USAF shenanigans

[Galo]

I was talking to an ol' disgruntled buddy of mine. He got out at 15 yrs of AD service, and although does not post here as he sees it sort of futile, he is continually assured he made the right decision.

Although I cannot substantiate this with names, dates, etc, and so naysayers can question it all day, here it is. A buddy of him currently in the sand box is coming back. He is at 18 yrs AD. Time has come up to re-enlist, and he has been given one choice. Learn to drive humvees, half-ton trucks, and accept a ONE YEAR deployment to Afghanistan. Not PCS, a one year call it what you want?????

A psychiatrists at my old base, also with 18 yrs in, (0-6), was told in order to continue on, he'd have to take a 3 yr overseas assingment, or just get out.

Is this the way you treat physicians and expect loyalty, happiness, work ethic. Unfortunately for the one's who have a conscience, they do this, do their work, and get out. But they have no power to effect change, and generally take a WTF attitude.

On the so called greener side, my buddy also thinks civilian medicine is crap, (not nearly as stincky as milmed), and every day of dealing with insurance companies, I agree more and more.

I also agree with him that the premise of milmed is great. Prevention, primary care, promote health, but the way the system is with its structure, underfunding, POOR leadership, just cannot be implemented efficiently.

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[militarymd]

One of my Mentors.

former Submariner
Harvard trained CCM anesthesiologist
with sub specialty training in peds at a nationally recognized center
multiple publications
ardent resident education.



19 years....got KICKED out because he was overweight...although scores OUTSTANDING on PFT.


He actually wanted to stay.

 

[dry dre]

Just a couple weeks ago some of us were complaining that commanders got preferred parking spots. I don't proclaim to know where the happy balance is, but the crap seems to be everywhere (in and out of uniform).

To bring up a subject that might be of interest to someone, ex-mil docs might consider giving the uniformed public health service a look. I've spoken recently with an 0-6 in the PHS. I'll summarize some potentially interesting points below.

-The PHS has a retirement and benefit system essentially the same as the military. Retirement starts at 20 years. Prior military service counts towards the 20 year retirement.
-They have their fair share of BS requirements (sexual harassment classes, etc).
-Height/weight requirements are there.
-It is a govt operation. Enough said.
-Promotions traditionally have not been related to changing duty stations, but this may be changing. In other words, if you like where you're working, it might be possible to spend a 20 year career in one spot, but you might get
held up for 0-6 or maybe even 0-5. This depends a lot on where you are working and TDY assignments you've taken (frankly, some of it sounds a little fun/interesting....e.g. doing a relief work med float in the Caribbean or couple months from home in Nowhere, AK.)
-Worksites and jobs availability vary, from mostly FP reservation jobs to ortho/anesthesiology here and there.
-Opportunity (obviously) for treating indigent etc, for those so pre-disposed.
-Possibility of deployment real but generally sucked up by adventure-seekers/those that want to get away from their spouses/the clinic etc.
-Headaches as you could imagine for all of the above.
-Generally completely rank-free environment on a practical basis, at least in the operation of the individual with whom I was speaking.
-Student loan repayment available if the site where you work qualifies.
-Special pays essentially the same (exactly the same) as the military
-Multi-year bonus available from year one

Anyhow, pretty interesting...might be something to consider for someone out there, especially with 15 years in who is getting out.

 

[backrow]

Although I cannot substantiate this with names, dates, etc, and so naysayers can question it all day, here it is. A buddy of him currently in the sand box is coming back. He is at 18 yrs AD. Time has come up to re-enlist, and he has been given one choice. Learn to drive humvees, half-ton trucks, and accept a ONE YEAR deployment to Afghanistan. Not PCS, a one year call it what you want?????

And this enlisted person's prediciment has what to do with physicians?

A psychiatrists at my old base, also with 18 yrs in, (0-6), was told in order to continue on, he'd have to take a 3 yr overseas assingment, or just get out.

I wonder if this is one of these guys who has never been anywhere in his career except for CONUS billets. The services need people everywhere, and guess what, sometimes that means overseas. He can take the 3yr tour and retire in 2 if he has 18. Sorry, not getting any sympathy from me on this one. Does it suck, sure! It would be nice to sit back at the current duty station for a couple more years, but this is a reality for all military members. At least we have a better chance of staying at one place for multiple years, try talking to some line officers on how long they get to stay places.

 

[USAFdoc]

And this enlisted person's prediciment has what to do with physicians?



I wonder if this is one of these guys who has never been anywhere in his career except for CONUS billets. The services need people everywhere, and guess what, sometimes that means overseas. He can take the 3yr tour and retire in 2 if he has 18. Sorry, not getting any sympathy from me on this one. Does it suck, sure! It would be nice to sit back at the current duty station for a couple more years, but this is a reality for all military members. At least we have a better chance of staying at one place for multiple years, try talking to some line officers on how long they get to stay places.

somebody please do the numbers and let me know how much $$$$$$$$$$$ the USAF is saving when they "convince/force" someone to leave at 19 years verses pay them a pension the rest of their life if they stay 20 years.

thats the reason for these stories most likely.
USAF "M & Ms".....................money and metrics rule the day again

 

[Galo]

And this enlisted person's prediciment has what to do with physicians? .

Sorry, perhaps I did not explain this well. Both are physicians.

[/QUOTE]I wonder if this is one of these guys who has never been anywhere in his career except for CONUS billets. The services need people everywhere, and guess what, sometimes that means overseas. He can take the 3yr tour and retire in 2 if he has 18. Sorry, not getting any sympathy from me on this one. Does it suck, sure! It would be nice to sit back at the current duty station for a couple more years, but this is a reality for all military members. At least we have a better chance of staying at one place for multiple years, try talking to some line officers on how long they get to stay places.[/QUOTE]


I do not know.

 

[militarymd]

If you score outstanding or above in all three categories, BCA standards are thrown out. You also have to fail three PRT/BCAs to get an administrative seperation, and even then that can be waived at the discretion of the CO if they are showing "progress" towards meeting standards.

Who did he piss off?

nobody...and this was 1997

 

[SF49ers Fan]

somebody please do the numbers and let me know how much $$$$$$$$$$$ the USAF is saving when they "convince/force" someone to leave at 19 years verses pay them a pension the rest of their life if they stay 20 years.

thats the reason for these stories most likely.
USAF "M & Ms".....................money and metrics rule the day again

I guess another way to think about it is: Why would someone spend 19 years in a system (long enough to know the good and bad) just to throw their retirement away? Unless they had a job offer that would be foolish to pass up, they deserve what they get.

Is this a "grassy knoll" theory about some top secret government scheme to save money by forcing docs out? Sorry, not buying it.

 

[IgD]

I guess another way to think about it is: Why would someone spend 19 years in a system (long enough to know the good and bad) just to throw their retirement away? Unless they had a job offer that would be foolish to pass up, they deserve what they get.

Is this a "grassy knoll" theory about some top secret government scheme to save money by forcing docs out? Sorry, not buying it.

Look at the situation now. We have a number of specialties that have been designated as wartime critical. Despite this, the military has done little or nothing to keep quality people in uniform. I'm on the verge of getting out myself. I've been deluged with calls from recruiters. The military's response is almost insulting like they want me to leave. We don't merit special treatment but at the same time we are professionals and we deserve to be treated as such.

 

[SF49ers Fan]

Look at the situation now. We have a number of specialties that have been designated as wartime critical. Despite this, the military has done little or nothing to keep quality people in uniform. I'm on the verge of getting out myself. I've been deluged with calls from recruiters. The military's response is almost insulting like they want me to leave. We don't merit special treatment but at the same time we are professionals and we deserve to be treated as such.

Agreed. If they want more docs to stay, they will have to throw more money at them to be competitive. Beyond that, what can they really do? The deployments are still going to be the same. The billets (locations) are still going to be the same. The chain of command will still be the same. It's kind of like trying to get someone to eat a sh$t sandwich. You can try and add pickles or onions, but in the end it will still be a sh$t sandwich.

 

[Galo]

Agreed. If they want more docs to stay, they will have to throw more money at them to be competitive. Beyond that, what can they really do? The deployments are still going to be the same. The billets (locations) are still going to be the same. The chain of command will still be the same. It's kind of like trying to get someone to eat a sh$t sandwich. You can try and add pickles or onions, but in the end it will still be a sh$t sandwich.

I like the sandwich analogy.

The fact is that for 99.9999999999% of us, there would be NO amount of money, (short of something totally unrealistic), that would have made us stay, because of all the other problems that you mentioned. Especially chain of command, and support, etc, etc. I guess one thing that you have up on us is you know that your breath is going to stink for a long time, maybe you can find an appropriate mouthwash for all those sandwiches you'll be eating.

 

[BomberDoc]

One of the SNCOs at my facility recently came back from some leadership seminar. He told me that the current physician retention rate is 6% in the AF, down from 11-12% a few years ago. So one in twenty stays past their initial commitment... half as many as before. Shouldn't this send a message to the flag officers that the base of their pyramid is crumbling?

 

[SF49ers Fan]

I like the sandwich analogy.

The fact is that for 99.9999999999% of us, there would be NO amount of money, (short of something totally unrealistic), that would have made us stay, because of all the other problems that you mentioned. Especially chain of command, and support, etc, etc. I guess one thing that you have up on us is you know that your breath is going to stink for a long time, maybe you can find an appropriate mouthwash for all those sandwiches you'll be eating.

As long as you can look past picking out an occational bit of undigested corn, they're not all that bad. My advice: Use plenty of ketchup and keep smiling despite what others may see stuck in your teeth.

Everyone has their price. I've seen it over and over the past few years.

The line sandwiches were easy to get used to. I'll let you know if the medicine ones have a different flavor.

 

[Galo]

As long as you can look past picking out an occational bit of undigested corn, they're not all that bad. My advice: Use plenty of ketchup and keep smiling despite what others may see stuck in your teeth.

Everyone has their price. I've seen it over and over the past few years.

The line sandwiches were easy to get used to. I'll let you know if the medicine ones have a different flavor.

Very good.

Although I have heard the line is a bit different, in milmed, other people will be involved on how well you can eat that sandwich.

 

[USAFdoc]

One of the SNCOs at my facility recently came back from some leadership seminar. He told me that the current physician retention rate is 6% in the AF, down from 11-12% a few years ago. So one in twenty stays past their initial commitment... half as many as before. Shouldn't this send a message to the flag officers that the base of their pyramid is crumbling?

is that retention rate for 1st timers or does it include all physicians,even the Commanders,people on 2nd, 3rd re-ups etc. etc?

and believe me when I say, the "message" has been sent their way for years now. And you would think that we all would have gotton the message back from them by now that "leadership could care less if you are goona stay 20"

 

[The White Coat Investor]

I like the sandwich analogy.

The fact is that for 99.9999999999% of us, there would be NO amount of money, (short of something totally unrealistic), that would have made us stay, because of all the other problems that you mentioned. Especially chain of command, and support, etc, etc.

I don't know. I think quite a few people (maybe 20% instead of the current 6%) would stay if the pay was 150% what a comparable civilian made. That's probably not yet into the totally unrealistic range. A typical O-4 with 7 years (first option for exit for an HPSPer) is making something like $140K. Throw in some MSP and you might get that to $160K or so. Plus $10K more of tax benefits. This is 40-80% of what they can make outside the military (remember that the FP/Peds/Medicine crowd is paid less due to lower ISP.) No wonder no one will stay. Deploy, deal with military B.S., AND make less money? That's too much to ask even a true patriot.

I wouldn't stay for 150% (mostly because my military practice is too different from what I want to do), but I know several folks planning to get out that would, even with the other downsides.

 

[Heeed!]

I don't know. I think quite a few people (maybe 20% instead of the current 6%) would stay if the pay was 150% what a comparable civilian made. That's probably not yet into the totally unrealistic range. A typical O-4 with 7 years (first option for exit for an HPSPer) is making something like $140K. Throw in some MSP and you might get that to $160K or so. Plus $10K more of tax benefits. This is 40-80% of what they can make outside the military (remember that the FP/Peds/Medicine crowd is paid less due to lower ISP.) No wonder no one will stay. Deploy, deal with military B.S., AND make less money? That's too much to ask even a true patriot.

I wouldn't stay for 150% (mostly because my military practice is too different from what I want to do), but I know several folks planning to get out that would, even with the other downsides.

I'd be happy if they would count the bonuses toward retirement pay. I think that would be doable, incentivise a few more people to stay, but not break the bank either. Unfortunately, the military doesn't want you to stay that long anyhow. It's all so jacked up!

 

[The White Coat Investor]

I'd be happy if they would count the bonuses toward retirement pay.

Yes, it's not much of a reward at the end of the tunnel to pay you 40% of 40% of your pay.

There is not doubt that military medicine suffers from multiple other issues, but throwing some more money at it (not only for physician pay but to increase staffing, improve equipment, and reduce panel size for PCMs by hiring contractors) would go a long way.