Good point. But you’re assuming more than 4 people read these and that the data is actually used to drive change 😎
I edited it and took the link off. Though I got it from the MCCareer blog which is also publicly available.
I don't think there are a lot of random people who do weird niche surveys like this for fun.
In all seriousness, there's a good argument to be made that their actual goal is anti-retention of clinicians, and limited retention of admin track people.
I had never even considered this until once upon a time you posted something similar with this point of view. Looking at it through that lens I completely agree with you and totally makes sense as to why they haven’t changed things and retention is so poor. It’s cheaper for them to recruit HPSPers and pay young O3’s and O4’s instead of paying O5’s and O6’s for years and then paying the pension as well. Especially since the pipeline seems to be steadily full with students signing up as they are.
Is the pipeline actually full? IDK, maybe it is and maybe it isn't but the military sure doesn't make those numbers public like they do their general recruiting numbers (which have been horrendous the last two years). Even it is full, I hear from my USUHS buddies still on active duty that the quality of candidate is horrible. All "puppy mill" for-profit DO schools and no allopathic instituions other than USUHS. I guess the line doesn't care that they are getting bottom of the barrel, either.
Not sure we need to be spending more money on this. RAND wrote it up and leadership already knows why people leave…they just don’t feel the need to stop the exodus right now
It's always interesting how you can be more productive at civilian facilities, while simultaneously feeling as though you're doing less work. I mean part of the issue is certainly the inefficiencies of the military bureaucracy, then you've got corpsmen/medics that don't like their job because the military chose it for them, contract nurses that know how to do just enough work to not get fired, constant down time, IT departments that suck, etc.
The fact the juice is not worth the squeeze. No deployments, more time off, way more $$$. Do your time and get out!
Most of that, of course, is the better support structure that offloads ancillary tasks to nonphysicians, so the physicians can devote more time to being physicians.
The pathetic thing about this situation is its utter forseeability. Devalue the professionals both in pay and status, humiliate them officially by having a "surgeon" general not even be a physician, diminish the quality of hospitals and the training they are capable of providing while withholding training, perpetuate the antique and abusive use of GMOs, cut the retirement benefits. What individual cognizant of their professional value would want to settle for a long-term committment to such an employer? It is telling of the abject failure of institutional leadership for a senior officer--an admiral, no less--to express wonder why so many are leaving. Tell me what value there is anymore to staying. Over a decade ago, the Navy surgeon general (one who didn't pad his Navy resume with fake diplomas) made the incisive observation about the decline in diversity of applicants to HPSP from American medical schools, especially the decline in the proportion of applicants from allopathic schools. That hasn't stopped. When the HPSP program started to falter in attracting a bare minimum from any U.S. schools, they responded with a bonus program, which brought applications up a bit but did nothing to change the skew away from allopathic student accessions.
DO here and not offended. My school looks on paper like a "puppy mill", though it wasn't for profit. I think the Education Bubble(TM) has just pushed so many DO students to seek assistance through the HPSP scholarship. I think if I went to even a lower tier MD school, that was in state and had in state type tuition, there would certainly be less pressure than those of us that sign up knowing we'd graduate with >$400k in debt.
This highlights a problem with training at a mtf. Residents perceverated over jobs that nurses and techs do. We had to place our own ivs first round, very limited preop resources. At nmcp one preop nurse checked in all the patients versus in private practice we have 1 preop nurse to 2 patients. Our preop nurses are a very valuable resource. I don’t worry about difficult iv starts or labs everything is ready for review. Even on my worst days its 10x better then my best day in the .mil.
Which leadership has no one to blame for but themselves. Tasking attendings and residents to do labor that could and should absolutely be done by "lower level" staff just contributes to the lack of productivity and makes manning issues worse. I think leadership sees - Oh we have residents who can do IVs and it works and there's a month here and there without delays, this is the best! But then when there's higher volume, or tougher sticks, or an MD isn't available for it - the nurses and techs just sit and stare at each other wondering who's going to give the next break.
I agree with this. Seems like the restructuring has us worse than we were before…hopefully temporarily. Too many active duty losses, not enough civilian hires because pay isn’t enough and hospital system hasn’t been rebuilt yet. There are good idea fairys in leadership who aren’t using the org structure to implement so we are seeing the same disorganized and disconnected service specific MTFs that we always had.
Completely agree. I think the absurdity is only going to be highlighted by the shutdown. It's tragically funny that Active Duty will stay and work longer hours to pick up the slack from the system while our civilian "support" is furloughed.
Denying leave is a local issue and also intra departmental. It means their leadership didn’t have the backbone to stand up for their people and they continued to say yes sir/ma’am when told to do more with less.
I agree with most of the statements here except it should be tricare Megatron.
That’s a best case scenario I’m afraid.
Military physicians lost the battle with CRNAs 20 years ago. Many of us sounded the alarm, but the ASA and VA
