Yeah and the people who do make those decisions are IDIOTS. The main problem with government run healthcare is primarily that it is not run like a 'for profit' business. Inefficiency and creating numbers that make people look good on their OER for promotion is the name of the game. Promoting efficiency, being frugal, and giving incentives for productivity would all improve the current system. Also creating a system where the docs actually have some authority over employees would be awesome too. I'm not complaining because the military paid over 400k for me and I only owe 3 yrs payback. It's one heck of a deal for me, but if a corporation gave me a similar deal, they would expect me to produce more and give me the facilities and staff to make that happen. It's a sad system of inefficiency
With shrinking of the military budget, I don't think they were cutting the Navy budget much, if at all. You will not lose your special pay, you may have the CE budget cut, which is nothing IMO, but most only let you go to major meetings anyway (ADA, Chicago Midwinter, etc). I couldn't attend CE while on my ship, so I did a correspondence course through Bethesda. It wasn't the greatest way to do it, but I got my CE. Also, CE isn't cheap anymore, many of my colleagues do much of their CE online.
Government has never been efficient, however, you can make things efficient for yourself at your command by being more proactive with your schedule and staff. I don't know your situation, but you can find ways to make yourself more efficient, you just have to be motivated to do it. Most are happy with the 1 hr/1 patient thing and that was how it was for me at my AEGD (may I assume you are doing a residency?). On my ship, we busted our asses to produce and gave special liberty or had parties for making our production goals. Staff want to be appreciated and they will want to produce for you when they are motivated. Command structure/climate may make that difficult, but it can be done if you really want to push yourself. Keep in mind, if you plan on getting out, you will need to be more efficient and faster. Use your time now to work on this, then when you are faster, work with whoever schedules to make a staggered schedule or to sneak in other simple procedures...like you would do in private practice.
Corporate have production goal minimums they want you to meet and will reward for more production and you may be dismissed or reprimanded for not producing (which can be tough in slow months). I think they often times walk a fine line with ethics when production becomes more important than what a patient really needs (ie. overtreatment, overselling, bundling procedure codes).
