Thoughts

[undecided2009]

So after a recent experience in military med, I've had a change of heart and some new thoughts on the matter. There are plenty of reasons why one shouldn't join military medicine, and I think that's a personal issue and preference for military vs. civillian life, etc. Read the posts, make up your own mind. However, as a once jaded student entering the service, I now again realize why I did. There is no greater honor or priveledge than to help heal the soldiers serving our country and protecting our freedom (however you want to look at it, whether you agree with the war or not, someone has died at some point in our history for us to be able to live in relative comfort compared to 99% of the world). The experience I had on rotation working with the wounded coming back from the two theaters was incredible to say the least. Were there aspects of military med I disliked? Absolutely. Will I be able to do exactly the thing I want to do with my career as a physician? Maybe, maybe not. When I put it into perspective, though, and realize that not only do I get the opportunity to become a physician but I also get the chance to serve the honorable men and women that work hard every day for you and I (some losing life, limb, etc.), I can't help but feel a sense that there is something powerful in being a "doc" in the military (be it for however long or short you want it - 5 years minimum though, haha).

If you want to earn the big bucks, you maybe shouldn't have become a physician in the first place (seek out business). If you want a career of service to others, become a physician. Even more so, if you feel as though you have somehow benefitted from living in a country like our own, you might consider joining - just be ready for bumps along the way. As a physician told me earlier today, "in military medicine, stay flexible." God bless our service men and women!

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[IgD]

I don't think anyone would disagree with you. We all joined for the same reason. I used to joke that they should have a recruiter on patriotic occasions like you described so I could sign on for more. My family and I were more than willing to make sacrifices (and we did) but the burden was too high.

Before you sit down with the military health system and sign in blood there needs to be some pre-conditions. You need to be respected as an individual and as a physician. Your family needs to be taken care of. Professional boundaries need to be respected. As much as possible, you need to have appropriate support staff, resources and facilities so you can practice medicine.

Do you agree with the direction the DoD is headed? What do you think we should do as physicians? Are we enabling a broken system by signing up for more and more without necessary change?

 

[undecided2009]

Amen, IgD. Would I do it over again (albeit without any real fulltime experience yet so, caution, this is a personal opinion) I'm still not certain. I signed up under the impression that I could serve my country in whatever capacity my chosen specialty was, was told I could go to a civillian program without a problem (was actually told that it was 100% guaranteed), and had a preconcieved notion that my training would be the best of the best (as a side note: I was also naive, young, and jumped into it so it's my fault, not the recruiter's - recruiters have a job, our job is to listen to what they say, discover the truth for ourselves, and accept the consequences of our actions). What I found out is that there are "needs of the military," which anyone signing up must fully understand. It's a calling to medicine, and even more of a calling to serve ones country. The problem is that the current system of signing on physicians does not recognize the preexisting sacrifices one undertakes in going to medical school and becoming a physician. Along with that, the system is not flexible. I think for many, signing up was never about the money. It's a perk for certain, especially growing up in a family that never had cash to spend and then having extra dough in my pocket in medical school - awesome. But if it was never about money to begin with and our intention is to serve, there must be some understanding that sacrifices have already been made and some degree of catering must be done to ensure that our career goals are met along with the needs of the system we sign into.

I heard recently (could be a rumor) that it was the intention of the powers that be to eliminate the majority of milmed and outsource it to the civillian world (chime in if you know fact in this matter). When the war started, that eliminated any chance of that, as deployable/active duty physicians were needed in great numbers (again, could just be some dude running his mouth so don't take my word on it). If milmed were to become completely civillian outsourced, I do think things would improve (i.e. service men and women could seek the best available care, recieve care near home, recieve care in a more efficienct system, etc.). While we would still need active duty physicians, I think that there would be more than enough remaining personell within the military (i.e. USU grads) that could fill those positions (i.e. deployable docs, GMOs, etc.). Note: I'm no logistics expert so I could be way off. In some sense, IgD, I think we are enabling a broken system. But we are enabling it by not trying to change it, not because we sign up ("We all must fear evil, but the evil we must fear the most is the indifference of good men" - granted there is absolutely nothing evil about the system, but you get my point in the quote). Those of us who are in it might should think about organizing to the point that the issues at hand are recognized, with the end goal of improving the system while ensuring quality of health care delivery for the military.

(Let's all do each other a favor and not make this another pity party page for venting personal grievences but, rather, a place to make suggestions from those more experienced than people like myself - i.e. let's try the "No B****ing Allowed" concept one more time.)

 

[notdeadyet]

It's a calling to medicine, and even more of a calling to serve ones country.

I think this is kind of the crux about how people feel about things like the HPSP scholarship.

When people think of something as a "calling", they tend to better tolerate suffering for it. This is true of monks, martyrs and some physicians. Preists have been stoned and walked through it with a smile on their face, saying it's "God's will". If you can walk through any milmed challenges with this smile on your face and say that it's "the Military's will", I can see how you could tolerate just about anything.

The problem with the "calling" point of view is that I think a lot of it is an age thing. By the time you hit your thirties, you might find yourself viewing medicine less as a "calling" and more of a "career". And no one's willing to be martyred for their career. You want to do a good job that brings you satisfaction, have an employer that allows you to do your job and treats you with respect, and the ability to be a good provider (financial and otherwise) for your family.

I'm old and well past the "calling" point-of-view, which ultimately kept me away from HPSP. I personally found that the scholarship would not allow me to get the kind of career that I wanted (the choice of straight-through residency training at a selection of top quality programs best suited to my strengths/weaknesses to make me the best possible physician). Instead, I'm in the application process for a National Guard scholarship that will allow me to serve but also allow me to get the training that my career requires.

I applaud those who serve in any capacity in any form. I would just strongly suggest those who take scholarships like HPSP, NHSC, or any other long-term binding contract to stop for a moment and ask themselves this:

Are you confident that the scholarship in question is good for you right now and the person you will become by the time your commitment ends? Will it bring you happiness and job satisfaction? If so, hab at it and best wishes.

Or are you taking the scholarship because you feel you can tolerate expected pain and obstacles due to your "calling"? If this is the reason, I'd stop and give it some second thoughts. After a while, you may find that with the years, and not that many of them, medicine will actually be a career. And you want to be damn sure that an employer you're bound to for many years is one that you will find professionally satisfying, not just one you're willing to suffer for.

 

[adismo]

after 30yrs old, they should automatically give you the "calling bonus" somewhere around (and appropriately so) 30 large, to offset some of the obligatory BS that comes with certain commands.

that's a much better use for all that bailout money

 

[rotatores]

Before you sit down with the military health system and sign in blood there needs to be some pre-conditions. You need to be respected as an individual and as a physician. Your family needs to be taken care of. Professional boundaries need to be respected. As much as possible, you need to have appropriate support staff, resources and facilities so you can practice medicine.

I often find myself wondering what you're thinking...or trying to say at least