Toxic Work Environment

[The White Coat Investor]

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I was reflecting today on how toxic the work environment is in my particular MTF. I sat in a high level meeting (includes the heads of every department in the hospital-cardiology, Peds, EM, Plastics, Psych, Anesthesia, Surgery etc, the chief of staff etc.) Most of the group was split between O-4s and O-3s. Now, mind you, these are the SENIOR docs in the hospital. Everyone of us is under our initial training commitment except the O-5, who did a second residency and the dentist, who's making a career of it. Every one of us is planning on getting out at the earliest possible moment, passing up thousands of dollars in "bonuses" to do so. One doc is even passing up his ASP ($15K) to get out 3 weeks earlier. We've all deployed at least once and some of us are up for our 2nd deployment within 2 years. Almost all of us moonlight as much as we can but are still concerned about skill atrophy (except the pediatricians and FPs.) Several of us pay for Tricare Standard so we can take our kids out in the community because there's no access into the peds clinic. The IM clinic and the FP clinic are each short a couple docs. The ED has an admission rate less than 3%. We don't have enough techs to start with, and more and more of them are deploying ILO (in lieu of, meaning with the Army). The contracting companies that are supposed to be finding us nurses haven't filled positions in months and months. Man, it's depressing sometimes.

If I was employed in a hospital like this on the outside I would honestly quit and move my family to another town, no matter what the pay was like. Never in med school or residency did I ever dread going to work, but I do more often than not now. It just isn't fun like medicine should be. I wonder how many other MTFs out there are like this. Maybe mine is particularly bad.

Edited to remove a few specifics.

 

[IgD]

It's like a military medicine version of the Simpsons. Hang in there! My commanding general said it best: "fear no man". He meant it for combat and for staffing issues. Remember that when you are dealing with those medical-political-administrative types. I kept my sanity by remember that we are doing it for the warfighters and their families.

 

[crazybrancato]

I was reflecting today on how toxic the work environment is in my particular MTF.

ya know, given the amount of experience you've had in the military machine, given that you're intent on getting out and will play the political game to do so (presumably) . . . you're sure trying hard to out yourself here! if somebody else from that meeting (or somebody that had knowledge of it) is on here, it wouldn't be hard to identify you. Couple your >1000 post with a spitful superior (or even subordinate who plants the seed in your superior's head), and that second deployment may come sooner than you think. I commend your courage but also urge you to be cautious. I understand your need to vent, but such specifics are better discussed with your local bartender vice a forum (probably) frequented by many of your co-workers.

In any case, sorry to hear about this situation. Mind telling us which MTF, so we can stay F clear of it!?

 

[Perrotfish]

The IM clinic has 5 empanelments worth of patients for 3 docs and is begging the FPs to share some of the inpatient duties (usually ~2 inpatients at a time.) The active duty FP clinic is short a couple of docs from what they need. The 10 bed ED sees 30,000 patients a year, but admits less than 3%. We don't have enough techs to start with, and more and more of them are deploying ILO (in lieu of, meaning with the Army). The contracting companies that are supposed to be finding us nurses haven't filled positions in months and months. Man, it's depressing sometimes.

Do you think everyone will continue to be understaffed when we're back to basically peacetime?

 

[crazybrancato]

Based on the description, it sounds like one of the smaller military hospitals, rather than a major MTF. .

Maybe we can play a game. "Guess the MTF"

I'll start. Is it . . . . . .Keesler AFB 😕

 

[Habeed]

You know, at Fort Sam Houston there's a whole museum dedicated to the supposed 'advancements' in medicine that military medicine has stimulated. Allegedly, innovations like medevac helicopters and mass produced medical care were originally made possible through the efforts of military doctors.

So, I wonder if things have changed since those glory days...or if said glory days never actually existed. It sort of seems as if all the inefficiencies of the military are just inherent, and can never be fixed.

 

[BigNavyPedsGuy]

I was reflecting today on how toxic the work environment is in my particular MTF. . . . . .

Never in med school or residency did I ever dread going to work, but I do more often than not now. It just isn't fun like medicine should be. I wonder how many other MTFs out there are like this. Maybe mine is particularly bad.

Man this is too bad. I learned back in college deliverring pizzas that any job you do, the majortiy of the experience comes from the people you work with.

It won't last forever. Don't let this part of your life go by without enjoying it, just because of other people. I hope that makes sense.

 

[orbitsurgMD]

You know, at Fort Sam Houston there's a whole museum dedicated to the supposed 'advancements' in medicine that military medicine has stimulated. Allegedly, innovations like medevac helicopters and mass produced medical care were originally made possible through the efforts of military doctors.

So, I wonder if things have changed since those glory days...or if said glory days never actually existed. It sort of seems as if all the inefficiencies of the military are just inherent, and can never be fixed.

There was a time when residency training at military hospitals in most specialties was so complete, and with such a high census of patient encounters and procedures, that no out-service rotations were thought necessary for complete training of a resident. It wasn't possible to go somewhere else and see more patients.

 

[The White Coat Investor]

ya know, given the amount of experience you've had in the military machine, given that you're intent on getting out and will play the political game to do so (presumably) . . . you're sure trying hard to out yourself here! if somebody else from that meeting (or somebody that had knowledge of it) is on here, it wouldn't be hard to identify you. Couple your >1000 post with a spitful superior (or even subordinate who plants the seed in your superior's head), and that second deployment may come sooner than you think. I commend your courage but also urge you to be cautious. I understand your need to vent, but such specifics are better discussed with your local bartender vice a forum (probably) frequented by many of your co-workers.

In any case, sorry to hear about this situation. Mind telling us which MTF, so we can stay F clear of it!?

Sometimes I wonder what more they can do, you know? Deployment actually looks kind of good these days.

But you're right. It's about time to change my name again. ActiveDutyMD out!

 

[IgD]

I remember going to a similar meeting and trying to explain why 2 psychiatrists wasn't enough to cover inpatient, the emergency room, outpatient (both child and adult) and ward consults.

crazy, you should support ActiveDutyMD he is playing a critical role in trying to support the warfighters and their families.

What if the situation did get outed? It would be an embarrassment to military medicine because people did see how silly situations like that are.

 

[crazybrancato]

I remember going to a similar meeting and trying to explain why 2 psychiatrists wasn't enough to cover inpatient, the emergency room, outpatient (both child and adult) and ward consults.

crazy, you should support ActiveDutyMD he is playing a critical role in trying to support the warfighters and their families.

What if the situation did get outed? It would be an embarrassment to military medicine because people did see how silly situations like that are.

I do support him. I support and commend all of you for at least serving. If anything, I argue that you should be prouder of your service. i was just pointing out to Active that he should be cautious.

 

[jabreal00]

I was reflecting today on how toxic the work environment is in my particular MTF. I sat in a high level meeting (includes the heads of every department in the hospital-cardiology, Peds, EM, Plastics, Psych, Anesthesia, Surgery etc, the chief of staff etc.) Most of the group was split between O-4s and O-3s. Now, mind you, these are the SENIOR docs in the hospital. Everyone of us is under our initial training commitment except the O-5, who did a second residency and the dentist, who's making a career of it. Every one of us is planning on getting out at the earliest possible moment, passing up thousands of dollars in "bonuses" to do so. One doc is even passing up his ASP ($15K) to get out 3 weeks earlier. We've all deployed at least once and some of us are up for our 2nd deployment within 2 years. Almost all of us moonlight as much as we can but are still concerned about skill atrophy (except the pediatricians and FPs.) Several of us pay for Tricare Standard so we can take our kids out in the community because there's no access into the peds clinic. The IM clinic and the FP clinic are each short a couple docs. The ED has an admission rate less than 3%. We don't have enough techs to start with, and more and more of them are deploying ILO (in lieu of, meaning with the Army). The contracting companies that are supposed to be finding us nurses haven't filled positions in months and months. Man, it's depressing sometimes.

If I was employed in a hospital like this on the outside I would honestly quit and move my family to another town, no matter what the pay was like. Never in med school or residency did I ever dread going to work, but I do more often than not now. It just isn't fun like medicine should be. I wonder how many other MTFs out there are like this. Maybe mine is particularly bad.

Edited to remove a few specifics.

I actually envy your plight. The fact that you have medicine subspecialists and plastics means it's a decent sized MTF. Where I am is in the midwest, in a very isolated and rural area. The hospital is totally dysfunctional. Because there are so few MDs (deployments) midlevels (PA and NP) fill in. There is no over sight to the midlevels and they run free reign. Many are well intentioned but they do not practice evidence based medicine, it's based on hunches and anectdotal evidence. Their is a huge number of patients addicted to narcotics. Some patients can go two years without ever seeing a provider but getting refills of their Oxycontin, Percocet, etc via T-cons. The ER is dysfuctional. There's only one ER trained physician, the rest are FP or PAs. My last 8 months here have been miserable. I was actually looking forward to deploying to get away. Fortunately I got picked up for a fellowship at a major medcen in a good location. I don't mind accruing the extra few years. I'll fight to stay at my fellowship medcen for payback to keep my procedural skills up, coupled with moonlighting. After my payback, I'll get out and never look back.

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