USA Today Article

[R-Me-Doc]

Well, this pretty much hits the nail on the head.

I love the one comment about how expanding the Army by 65,000 members will "provide more doctors."

Would love to see your comments (especially from the "rose-colored-glasses" crowd who've never actually experienced The System . . .)

http://www.usatoday.com/news/nation/2007-06-04-military-hospitals_N.htm?loc=interstitialskip



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[West Side]

Other doctors only accept military patients if they can prescribe whatever medical treatments they deem necessary, which often conflicts with Army physicians who may prefer more limited procedures, Goodrich says.

Hmm, this is a new one as to why referrals aren't working smoothly. Is this true?

The article really does bang the major points from the patient's perspective.

 

[R-Me-Doc]

Hmm, this is a new one as to why referrals aren't working smoothly. Is this true?

I don't know if any civilian docs are putting those conditions up front, but it was not unusual to see active duty soldiers (especially OIF med hold soldiers) get sent out to see civilian MDs, get set up with some type of treatment (often involving a procedure or extended physical therapy) and then have their case manager or some military doc involved in their med board nix the plan. So you can see the potential for frustration on everyone's part.

X-RMD

 

[orbitsurgMD]

I don't know if any civilian docs are putting those conditions up front, but it was not unusual to see active duty soldiers (especially OIF med hold soldiers) get sent out to see civilian MDs, get set up with some type of treatment (often involving a procedure or extended physical therapy) and then have their case manager or some military doc involved in their med board nix the plan. So you can see the potential for frustration on everyone's part.

X-RMD

I think I would let that happen only once before I decided to tell the military referral office to either commit in writing beforehand to approval of all my recommended studies and treatments or to send their patients elsewhere.

If the case managers for the military aren't qualified to evaluate and treat in the first place, what makes them think they are qualified to decide which studies or treatments are necessary or beneficial after the fact? Nixing a recommended treatment as a third-party is no more acceptable from a military branch than it is from an insurance company.

Unlike the military physician, the civilian consultant is not protected by Feres, et al. Who needs the grief or the risk, and worse at Tricare rates?

 

[West Side]

I think I would let that happen only once before I decided to tell the military referral office to either commit in writing beforehand to approval of all my recommended studies and treatments or to send their patients elsewhere.

If the case managers for the military aren't qualified to evaluate and treat in the first place, what makes them think they are qualified to decide which studies or treatments are necessary or beneficial after the fact? Nixing a recommended treatment as a third-party is no more acceptable from a military branch than it is from an insurance company.

Unlike the military physician, the civilian consultant is not protected by Feres, et al. Who needs the grief or the risk, and worse at Tricare rates?

I would imagine that it would also create the perception that the military medical system is either a) criminally cheap or b)incompetent if they propose a more "limited" program of care after being perscribed something more extensive by the civilian doctor. It's the humanly natural tendency of "more must be better".

I'm curious, though, why the pattern would be uniformly one-sided: why wouldn't the military case manager or doctor ever come up with something MORE aggressive? The article and R-Me-Doc seem to suggest it never/rarely happens. What does this suggest about military medicine vs. civilian?

 

[BomberDoc]

How can we encourage the press to keep military medicine under the gun? I'm not surprised that you don't hear anything about Walter Reed anymore, but am pleasantly surprised that articles like this one keep coming out. Access is terrible everywhere. Quality of care is declining everywhere. Certainly those of us in milmed can't make any significant changes so we need external pressure on the powers that be. Someone a while back mentioned taking out a full-page ad in the NY Times on behalf of military docs. This might get some attention. Of course if anybody on active duty participated in this, they would be castrated, crucified, and sent to Gitmo (as an inmate) for a very long time.

 

[West Side]

How can we encourage the press to keep military medicine under the gun? I'm not surprised that you don't hear anything about Walter Reed anymore, but am pleasantly surprised that articles like this one keep coming out. Access is terrible everywhere. Quality of care is declining everywhere. Certainly those of us in milmed can't make any significant changes so we need external pressure on the powers that be. Someone a while back mentioned taking out a full-page ad in the NY Times on behalf of military docs. This might get some attention. Of course if anybody on active duty participated in this, they would be castrated, crucified, and sent to Gitmo (as an inmate) for a very long time.

That would be a pretty frivolous waste of ad money.

Why not put your friendly neighborhood investigative journalist in touch with the scads of disenfranchised patients you guys deal with on a daily basis? People that really got the shaft?

Lookit, nurses and doctors had to know about the conditions at Walter Reed outpatient quarters, because I'm pretty sure a) someone had to ask why patients were late/missing frequently, and b) the patients probably bitched and moaned to no end to someone.

If you folks hear this type of thing, I'd say it's partly an indictment of you that you don't speak up; making it news is the logical extention of "passing it up the chain of command". Last I checked, the ultimate commander of the military is the People.

Reporters have a pain in the ass of a job, drumming up stories. They'll never be happier than when you package one up and hand it to them with a pretty pink ribbon on top. The advatage is that you get some control over discourse, on how the story's framed.

 

[Galo]

Another eye opening article to people everywhere. Just like the Walter Reed thing, it will go away. People not in the military are not experiencing it, so they will not care. What a shame that what we talk about on this forum daily, seems to be almost public knowledge, but our leadership in goverment will not do a damn thing to fix it. I often, and with much reason, bash the *****s that are in command. But alot of times those *****s really can't do anything other than listen to the ***** on top of him. Its a totally fubar situation that this country has gotten itself into, and I see no quick fix, no long term fix. It will continue like this and likely get worse before it gets any better.

My god, 33% of our population meets NIH criteria for gastric bypass surgery. You'd think I'd be happy, since that is what I do, and I do provide a needed service, and make people healthier. But the attitude most Americans have about their health is so piss poor that it will continue to burden the health care system for decades to come.........

 

[edinOH]

How can we encourage the press to keep military medicine under the gun?

When I read this article yesterday I had the exact same question. My thought would be for an active duty military doc to email the author of this article a short note and a link to this board. Plenty of information and potential contacts here for a whole series of stories.