Soldiers Face Neglect, Frustration At Army's Top Medical Facility

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IgD

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Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses...

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html
 

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Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses...

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html

what can you say.........nothing surprises me anymore in milmed. And if you present this to congress, you will get a generic letter back talking about the "funding problems."

But with this going public, perhaps we will see a least a more prepared verbal response/lip service.

sad.:(
 

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Sad is right. :(

I hate to say it, but the bureaucracy of the military is probably at its worst in the medical setting... and these wounded vets are vulnerable men. They've served, given their all, and they deserve better.

That article made me ill.

This is what an admin-heavy, underfunded, and understaffed medical system does... this is how it acts. Three forms to fill out for everything (and you'll probably have to fill them out again after they lose them), and you wait in line to find out which line to wait in. It's completely impersonal, you cannot get money for the things your patients need, there's no accountability, and you're just expected to deal with it.

When I, as an active-duty medical staff member in my own facility, had trouble getting through the phone triage system, setting up appointments for family members, getting past the front desk, etc. Jiminey Christmas... when I work in the facility and I can't make the system work smoothly for myself and my dependents, how much more difficult is it for Airman Schmuckatelli from the SP squadron, an F-15 crewchief, or even somebody from a different branch of service, who doesnt know the system, doesn't know who to call, doesn't know where to go...
 
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this is just what walter reed is like. It's not just the vets that have to deal with this crap, although they get screwed more by it though.

the article definitely left a lot of stuff out though. It didn't mention the huge number of soldiers who will do anything they can to never leave medhold (full pay, free housing in DC, no responsibility). Nor did it mention that the formations, which it heavily criticized, were designed to combat the overwhelming number of those soldiers with secondary gain issues.
 

orbitsurgMD

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this is just what walter reed is like. It's not just the vets that have to deal with this crap, although they get screwed more by it though.

the article definitely left a lot of stuff out though. It didn't mention the huge number of soldiers who will do anything they can to never leave medhold (full pay, free housing in DC, no responsibility). Nor did it mention that the formations, which it heavily criticized, were designed to combat the overwhelming number of those soldiers with secondary gain issues.

I have no problem with the reville, or even the uniform requirements, but the woeful neglect of the physical plant is beyond excuses. Go lease an entire hotel like the Bethesda Marriott that is within reasonable distance of the hospital and set up a temporary command there.

This kind of institutional failure--and the Army at its highest levels is where the responsibility for these things lies--is nothing less than the predictible result of multiple years of underfunding and an ingrained culture that recognizes cost cutting and containment as the highest goal of job performance. This is what death by bean counting looks like.
 

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They forgot to tell about the time in 2005 that the ceiling in the OR opened up and flooded the OR with who knows what just before a pt was wheeled into the room....

I hear people complain all the time that they are shutting down Walter Reed and "how could they do that", I'm glad it's going away at least there will be newer buildings.
 

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The whole situation is so typical of WRAMC—a lot of dedicated medical staff battling an intractable bureaucracy. Unfortunately, once a soldier leaves the hospital, there are no longer dedicated residents pushing the system on his behalf and he is totally in the clutches of the nameless, faceless paper-pushers. Giving the brain-injured guy a map and telling him to find his way across base is a classic move by WRAMC support staff.

Of course, the situation is not quite as one-sided as the Post makes it sound. As mirror-form notes, there certainly are a few secondary gain types working the med hold system for an easy paycheck, but this is a small minority.

Problems like this are why very few people I know are upset about the closure/relocation of Walter Reed. It’s long overdue.
 

met19

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the situation in this article is absoultely disgusting. I can think of some other choice terms, but it would be improper to write them out.

Hopoefully this will wake up admin, congress, and the white house to fund milmed appropriately.

Its amazing how some congressman/woman gets $150k to live in comfort and have at least 2 homes, when our specialists get $38k but the benefits of free medical care and facilites that need a ton of cash.

I say deduct some cash from the politicians to fund milmed properly. Sigh- it will never happen.

I remember a couple years ago, the VA offered every hospital in the country (including the milmed) their amazing state of the art software/computer system in return for a little cash. Everyone said no thanks. The milmed then wastes money on its own systems which to put in bluntly- suck.

Our admin/beauracy only know one thing- how to protect their jobs- not how to do a strong job that serves the average member.
 

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I remember a couple years ago, the VA offered every hospital in the country (including the milmed) their amazing state of the art software/computer system in return for a little cash. Everyone said no thanks. The milmed then wastes money on its own systems which to put in bluntly- suck.
I hated the VA EMR when I used it during residency, but once I got a whiff of what the AF was developing I wished that I could go back to the VA system. The CHCS II/PGUI/whatever the new acronym is/etc. was a complete waste of BILLIONS of dollars.
 

met19

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I hated the VA EMR when I used it during residency, but once I got a whiff of what the AF was developing I wished that I could go back to the VA system. The CHCS II/PGUI/whatever the new acronym is/etc. was a complete waste of BILLIONS of dollars.

CHCS II in the navy is ALTA or something like that. I actually like the VA system. Ofcourse I'm only a MS IV, that might change when Im a resident. however, the VA stuff is heads and shoulders above ALTA. I agree that its a waste of a billion or so.

All that proves is the mil admin people know how to waste money rather than apply it smarlty to fix a problem. It shows in the article when they applied for a small grant (30k) to improve the amenities and it eventually went downhill. If the military can't run a small grant how can anyone expect them to run a multi-billion dollar enterprise such as military medicine without multiple failures, screw-ups and iritating many people.
 

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As it seems (from numerous posters on this board) that the military medical system can't even cope with its basic (generally healthy) patient base, it's only logical that the system will be taxed beyond capacity with some 32,500 wounded from Iraq + 6,000 wounded from Afghanistan, many of whom have extreme health issues like amputations, brain injuries, and of course mental problems.

However, that obviously doesn't excuse what was documented in the Post article. However, I highly doubt that anything will be done about it for the forseeable future. Military leaders are likely to fund new military hardware over healthcare costs, as helicopters, vehicles and whatnot are worn down or destroyed at an alarming rate. And politically, huge funding increases on top of what's already allocated unfortunately just isn't in the cards. Add to that, that the system seems to have broken down administratively a long time ago, so throwing money at it is just unlikely to fix it properly.

So sad, that another lesson from the Vietnam War has been forgotten. One of the huge legacies of that conflict was the entirely insufficient healthcare system available to returning soldiers, and the huge human costs that followed. And this just seems like a replay.

Apparently, the richest nation in the world elects to engage in war, using poorly paid and often poorly trained soldiers, and then offers them substandard medical care when they need it the most. Simply shameful.
 

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As a health care provider in the very setting this article speaks of who has spent countless hours of his time away from patient care battling the very forces that lead to these unacceptable situations, I think a large part of the problem lies in that senior military medial leadership has failed to set the tone that our civilian contract help will work for us...not the other way around. The entire process of firing a government worker or contractor who will treat our patients this way, can be much more work than actually unf**king it ourselves.

I am sorry... just fired up... I as well as countless other dedicated military health care providers here at WRAMC spend many hours passed our civilian support staff (who often sneak out around 1530) to ensure these men and women who have given so much of themselves are appropriately taken care of.

I agree with a lot of what is said here, this is just a window into the larger problems facing military medicine. I am glad the truth will be know to the public and just maybe we will get the help that is needed...But it is unfortunate that many of the people who truely care and dedicate their lives to this will bear the brunt of the blame.
 

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As a health care provider in the very setting this article speaks of who has spent countless hours of his time away from patient care battling the very forces that lead to these unacceptable situations, I think a large part of the problem lies in that senior military medial leadership has failed to set the tone that our civilian contract help will work for us...not the other way around. The entire process of firing a government worker or contractor who will treat our patients this way, can be much more work than actually unf**king it ourselves.

I am sorry... just fired up... I as well as countless other dedicated military health care providers here at WRAMC spend many hours passed our civilian support staff (who often sneak out around 1530) to ensure these men and women who have given so much of themselves are appropriately taken care of.

I agree with a lot of what is said here, this is just a window into the larger problems facing military medicine. I am glad the truth will be know to the public and just maybe we will get the help that is needed...But it is unfortunate that many of the people who truely care and dedicate their lives to this will bear the brunt of the blame.

just how many threads, just how many personal accounts from on the job physicians, just how many newspaper articles, poor patient outcomes, doctors separating etc. will it take until somebody with some big enough clout in Washington gets a big enough clue that something stinks in milmed and its time to sweep the crap out the door and do the right thing???????
 
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just how many threads, just how many personal accounts from on the job physicians, just how many newspaper articles, poor patient outcomes, doctors separating etc. will it take until somebody with some big enough clout in Washington gets a big enough clue that something stinks in milmed and its time to sweep the crap out the door and do the right thing???????


This is exactly right. Unfortunately articles like this have been around before. Most poignantly the Pulitzer price winning expose in 1998 that we can see did little to nothing.

http://www.pulitzer.org/year/1998/national-reporting/works/index.html

(posted for the hundreth time here)



It looks like the masses of poor, underpriviledged, patriotic soldiers we use to fight our wars will continue to receive treatment on par with what medicare patients get, or worse.

Military medicine is truly an abomination that needs massive and immediate change.....that's why it will not happen.
 

met19

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This is exactly right. Unfortunately articles like this have been around before. Most poignantly the Pulitzer price winning expose in 1998 that we can see did little to nothing.

http://www.pulitzer.org/year/1998/national-reporting/works/index.html

(posted for the hundreth time here)



It looks like the masses of poor, underpriviledged, patriotic soldiers we use to fight our wars will continue to receive treatment on par with what medicare patients get, or worse.

Military medicine is truly an abomination that needs massive and immediate change.....that's why it will not happen.



That link reveals some of the scariest stories I have ever read. When I'm active duty, I'm gonna use MDs in the civ world....
 

georgia_md

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Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses...

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html


When I was in the Army, I did my medical lab tech training at WRAMC. I sort of remember the old buildings, the cheap furniture, the mouse droppings, cracked tiles, dingy bathrooms, etc... What I really remember is all the good training and education I got there. Being a young person with no prior medical knowledge or experience, WRAMC exposed me to an entirely different world. And I've been in love with that world every since. I am greatful for the Army giving me the experience. Before joining the Army, I wanted to become a chimpanzee trainer.
 

IgD

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Here is the best part:

We've done our duty. We fought the war. We came home wounded. Fine. But whoever the people are back here who are supposed to give us the easy transition should be doing it," said Marine Sgt. Ryan Groves, 26, an amputee who lived at Walter Reed for 16 months. "We don't know what to do. The people who are supposed to know don't have the answers. It's a nonstop process of stalling."

Soldiers, family members, volunteers and caregivers who have tried to fix the system say each mishap seems trivial by itself, but the cumulative effect wears down the spirits of the wounded and can stall their recovery.

"It creates resentment and disenfranchisement," said Joe Wilson, a clinical social worker at Walter Reed. "These soldiers will withdraw and stay in their rooms. They will actively avoid the very treatment and services that are meant to be helpful."

Danny Soto, a national service officer for Disabled American Veterans who helps dozens of wounded service members each week at Walter Reed, said soldiers "get awesome medical care and their lives are being saved," but, "Then they get into the administrative part of it and they are like, 'You saved me for what?' The soldiers feel like they are not getting proper respect. This leads to anger."

I can relate to that. I think this has happened to a lot of us here we have become resentful and disenfranchised. Someone said never trust an O5 or above. I think sometimes staying in the military means accepting the stuff in the news story as okay. I can keep my head up but I'm not willing to do that.
 

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Here is the best part:



I can relate to that. I think this has happened to a lot of us here we have become resentful and disenfranchised. Someone said never trust an O5 or above. I think sometimes staying in the military means accepting the stuff in the news story as okay. I can keep my head up but I'm not willing to do that.

I must say IDG, from where you began, you certainly have made a very strong turn around in your attitude towards military medicine. Is it one thing, or just a continuing of little events llike we all describe. THe one thing, is that knowing all this at your stage, you will be better able to deal with some of it as an attending. I'm glad and sad you have seen the light/darkness.
 

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Here's more info on how big this fire is getting...

http://blog.washingtonpost.com/capitol-briefing/


For you veteran milmed physicians that have sailed this ship, fought this battle, and flown this plane(?) in your past lives... just on cue, the clipboard brigade/squadran/fleet has crawled out from under their desks and out of the slumber from their offices to inflict their havoc on the situation.

Sorry, just venting.
 

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Just saw a clip of this televised on CNN. I would certainly hate to be at the bottom of that hill where a bunch of $h!+ is about to start rolling.

Sadly, Bldg. 18 at WRAMC is going to be in the spotlight until it is fixed, and then subsequently demolished following the closure of WRAMC as a result of the BRAC.
 

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Just saw a clip of this televised on CNN. I would certainly hate to be at the bottom of that hill where a bunch of $h!+ is about to start rolling.

Sadly, Bldg. 18 at WRAMC is going to be in the spotlight until it is fixed, and then subsequently demolished following the closure of WRAMC as a result of the BRAC.

you have to ask the question: Just how in the world could a medical facility get that bad, for that long without anyone speaking up till now.

and when you answer than question you will have the answer on why milmed in general has fallen into the latrine. :thumbdown: :eek: :thumbdown: :eek: :thumbdown:
 
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Whew, I just saw the clip on CNN too. This is the first time I've seen mil med problems make it on national TV.

I think this is going to bring some improvements to the facility or enough to trick the media into think it is improving.
 

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On NPR this morning, the Secretary of the Army referred to this debacle as a "leadership failure". Surely there can't be such a thing in Washington...
 

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you have to ask the question: Just how in the world could a medical facility get that bad, for that long without anyone speaking up till now.

and when you answer than question you will have the answer on why milmed in general has fallen into the latrine. :thumbdown: :eek: :thumbdown: :eek: :thumbdown:


I was speaking with an retired 06 (US Army) physician the other day, and he told me that there was so much the medical administration could do. DOD overides MEDCOM, so the medical administration can complain all they want, but the Pentagon will have the final word.

He told me that most of the best doctors were usually deployed to foreign lands, leaving the lesser experienced ones and residents behind to front the CONUS hospital he worked at. This bothered him a lot. Well, at least he doesn't have to worry about that anymore, with his private practice.
 

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I was speaking with an retired 06 (US Army) physician the other day, and he told me that there was so much the medical administration could do. DOD overides MEDCOM, so the medical administration can complain all they want, but the Pentagon will have the final word.

He told me that most of the best doctors were usually deployed to foreign lands, leaving the lesser experienced ones and residents behind to front the CONUS hospital he worked at. This bothered him a lot. Well, at least he doesn't have to worry about that anymore, with his private practice.

well then MEDCOM needs to go over the head of DOD and present the problems to congress, and if congrees looks the other way, present the problems to the WASHINGTON post or similar. In the end, you have to do the right thing.
 

georgia_md

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well then MEDCOM needs to go over the head of DOD and present the problems to congress, and if congrees looks the other way, present the problems to the WASHINGTON post or similar. In the end, you have to do the right thing.


Wow, Sir , you make it sound so simple
 

USAFdoc

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Wow, Sir , you make it sound so simple


no, it's absolutely not simple. And our USAF/Medical leadership could do the right thing and still end up with a screwed up result (no funding etc), but then it's on congress for the poor result and the American people who elected them.

As things stand now, we have too many milmed leadership that are simply not addressing issues that need addressing, and not doing the right thing. And again, a large part of the problem is the inherent nature of military hierchy, and inparticular to medicine, that in which those with the responsibility, have no authority (the docs). One answer would be to have a nonmilmed board with power that would field concerns from active duty docs.
 

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He told me that most of the best doctors were usually deployed to foreign lands, leaving the lesser experienced ones and residents behind to front the CONUS hospital he worked at.

I find it hard to believe, first, that it's even true. Getting deployed is not contingent on the "quality" (perceived or real) of the doc. Second, that it would have any effect on the quality of milmed in CONUS. The same problems overseas are present here, and if we're talking deployment not overseas stations, then all the docs come back anyway in only a few months (there are a few exceptions).

Dissatisfaction is military-wide (and to be fair there are those who enjoy themselves, though in my opinion fewer in number, military-wide) and is not contingent on a relatively small percentage not being in CONUS facilities.

In other words, sending docs overseas is not even remotely the cause for poor administration in my opinion. It's not a lack of effective/experienced docs stateside that has put this ship in it's current hole.
 

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He told me that most of the best doctors were usually deployed to foreign lands, leaving the lesser experienced ones and residents behind to front the CONUS hospital he worked at.

That might have been true during WW2 or something. It's definitley not the case now. The more experienced ones stay and the new guy gets deployed. Although, many surgical fields only deploy docs who have been out of residency for at least one year.
 

IgD

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I was at a conference recently and a flag officer said:
"Junior officer and junior enlisted have lost confidence in leadership. They are going on multiple deployments while more senior leaders are in protected positions."
 
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Of course it isn't just the deployments.

If you have a supervisor or commander more interested in feathering their own personal nest than in sharing the load, it'll always roll down hill; the FNG (f***ing New Guy) takes the hit.

This happens with deployments, undesireable TDYs (like CSTARS), and extra duties. Even holiday call assignments... in my last active duty year, one of my buddies happened to look at the holiday call schedule for his specialty, and noticed that the defacto "supervisor" (normal one was deployed) had given himself every single holiday off, from thanksgiving through the new year, whilst shafting everyone else.

Extra duties are easily reassigned based on commander whim, but anyone can get deployed, and it's harder to move people from one AEF rotation to another... I'm pretty sure that has to be done fairly far up the command chain. A vengeful or manipulative commander, however, can probably get it done.

In fairness (and as far as medical skill goes), you might actually want the younger guys deployed. An O-5/6 who has only been operating within the military system for his entire career probably hasn't done the hugely complex cases, the nasty trauma, and doesn't have the skills of a fresh-from-the-trauma-center grad. Skill atrophy is real.
 

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Whew, I just saw the clip on CNN too. This is the first time I've seen mil med problems make it on national TV.

C-SPAN also was apparently covering this story at length yesterday and is currently rebroadcasting it.
 

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The more experienced ones stay and the new guy gets deployed.



Yes, that makes a lot of sense. Send the residents overseas to the combat zones to treat seriously wounded Soldiers. Let them practice medicine without a license. The jail time for practicing without a license is no big deal
 

georgia_md

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I find it hard to believe, first, that it's even true. Getting deployed is not contingent on the "quality" (perceived or real) of the doc. Second, that it would have any effect on the quality of milmed in CONUS. The same problems overseas are present here, and if we're talking deployment not overseas stations, then all the docs come back anyway in only a few months (there are a few exceptions).

Dissatisfaction is military-wide (and to be fair there are those who enjoy themselves, though in my opinion fewer in number, military-wide) and is not contingent on a relatively small percentage not being in CONUS facilities.

In other words, sending docs overseas is not even remotely the cause for poor administration in my opinion. It's not a lack of effective/experienced docs stateside that has put this ship in it's current hole.

You are joking right?
 

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fortyfourhundred said:
Yes, that makes a lot of sense. Send the residents overseas to the combat zones to treat seriously wounded Soldiers. Let them practice medicine without a license. The jail time for practicing without a license is no big deal

Residents don't get deployed. GMOs have medical licenses. Jail time? What? :confused:
 

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This situation was also mentioned in the Op Ed section of the New York Times today. I am sorry for the patients who are affected by this, but at least I no longer have to wonder if I am going to do mil med!
 

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Residents have medical licenses, too.

Yes, they do. Are you suggesting that military residents face any credible risk of deployment, either now or in the near future?

Do you know how many residents have been pulled from their programs and deployed since this all started in 2001?
 

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Expect a lot of talk and little or no action other than maybe some new paint at Walter Reed. As with all things military, the feces will roll downhill and those of us in the trenches will soon be swimming in that much more of it.

I ran into a doc who in the 1980's was at the same facility where I'm stationed currently. She was shocked and horrified when we started comparing notes. She noticed the changes for the worse back then and promptly left for private practice. It took a generation to slide this far into the depths, but sadly nobody at the helm seems interested in reversing course. It will take a generation to fix milmed, and that is if anyone gave enough of a damn to get started.
 

FizbanZymogen

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Yes, they do. Are you suggesting that military residents face any credible risk of deployment, either now or in the near future?

Do you know how many residents have been pulled from their programs and deployed since this all started in 2001?

As far as I know this just doesn't happen (and yes, I know it is always a possiblity) but the reality is if you get into a residency in the military and aren't going GMO you really have no chance of being deployed as a resident.

someone correct me if I am way off base here.
 

edinOH

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I agree with the new paint prediction.

The hosptial commander will be reprimanded and retire. The dept. head in charge of the medhold outpts. will not be selected for Colonel. A bunch of promises will be made. Ultimately nothing will change unless congress sends a few bucks their way. Then we start the bidding.

I predict that the pentagon will point out that the whole place is scheduled to be closed in a few years anyway, so no further major improvement is justified. A few cans of white indoor latex paint and Plaster of Paris will keep the enlisted walking-wounded busy "fixing" the place until this thing blows over.
 

georgia_md

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uh, no. Are you serious in your belief that deployments have ruined CONUS medicine


I guess you were serious. It's obvious that deploying doctors has nothing to do with hospital administration. Anyways, I never said anything about deploying docs ruining conus medicine. You took two seperate unrelated paraphrases and connected them together
 

mitchconnie

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A few quick observations from the Washington scene after the Post Article:

Out at the AFB they are slapping on a coat of paint, and caulking the windows on all the areas that the OIF wounded see on their way through.

The prevailing Air Force attitude seems to be “Thank God we are so much better than those Army losers.”

The WRAMC commander sent a letter to all the employees/staff which essentially denied that the Washington Post story was true in any way. It contained the usual BS about how great our military healthcare system is.

It was quite a striking juxtaposition—the highest officials in the DoD are on CNN admitting that there are serious problems that need to be fixed, and at the same time the local commander is telling everyone that things are great.

Bottom line is that the leadership plan here is to hunker down and wait for the storm to blow over and the media to move on to the next crisis. A few buildings will get some paint (and apparently caulk), a couple mid-level military heads will roll (you can’t fire civilians), and we’ll all pretend that we’re fixing the problems until the war winds down or WRAMC closes, whichever comes first.
 

orbitsurgMD

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A few quick observations from the Washington scene after the Post Article:

Out at the AFB they are slapping on a coat of paint, and caulking the windows on all the areas that the OIF wounded see on their way through.

The prevailing Air Force attitude seems to be "Thank God we are so much better than those Army losers."

The WRAMC commander sent a letter to all the employees/staff which essentially denied that the Washington Post story was true in any way. It contained the usual BS about how great our military healthcare system is.

It was quite a striking juxtaposition—the highest officials in the DoD are on CNN admitting that there are serious problems that need to be fixed, and at the same time the local commander is telling everyone that things are great.

Bottom line is that the leadership plan here is to hunker down and wait for the storm to blow over and the media to move on to the next crisis. A few buildings will get some paint (and apparently caulk), a couple mid-level military heads will roll (you can't fire civilians), and we'll all pretend that we're fixing the problems until the war winds down or WRAMC closes, whichever comes first.

Sufficiently expendable heads will roll; but nobody who can point up the chain or say publicly that the Pentagon is responsible for underfunding milmed, which is the real truth. They will make it seem as if it is the local commander's fault entirely. Then the Greek chorus of critcs will join in and say how the closing of WRAMC is sad but ultimately necessary and should be accelerated so that adequate facilities can be funded at the new locations. If there is space near Ft. Myers or another D.C. military campus, the residents will be moved there. Building 18 will be symbolically closed, perhaps demolished for the cameras, if someone can pull it off.

Someone will try to point out that Medhold is a netherworld: not part of the medical command, technically under the umbrella of the Military District of Washington, but heretofore ignored by them and treated as if it were part of WRAMC as it members are in temporary status, not fit for duty, not part of any permanent wartime command, and now that they have been featured so negatively, not wanted to be owned by anybody.

The Pentagon will figure the bad press will blow over soon enough, as it usually does. So short term stage management will be done: the obligatory guillotinings, the public pronouncements, the wrecking ball, reassuring letters to all the people who were responsible for the low-level day to day management of the very problems that are getting bad press. Who knows, if the higher-ups can play it right, they might get a ribbon cutting or two out of it.
 

met19

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Sufficiently expendable heads will roll; but nobody who can point up the chain or say publicly that the Pentagon is responsible for underfunding milmed, which is the real truth. They will make it seem as if it is the local commander's fault entirely. Then the Greek chorus of critcs will join in and say how the closing of WRAMC is sad but ultimately necessary and should be accelerated so that adequate facilities can be funded at the new locations. If there is space near Ft. Myers or another D.C. military campus, the residents will be moved there. Building 18 will be symbolically closed, perhaps demolished for the cameras, if someone can pull it off.

Someone will try to point out that Medhold is a netherworld: not part of the medical command, technically under the umbrella of the Military District of Washington, but heretofore ignored by them and treated as if it were part of WRAMC as it members are in temporary status, not fit for duty, not part of any permanent wartime command, and now that they have been featured so negatively, not wanted to be owned by anybody.

The Pentagon will figure the bad press will blow over soon enough, as it usually does. So short term stage management will be done: the obligatory guillotinings, the public pronouncements, the wrecking ball, reassuring letters to all the people who were responsible for the low-level day to day management of the very problems that are getting bad press. Who knows, if the higher-ups can play it right, they might get a ribbon cutting or two out of it.

Do you think the military will realize it has a problem when retention of its best docs and recruitment of students starts to hit extremely low levels? Will they realize they totally screwed up milmed and correct it?
 
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