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

[USAFdoc]

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?

1) many know they have serious problems.

2) many are probably afraid to speak up when the SG asks "are there any problems with my healthcare system?"

3) In the military it is much easier to say "Yes sir/mam" and to go with the flow than to buck the system. In the civilian world if the "system" screws you/threatens you for "doing the right thing"...they get their butt taken to court. In the military, the military is the court, and you are the "piece of meat", the "number", the metric, etc.....

4) The problem is so deep, so widespread, that a major undertaking would need to be done, and that in itself makes any sudden improvements unlikely.

5) As long as the public, and as long as unsuspecting medschool students are unaware of what milmed is really about (money/metrics/promotion) and not about Core Values (Excellence/Integrity/Service).....well then there really is no reason that they need to change now is there............the never ending pipeline of HPSP students and patients are at their service.

6) Military Medicine is DESIGNED to get the outcomes you see on CNN; the stuff you read about here on SDN.
If you could run a healthcare system with novice docs, novice PAs, complete lack of continuity, 20% staffing, commanders changing every 2 years, 100% lack of physician control, nurses commanding docs, no charts, 18 yo techs as nurses, deployments, etc.......................................if you could do that and still have a safe, quality medical healthcare system, then everyone (civilians too) would be doing the same thing.

But you can't let a healthcare system take that many "hits" w/o something/somebody paying a big price, stuff falling between the cracks, frustrated patients/docs/staff etc..........

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[pgg]

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?

Starts? Heh. I don't think anything will change until the first underfilled HPSP class emerges from internship, and the line realizes they're short 150 doctors.

When LtCol Somebody with X Battalion, Y Marines looks up and sees that he doesn't have a medical officer, THEN they'll do something. I just hope that "something" isn't taking newly board certified Navy anesthesiologists and sending them back for more GMO tours.

 

[resxn]

Well, hopefully something starts now.

The headline on MSNBC.com this AM was that Gates is launching an investigation into "outpatient" military medicine. He essentially said some heads will roll and others already have.

How much is real and how much is for the cameras remains to be seen. One poor sign is that Congress announced that they plan on hearings. I hope their as effective and useful as they were when they had hearings on steroids in baseball. [seething sarcasm]

 

[met19]

Starts? Heh. I don't think anything will change until the first underfilled HPSP class emerges from internship, and the line realizes they're short 150 doctors.

When LtCol Somebody with X Battalion, Y Marines looks up and sees that he doesn't have a medical officer, THEN they'll do something. I just hope that "something" isn't taking newly board certified Navy anesthesiologists and sending them back for more GMO tours.

I think mine was the first class where they had a shortfall but still had enough for the entire milmed positions. Main result was less civ deferrals. I am pretty sure each class under me (i am an MS IV), has less and less. You'd think that NMETC & HPSP would be informing the pentagon and SG about the eventual shortfall....

 

[BomberDoc]

I asked somebody at AFPC if I could be force shaped which is how the AF is getting rid of tens of thousands of "extra" officers. I'm not even going to delve into why we would get rid of so many people when we are already so short in every career field. Anyway, no medical officers are eligible - big surprise. My year group is a zero, we have no extras but no shortfall. The following year is about 50 short and the year after that around 200 short. The collapse is coming. You board certified guys should get ready to be deploying 4-5 months per year as GMOs. Your regular patients will be empaneled at the nearest civilian hospital.

Getting back to the original topic of the thread, I read that congress is demanding more frequent inspections of milmed facilities. That is sure to increase useless CBT, stupid Powerpoint presentations, and reams of additional paperwork at the expense of patient care. Then management will come down to the clinics and berate us for not being productive enough and not meeting our arbitrary RVU quotas. In the end as always, the Soldier, Sailor, Airman, and Marine suffers.

 

[orbitsurgMD]

Starts? Heh. I don't think anything will change until the first underfilled HPSP class emerges from internship, and the line realizes they're short 150 doctors.

When LtCol Somebody with X Battalion, Y Marines looks up and sees that he doesn't have a medical officer, THEN they'll do something. I just hope that "something" isn't taking newly board certified Navy anesthesiologists and sending them back for more GMO tours.

They have already done this with former flight surgeons who had finished residency in ophthalmology. Of course it was a disaster, and the members tasked to take these assignments--people who had already done at least three years of GMO assignment-- bitterly resented the tasking. It mattered nought that an ophthalmologist should be doing ophthalmic surgery regularly to stay in tune with the fine motor skills required for intraocular surgery.

Don't kid yourself. The line will empty out every kind of clinic and department to fill forward billets missing GMOs and flight surgeons. They won't care what you did a residency in. That is the beautiful thing about GMOs and basic core privileges. They will make you recertify in ATLS. They will shake and bake you. And if the need is significant enough, they will call in training-deferred HPSP graduates and call up reserve units--wherever they can find them-- to make backfill. And for those who believe their military residency training status makes them untouchable, just remember that there are lots of civilian hospitals in this country very much capable of taking care of wounded soldiers; you aren't as essential stateside as you would think. It would be no trouble to send you to Balad or elsewhere for ninety or one hundred eighty days, all it takes is a stroke of a pen and an email. If it interrupts your training, tough. They'll just add a little extra time to your expected end date of training. The medical services will eat their young.

Nothing will be allowed to compromise forward medical support of combat operations. Nothing.

 

[met19]

They have already done this with former flight surgeons who had finished residency in ophthalmology. Of course it was a disaster, and the members tasked to take these assignments--people who had already done at least three years of GMO assignment-- bitterly resented the tasking. It mattered nought that an ophthalmologist should be doing ophthalmic surgery regularly to stay in tune with the fine motor skills required for intraocular surgery.



Don't kid yourself. The line will empty out every kind of clinic and department to fill forward billets missing GMOs and flight surgeons. They won't care what you did a residency in. That is the beautiful thing about GMOs and basic core privileges. They will make you recertify in ATLS. They will shake and bake you. And if the need is significant enough, they will call in training-deferred HPSP graduates and call up reserve units--wherever they can find them-- to make backfill. And for those who believe their military residency training status makes them untouchable, just remember that there are lots of civilian hospitals in this country very much capable of taking care of wounded soldiers; you aren't as essential stateside as you would think. It would be no trouble to send you to Balad or elsewhere for ninety or one hundred eighty days, all it takes is a stroke of a pen and an email. If it interrupts your training, tough. They'll just add a little extra time to your expected end date of training. The medical services will eat their young.

Nothing will be allowed to compromise forward medical support of combat operations. Nothing.

i will be supremely annoyed if the navy pulls me out of my full EM deferral for a GMO year.....especially when i would be more useful fully trained and capable of being sent as a fully boarded EP

 

[georgia_md]

i will be supremely annoyed if the navy pulls me out of my full EM deferral for a GMO year.....especially when i would be more useful fully trained and capable of being sent as a fully boarded EP

Prepare yourself to be supremely annoyed. Just kidding, I highly doubt that will happen. But then again ...

 

[vikingsfan]

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/28/AR2007022801954.html


And the beat goes on... any takers that our nursing collegues/clipboard warriors are looking at this failure of our most senior MEDCOM/physician leadership as their opportunity to shine and unleash their fury.

Great times here at Reed. And the kicker as the last paragraph of this follow-up article states, JHCAO made a "surprise visit" today.

 

[deuist]

Google News provides up-to-the-hour news coverage of Walter Reed. All of the headlines look ominous.

 

[met19]

Google News provides up-to-the-hour news coverage of Walter Reed. All of the headlines look ominous.

i'm not a huge jacho fan, but i hope jacho reams walter reed and the top officials there.....

 

[SemperJeff]

Maj. Gen. George W. Weightman has been relieved of duty. Army officials say they have lost "trust and confidence" in his abilities.

Walter Reed medical chief relieved of command

 

[West Side]

Yeesh. Haven't paid that much attention to the fallout beyond the initial story, but if you want to see some galling pass-the-buckery, check this Tony Snowjob out...

http://www.youtube.com/watch?v=9iV1MbPJgG4

 

[chopper]

Maj. Gen. George W. Weightman has been relieved of duty. Army officials say they have lost "trust and confidence" in his abilities.

Walter Reed medical chief relieved of command

And guess who is taking over temporarily . . . . wait for it . . . . Lt Gen Kiley, SG of the Army, and the commander at Walter Reed when all this got started back in 2002/2003.

The irony is just too much.

 

[Mirror Form]

And guess who is taking over temporarily . . . . wait for it . . . . Lt Gen Kiley, SG of the Army, and the commander at Walter Reed when all this got started back in 2002/2003.

The irony is just too much.

Yep, and isn't kiley the one who was denying that there was a leadership failure?

 

[Ex-44E3A]

Just my opinion:

Kiley is precisely the wrong man for this job... it was under his watch that all this was happening, and left unfixed as a landmine for the subsequent commander to step on.

Bad choice, Army leadership; nothing but more of the same. The problems run a lot deeper than a simple leadership change... Weightman is just the sacrificial lamb.

 

[NavyFP]

I think mine was the first class where they had a shortfall but still had enough for the entire milmed positions. Main result was less civ deferrals. I am pretty sure each class under me (i am an MS IV), has less and less. You'd think that NMETC & HPSP would be informing the pentagon and SG about the eventual shortfall....

What makes you think they aren't screaming at the tops of their lungs about the upcoming shortfall?

 

[NavyFP]

i will be supremely annoyed if the navy pulls me out of my full EM deferral for a GMO year.....especially when i would be more useful fully trained and capable of being sent as a fully boarded EP

The ONLY scenario that will pull a full deferment back from residency is the Canadians coming across the border (China does not have enough troop transports to mount an invasion). What WILL happen is reducing new full deferments and straight through training.

 

[met19]

What makes you think they aren't screaming at the tops of their lungs about the upcoming shortfall?

I havent heard nor seen any change that would reflect a decreasing number of HPSP or retention. I think while milmed knows what is going to happen in a few years, the line and DOD just doesn't care. Otherwise they would try to fix these problems regarding retention (by fixing milmed) or HPSP by increasing the stipend to be more realistic (or any other more creative way than I can think of.) I am probably wrong regarding them knowing but not doing anything, but it is frustrating seeing what the future holds.

I just dont know what milmed will do with decreasing rates of retention and decreasing rates of HPSP enrollees.

NavyFP- thanks for the post regarding the full deferment....

 

[OncoCaP]

Not sure if this really means anything at the physician / clinic level, but maybe this means that there is some potential for improvements being made in the future?

http://www.cnn.com/2007/POLITICS/03/02/army.secretary/index.html
Army secretary quits in wake of hospital scandal
POSTED: 4:43 p.m. EST, March 2, 2007
Story Highlights• Army secretary's resignation announced a day after hospital commander fired
• Army has been under fire for poor treatment of wounded veterans
• Francis Harvey had been Army secretary since 2004
Adjust font size:
WASHINGTON (CNN) -- Secretary of the Army Francis Harvey resigned Friday in the wake of recent reports of substandard conditions at Walter Reed Army Medical Center, a key facility treating troops wounded in Iraq.

Defense Secretary Robert Gates announced Harvey's resignation at the Pentagon, just a day after Harvey removed the hospital's commander, Maj. Gen. George Weightman, from his post.

A statement from the Army said it had "lost trust and confidence in the commander's leadership."

... "President Bush announced he will form a bipartisan panel to assess medical care for wounded U.S. service members."

 

[georgia_md]

Fresh off the press: ARMY Secretary Dr. Francis Harvey resigns apparently due to the Walter Reed situation. More heads will roll, stay tune

 

[georgia_md]

Major General Weightman (MD) received his Bachelor of Science from the United States Military Academy at West Point, N.Y., in 1973, and was commissioned as a lieutenant in the infantry and stationed at Schofield Barracks, Hawaii. He was awarded a Doctorate of Medicine from the University of Vermont in 1982 and completed his family practice residency training at Eisenhower Medical Center, in Fort Gordon, Ga. Dr. Weightman is board-certified by the American Board of Family Practice and is a fellow in the American Academy of Family Physicians.


Being relieved of his comand means the end of his military career.

 

[Ex-44E3A]

Anyone want to bet this wasn't a voluntary resignation? Could it be that we're not the only ones who were unsatisfied with Harvey's appointment of Lt. Gen Kiley?

Good for SecDef Gates... I think this quote from the CNN article speaks volumes:

"I am disappointed that some in the Army have not adequately appreciated the seriousness of the situation pertinent to outpatient care at Walter Reed. Some have shown too much defensiveness, and have not shown enough focus on digging into and addressing the problems."

More please... let's get it all on the table.

 

[georgia_md]

Anyone want to bet this wasn't a voluntary resignation? Could it be that we're not the only ones who were unsatisfied with Harvey's appointment of Lt. Gen Kiley?

Good for SecDef Gates... I think this quote from the CNN article speaks volumes:



More please... let's get it all on the table.

Now the BIG DOGS are playing ! We should expect some very interesting developments in the days to come!!

 

[HumptyDumptyMil]

Has anyone of the former mil physicians contacted any of the media about sharing their personal stories now? It might be a good opportunity for you guys to reach bigger audiences, and maybe catalyst some changes for the better for the entire system