the ones already posted, just conjecture.

 

[Mirror Form]

My predictions are that non-combat essential residencies will be slashed and the needed jobs will be given to civilian contractors in the USA. The remaining military personell will have greater restrictions on the type of residency or the type of job they will perform (i.e. trained in one thing, used as FP). Meanwhile, billet selection will get even worse, as it's easier to fill the billets that aren't in the middle of nowhere. Since civilians are not deployable, the fewer military docs will be deployed more frequently. I believe this will happen to more than just the Navy.

No facts here other than the ones already posted, just conjecture.

I strongly doubt this. It would be very difficult to recruit enough physicians to fill the deployable billets if the physicians knew ahead of time that they were just going to be gmo's for the entire commitment, of if they were going to be continually deployed.

 

[Neuronix]

That's why the military recruits pre-meds, who are signing up for 4 years of active duty and 3+ years of residency beginning 4 years after they've signed on. Even now nobody knows what their life will be like then and if they read this forum, they get a sense that military med is still screwed up. Yet, people still join. Everyone knows now they're going to be deployed, so what if the chances go up a bit? Everyone knows now that they'll be stationed in the middle of nowhere USA for their required payback. Despite everything we hear about the Navy, we still have people on here joining, no? So what if the military doesn't keep any long-term physicians, my understanding from militarymd is that they're having a hard time with that now. There will always be more debt-phobic pre-meds and patriotism driving future med students to Uncle Sam...

If all this stuff can't dissuade people from singing up, what will? I doubt anything will.

Again, just more speculation. Feel free to flame away...

 

[militarymd]

That's why the military recruits pre-meds, who are signing up for 4 years of active duty and 3+ years of residency beginning 4 years after they've signed on. Even now nobody knows what their life will be like then and if they read this forum, they get a sense that military med is still screwed up. Yet, people still join. Everyone knows now they're going to be deployed, so what if the chances go up a bit? Everyone knows now that they'll be stationed in the middle of nowhere USA for their required payback. Despite everything we hear about the Navy, we still have people on here joining, no? So what if the military doesn't keep any long-term physicians, my understanding from militarymd is that they're having a hard time with that now. There will always be more debt-phobic pre-meds and patriotism driving future med students to Uncle Sam...

If all this stuff can't dissuade people from singing up, what will? I doubt anything will.

Again, just more speculation. Feel free to flame away...

Man....N is worse than me

 

[Croooz]

Neuro,
Don't forget that the military also recruits those in residency and private practise. I agree though it's easier to get you guys when your young, dumb and full of seminal fluid...

I doubt this will work the way we are all speculating. There's no way a military of only the "high speed/stress" specialties is going to work. I can't see the recruitment getting easier. While there are many uninformed still signing up, there still are many scholarships going un-signed.

Military life happens in cycles. There's no telling where the wave will take us in the decade after this. Right now, with Rummy still doing his thing I can say that the next 8-10 years are going to be lean & mean.

A long term speculation is combining the different branches' military medicine. Opening up the billets of any service to any miliary physician. Probably not but with all the realignment that's going it's not that farfetched. There's a realignment that would take effect in 2011 and here we are in 2005. Therefore the decisions made today will not take effect for a number of years. So for those who take the scholarship today the climate will be changing once they join and again by the time residency is over and again when they finish paying back.

That is why Semper Gumby is the name of the game. It's not about the money. For those lurkers who only read....IT'S NOT ABOUT THE MONEY!