Spartan 'if' applies to the Commissioned Corps right now, and
@giga understands that too in terms of holding their end of the bargain. I'm also in agreement that usually Civil Service works best for long -term careers, but I'm going to write a couple of devil's advocate thoughts.
It's an impersonal bureaucracy at best, malevolent at worst. Most have been on the receiving end of nonsensical orders from DC. Leadership fluctuates between inspiring, dysfunctional, and Machiavellian with an undertone of incompetence from the 2000 mile pen. There will be days, possibly years that the only motivation is getting to pension as you are stuck with the sunk cost fallacy of giving up much ahead of time. That's government in general.
Black Mesa is not black and it is not a mesa. It is four thousand square miles of ginger-colored plateau land in northern Arizona, a distinct elevated
orionmagazine.org
In specific, the tribes has a bitter relationship between DoI and HHS. This results in a philosophical difference between the HHS attitude of "we clinicians know best" elitism which results in parochial attitudes toward the tribes or DoI BIA "the tribes know best" where tribal leadership does know their community needs and positioning, but are uneducated about hospital administration and have political practices that are ok for the tribe but would be felonious conduct under the Hatch Act if you were to engage in them. This contest results in alternate leadership regimes between HHS and DoI which switch out when the HHS acts too high handedly to their
charges, I mean, patients, which result in the population refusing to utilize services which drive up the cost, and DoI which appoints tribal leadership to run the system, which without ever seeming to recruit any tribal member with reasonable business background, much less healthcare management, the facility inevitably hits ruin. Finally, there are cross purposes within both HHS and DoI. HHS needs the IHS because without it, a key pillar of the reason for the CC's existence becomes moot (because part of the reason why CC has that status is to deal with the tribes as internally foreign governments). DoI has less savory reasons, the main one being Black Mesa projects. As long as the tribes live on the land, DoI has massive control over its disposition and zoning. Should enough tribes leave the reservation, most of the land then would fall under either HUD's (for residential planning), Commerce (for economic planning), and especially Department of Energy, because the land that many tribes have are the last key unspoiled domestic water and energy resources. The DoI's Beltway reasons for fiercely keeping the BIA under their authority is that they can use those lands as bargaining tools with the other agencies when it comes to the Budget, and historically, the DoI has absolutely no problem with displacing Native Americans when the money is good enough. This is called the "Black Mesa" problem, and it has a fascinating history on whether the BIA is actually the caretakers of the Native Americans OR their land, because even other elements within DoI have competing interests.
Given all of this, I STILL recommend working for the civil service, but you have to be internally motivated to stay. If you think you don't want to be committed, I actually would say take the money from the chains even though you don't have career security at all. If you do commit, realize that IHS has lifestyle implications as well as professional ones. If you run a half-mile for every stupid or corrupt thing you see, you'll be in great shape for marathon running in three months. Work in DC for IHS, you'll easily be in the ultramarathon class. But without a good internal motivation and the endurance to stay, it becomes very hard. Even the dumb who try ignoring everything eventually get axed before they can cash in, keeping your head down is not always a good strategy (as evidenced by the fact that you can see IHS and other civil service positions all the time). The churn is hard, and the survival requires an ability to see things through in spite of the institution many times. If you have the internal fortitude to endure and think you can go the distance, join the civil service.
And not to give mine or anyone else's statements in confidence away, part of the membership of this forum uses it in a way to talk about some of the particularly stupid, corrupt, and otherwise incomprehensible behavior of this institution of the United States Government. We all have our moments. Up until two weeks ago, I was serving time in a forced sinecure, because I mouthed off about a data issue a year ago that would get the VA's budget screwed over if unaddressed. Now that IG has cleaned house yet again after rediscovering just how in the red we are, they want to reassign me back to a position to fix the messes that others have made (and who are now gone). I actually said to the IG that this sinecure is fine for me and better for my health and marriage, so you can find someone other victim for this as I've 'suffered' enough that I tried to prevent the mess, I'm not going to clean this up. I'm now waiting for the inevitable forced personnel transfer as that excuse will only buy me a month or two of tranquility. But, I also happen to know that the personnel officer who would be able to sign off on that order retires effective September 30th, and the replacement has to face Senate hearings, so I will be off the hook for the rest of this year, and by then, the biennial budget for the Defense and VA will either pass or be in continuance such that when I do come back, it will be with a clean slate and not from the negative red. In any event, I know the organization will eventually get what they want, but the entire point of all of this is to get what they want on my terms and not theirs.
That's the sort of thinking that you start to do when you work here long enough, how do I accomplish the mission knowing how dysfunctional this place is? Clinical or technical work, that's easy. Getting the job done while keeping sane, that's not so easy. Getting other people to do the things that you need done to do your job, well, that's the challenge here in the civil service.
