AVOID MILITARY MEDICINE if possible

[Cloud Strife]

yep, he's right folks, I know first hand. I had an acromioplasty on my right shoulder done on base last June which went oh so wrong. First, it was supposed to be arthroscopic but the scope didn't work and the back up scope was out being fixed. So he decided to open it up and apparently didn't do a very good job of smooothing, or it could have scarred I'm not sure which yet. Then I had the worst stitch job ever, the skin was folded over all crapily and it was so tight the stitch starting going through the skin. It was so bad I was contemplating ripping it out and let it heal together on it's own, maybe use some athletic tape to try to hold it together. (looking back I wish I had) After my surgery I had a little less than two months to heal before returning to heavy lifting and maintenance.(F-16 crew chief) It also never really felt better in the first place but my doctor told me "well, it might still be hurting you for 6 months after surgery so just go with it" yeah.... So here I am 6 months after surgery STILL having to work because my supervisors tell me "we're all hurt" and my shoulder being worse than it was before the surgery. Keep in mind it's been well over a year since I originally hurt it.
oh one other gem of a story I have:
A while ago I got really sick and should have gone in to see the doctor but waited too long. When I finally went in to see him he gave me some antibiotics and decided to do a chest x-ray just in case. I got a call the next day to come in and they told me that there appears to be a malignant area in one of my lungs, I forget which. So, in usual military fashion, I was put in for a catscan but had to wait 4 weeks. yep. Oh, and I was working the entire time of course.
So here I am with 5 months left, body destroyed, depressed and aggitated beyond belief that it's safe to say, the Air Force and all the military for that matter can fornicate itself with a rusty metal rod and no child of mine will EVER enlist.
One more thing, I'm not an exception, I'm more of the rule because every single person I've known that has gotten hurt, sick, operated on has turned out the worse.

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[Mirror Form]

yep, he's right folks, I know first hand. I had an acromioplasty on my right shoulder done on base last June which went oh so wrong. First, it was supposed to be arthroscopic but the scope didn't work and the back up scope was out being fixed. So he decided to open it up and apparently didn't do a very good job of smooothing, or it could have scarred I'm not sure which yet. Then I had the worst stitch job ever, the skin was folded over all crapily and it was so tight the stitch starting going through the skin. It was so bad I was contemplating ripping it out and let it heal together on it's own, maybe use some athletic tape to try to hold it together. (looking back I wish I had) After my surgery I had a little less than two months to heal before returning to heavy lifting and maintenance.(F-16 crew chief) It also never really felt better in the first place but my doctor told me "well, it might still be hurting you for 6 months after surgery so just go with it" yeah.... So here I am 6 months after surgery STILL having to work because my supervisors tell me "we're all hurt" and my shoulder being worse than it was before the surgery. Keep in mind it's been well over a year since I originally hurt it.
oh one other gem of a story I have:
A while ago I got really sick and should have gone in to see the doctor but waited too long. When I finally went in to see him he gave me some antibiotics and decided to do a chest x-ray just in case. I got a call the next day to come in and they told me that there appears to be a malignant area in one of my lungs, I forget which. So, in usual military fashion, I was put in for a catscan but had to wait 4 weeks. yep. Oh, and I was working the entire time of course.
So here I am with 5 months left, body destroyed, depressed and aggitated beyond belief that it's safe to say, the Air Force and all the military for that matter can fornicate itself with a rusty metal rod and no child of mine will EVER enlist.
One more thing, I'm not an exception, I'm more of the rule because every single person I've known that has gotten hurt, sick, operated on has turned out the worse.

Yep, that sounds just like my military "med cen's" general surgery department. All the good attendings get deployed (I wish I was joking, but it's true), and the only people left to train are the colonel's who stayed in the military b/c they're too lazy and incompetent for anywhere on the outside other then the VA. Therefore, our surgery residents aren't getting enough cases, nor are they being taught well on the few cases they are getting. So the next generation of military surgeons will likely be even worse.

 

[USAFdoc]

Yep, that sounds just like my military "med cen's" surgery department. Completely incompetent with no hope on the horizon of ever getting better. All the good attendings get deployed (I wish I was joking, but it's true), and the only people left to train are the colonel's who stayed in the military b/c they're too lazy and incompetent for anywhere on the outside other then the VA. Therefore, our surgery residents aren't getting enough cases, nor are they being taught well on the few cases they are getting. So the next generation of military surgeons will likely be even worse.

let me say that I did have surgery about 2 years ago at an army base; the surgeon did a great job (just prior to his deployment).

My point being that not ALL surgeons, not ALL military medicine is terrible, however, the system in general is designed so poorly, that poor results (adverse outcomes, low morale, retention, frequent "near misses" etc) are going to be much more the norm that what they should be.

By the way; IgD is in dire need of a brain transplant so if any of you know of a military brain surgeon......................

 

[USAFdoc]

let me say that I did have surgery about 2 years ago at an army base; the surgeon did a great job (just prior to his deployment).

My point being that not ALL surgeons, not ALL military medicine is terrible, however, the system in general is designed so poorly, that poor results (adverse outcomes, low morale, retention, frequent "near misses" etc) are going to be much more the norm that what they should be.

By the way; IgD is in dire need of a brain transplant so if any of you know of a military brain surgeon......................

a site that you can get some more information on the state of military family medicine, filtered somewhat, but some good information pro and con, usually more pro since it is a military sponsored journal, but you would be surprised at some of the "honesty" which began to surface about 1 year ago in the journal.

https://walker.internetsecuresite.c...-Newsletter.pdf

http://www.usafp.org/

 

[USAFdoc]

a site that you can get some more information on the state of military family medicine, filtered somewhat, but some good information pro and con, usually more pro since it is a military sponsored journal, but you would be surprised at some of the "honesty" which began to surface about 1 year ago in the journal.

https://walker.internetsecuresite.c...-Newsletter.pdf

http://www.usafp.org/

Below is an exerpt from the USAF Surgeon general's site talking about the LACK of TRAINING. I completely agree,although the reason for the lack of training that the site states I disagree with. While the essay says it was because of a lack of a plan, I'll tell you it was because of a lack of time and people. There was no time to train becasue we were 20% manned and didn't have any appts for patients as it was. TRaining would have just eaten into an already overloaded schedule. Again,just like PCO (primary care optimization); the senior admin of the USAF is great at coming up with plans, then terrible at the implementation. To quote one of the SG's favorite slogans; "Execution is the chariot of genius." So,obviously no one has the right to be claiming genius up there, And with that, USAF Family Medicine continues to be "executed."

SG Newswire August 2005
Medical OJT
A close look at a persistent write-up on Health Services Inspections


Chief Master Sgt. Jody Hanks
Air Force Inspection Agency Editor’s Note: This article appeared In the July-August edition of the TIG Brief.

KIRTLAND AIR FORCE BASE, N.M. -- Ultimately, training is a commander’s program. To ensure success, commanders must take an active role in the training and development of their subordinate staff, specifically the enlisted men and women of their command. Commanders who truly understand Air Force OJT lead from the front, giving sound direction to their training managers and making informed decisions.

“Supervisory Involvement—OJT” (LD.3.3.2) was the number one discrepancy and was cited in every Health Services Inspection (HSI) of active-duty facilities in fiscal year 2004. With an average score of 1 (critical discrepancy), it’s obvious that our folks are struggling, but what can they do to turn the OJT program around? The biggest deficiency is in the development of master training plans (MTPs). An MTP is supposed to be designed to ensure completion of all workcenter duty position requirements (meaning 100-percent task coverage). According to Air Force Instruction 36-2201V3, Air Force Training Program On The Job Training Administration, a solid MTP “employs a strategy for ensuring the completion of all workcenter job requirements by using a master task listing (MTL) and provides milestones for task, career development course (CDC) completion, and prioritizes deployment/unit type code (UTC), home station, upgrade, and qualification tasks.” So, what is this “strategy”? The instructional system development (ISD) process is systematic but flexible. It is used to plan, design, develop, and implement OJT programs in an effective and cost-efficient manner. ISD requires:

 

[USAFdoc]

Below is an exerpt from the USAF Surgeon general's site talking about the LACK of TRAINING. I completely agree,although the reason for the lack of training that the site states I disagree with. While the essay says it was because of a lack of a plan, I'll tell you it was because of a lack of time and people. There was no time to train becasue we were 20% manned and didn't have any appts for patients as it was. TRaining would have just eaten into an already overloaded schedule. Again,just like PCO (primary care optimization); the senior admin of the USAF is great at coming up with plans, then terrible at the implementation. To quote one of the SG's favorite slogans; "Execution is the chariot of genius." So,obviously no one has the right to be claiming genius up there, And with that, USAF Family Medicine continues to be "executed."

SG Newswire August 2005
Medical OJT
A close look at a persistent write-up on Health Services Inspections


Chief Master Sgt. Jody Hanks
Air Force Inspection Agency Editor’s Note: This article appeared In the July-August edition of the TIG Brief.

KIRTLAND AIR FORCE BASE, N.M. -- Ultimately, training is a commander’s program. To ensure success, commanders must take an active role in the training and development of their subordinate staff, specifically the enlisted men and women of their command. Commanders who truly understand Air Force OJT lead from the front, giving sound direction to their training managers and making informed decisions.

“Supervisory Involvement—OJT” (LD.3.3.2) was the number one discrepancy and was cited in every Health Services Inspection (HSI) of active-duty facilities in fiscal year 2004. With an average score of 1 (critical discrepancy), it’s obvious that our folks are struggling, but what can they do to turn the OJT program around? The biggest deficiency is in the development of master training plans (MTPs). An MTP is supposed to be designed to ensure completion of all workcenter duty position requirements (meaning 100-percent task coverage). According to Air Force Instruction 36-2201V3, Air Force Training Program On The Job Training Administration, a solid MTP “employs a strategy for ensuring the completion of all workcenter job requirements by using a master task listing (MTL) and provides milestones for task, career development course (CDC) completion, and prioritizes deployment/unit type code (UTC), home station, upgrade, and qualification tasks.” So, what is this “strategy”? The instructional system development (ISD) process is systematic but flexible. It is used to plan, design, develop, and implement OJT programs in an effective and cost-efficient manner. ISD requires:

bump

 

[USAFdoc]

bump

bump

 

[RichL025]

Obviously you feel this is of earthshaking importance. And just as obviously, not too many other people agree.

So please stop bumping your own thread.

 

[curlycorday]

Hi all,

So, here's the breakdown of what I've discovered so far about Navy HPSP:

- I was 'field selected' for this program based on my gpa/mcat scores;
- I am applying to med school in fall 2006
- I want to ultimately go into primary care and have a family
- I haven't signed anything yet, but this is what I know so far and would really like input from current military mds, etc.

So, for all other pre-meds out there, hopefully this helps:

The HPSP program: you apply, you get accepted, you are commisioned as an officer (O1 in whatever branch) and you go off to med school, you do 45 adt every year, you go to OIS, you owe year-for-year service; which as I understand it (for emergency medicine) from my recruiter is 1 GMO tour, followed by 3 yr military residency, and commitment would be 3 years (4 yr HPSP -1yr GMO tour).

So, the summary:

PROS: no med school debt, no worry about money in med school, military benefits (health insurance, dental, cheap stuff at the exchange, etc), pride/prestige of being a military officer, cheap housing, etc., no malpractice fees, you don't worry about patients paying you, your patients don't worry about filling scripts, your patients aren't insubordinate (because they are reported to their CO), paid to study for USMLE/boards, bonus for passing boards, specialty pay
PROS come down to money...

CONS: you owe years of your life, you could be deployed during GMO/Reserves, military training time, limited hospitals to work at (military/VA), Apparently some administrative issues (understaffing, etc), malpractice= time in the brig instead of lawsuit, did I miss some?

CONS come down to time and frustration...

So, here I am, trying to decide whether or not to do this... After all, I just want to practice medicine, earn enough money to make my family comfortable, and live in a nice area. I am not in the military at all-- I just know the system well because I happen to be dating a hospital corpsman. He regrets his decision to join up, but is glad that he has his license at the end of it all.

I have worked extensively in the civilian healthcare sector as an EMT, and I can tell you that I was astonished at the mismanagement there. In the ER I worked in, the management was fired, replaced, sued, and then fired again countless times. The country is in a healthcare crisis all around, so I doubt that issues earlier in this thread are unique to the military. I also spoke with military docs that seemed mixed about it. Some mentioned that no liability and obedient patients was the best. Some didn't like the constraints and rules.

Any thoughts? Hope this helps those of you in my position!
Also, any input about raising a family as a military doc????

~Corday




See one, do one, teach one.

 

[USAFdoc]

Hi all,

So, here's the breakdown of what I've discovered so far about Navy HPSP:

- I was 'field selected' for this program based on my gpa/mcat scores;
- I am applying to med school in fall 2006
- I want to ultimately go into primary care and have a family
- I haven't signed anything yet, but this is what I know so far and would really like input from current military mds, etc.

So, for all other pre-meds out there, hopefully this helps:

The HPSP program: you apply, you get accepted, you are commisioned as an officer (O1 in whatever branch) and you go off to med school, you do 45 adt every year, you go to OIS, you owe year-for-year service; which as I understand it (for emergency medicine) from my recruiter is 1 GMO tour, followed by 3 yr military residency, and commitment would be 3 years (4 yr HPSP -1yr GMO tour).

So, the summary:

PROS: no med school debt, no worry about money in med school, military benefits (health insurance, dental, cheap stuff at the exchange, etc), pride/prestige of being a military officer, cheap housing, etc., no malpractice fees, you don't worry about patients paying you, your patients don't worry about filling scripts, your patients aren't insubordinate (because they are reported to their CO), paid to study for USMLE/boards, bonus for passing boards, specialty pay
PROS come down to money...

CONS: you owe years of your life, you could be deployed during GMO/Reserves, military training time, limited hospitals to work at (military/VA), Apparently some administrative issues (understaffing, etc), malpractice= time in the brig instead of lawsuit, did I miss some?

CONS come down to time and frustration...

So, here I am, trying to decide whether or not to do this... After all, I just want to practice medicine, earn enough money to make my family comfortable, and live in a nice area. I am not in the military at all-- I just know the system well because I happen to be dating a hospital corpsman. He regrets his decision to join up, but is glad that he has his license at the end of it all.

I have worked extensively in the civilian healthcare sector as an EMT, and I can tell you that I was astonished at the mismanagement there. In the ER I worked in, the management was fired, replaced, sued, and then fired again countless times. The country is in a healthcare crisis all around, so I doubt that issues earlier in this thread are unique to the military. I also spoke with military docs that seemed mixed about it. Some mentioned that no liability and obedient patients was the best. Some didn't like the constraints and rules.

Any thoughts? Hope this helps those of you in my position!
Also, any input about raising a family as a military doc????

~Corday




See one, do one, teach one.

I agree, some of the CONS of military medicine are NOT unique to the military, but many of them are. Show me another Family Medicien clinic that is staffed with 4/4 FP right out of residency, and 2/4 PAs right out of PA school; show me a clinic that has the majority of it's nurses (techs) 1 year out of HIGH SCHOOL, show me a clinic that has 50% of its docs deployed, show me a clinic that has chart availability at 20-40% at time of patient visit, a clinic that gives docs ZERO% clout in admin decisions, and the list goes on, and on......................Now BOTH military and civilian health care systems are under tremendous stress in todays business world, it's just that the military system has unique DISADVANTAGES and an admin design that is poorly capable to maneuver through these problems. Being a military doc also straps you in with no recourse when you find yourself in a broken clinic. Now having a great local Commander can do wonders, but those are few and far between. Broken clinics are numerous.

 

[haujun]

I still don't understand why people in this post want to compare the medicine in the military to the civilian sector??? You don't see military cooks complain about their life style because civilian cooks have easier life?? Military physicians exist to provide medical support and leadership to the enlisted soldiers and conserve their fighting strength to win the war. So in order to accomplish the task you are expected to be deployed, to offer support to other soldiers who may place their lives in the more dangerous situtations.
When I was in enlisted my commanding officer who has a doctorate in preventive medicine led a detachment composed of six enlisted soliders who were barely out of high school. This detachment existed to provide preventive medicine support to over 10,000 solidiers, and this commander successfully used her leadership and problem solving skill in accomplishing the numerous missions despite of OUTDATED equipment and enlisted soliders with low level of education.
Problems you mentioned (*poor staff, administrational problem, deployments, little education, poor pay etc*) are even more true in other parts of U.S. military such as logistics, communcation, combat esp. in the enlisted side and ironically you see these soldiers serving proudly and certaintly deserve to be treated by military physicians with strong leadership and problem solving skill than those problem identifying military docs...

 

[USAFdoc]

I still don't understand why people in this post want to compare the medicine in the military to the civilian sector??? You don't see military cooks complain about their life style because civilian cooks have easier life?? Military physicians exist to provide medical support and leadership to the enlisted soldiers and conserve their fighting strength to win the war. So in order to accomplish the task you are expected to be deployed, to offer support to other soldiers who may place their lives in the more dangerous situtations.
When I was in enlisted my commanding officer who has a doctorate in preventive medicine led a detachment composed of six enlisted soliders who were barely out of high school. This detachment existed to provide preventive medicine support to over 10,000 solidiers, and this commander successfully used her leadership and problem solving skill in accomplishing the numerous missions despite of OUTDATED equipment and enlisted soliders with low level of education.
Problems you mentioned (*poor staff, administrational problem, deployments, little education, poor pay etc*) are even more true in other parts of U.S. military such as logistics, communcation, combat esp. in the enlisted side and ironically you see these soldiers serving proudly and certaintly deserve to be treated by military physicians with strong leadership and problem solving skill than those problem identifying military docs...

some good points...true that most Military (non med incl) lack experience as you noted above.

some clarification on your rebuttle:
1) the military physicians (myself and others) were not just problems identifiers, we offered page after page of solutions, just that admin and senior admin staff IGNORE our solutions (MICROMANAGEMENT).
2) We DO SERVE proudly, and with great effort! Myself and others I know routinely worked 12+ hour days, 300+ hour months. I performed needed procedures on my free time (weekends), we gave the absolute best care we could under the circumstances. I have no regrets about the effort of myself or the other docs I worked with. And of course we Expect to get deployed, but what about the mission of those retirees that we leave behind? The USAF had, and continues to have to real contingency plan to account for that "homeland" mission.
3) you MUST know when you no longer have the resourses to get a job done. As stated in earlier threads, my effective panel size prior to primary care optimization would have been about 700 pts. With PCO and then with deployments and other loss of docs, we were covering 3000+ patients per provider. And if you consider that PAs are used as "full fledged docs, each doc was responsible for 6000+ patients. Our civilian counterparts average 1000-1500 patients. What I am saying is I witnessed our clinic being overrun in failure mode for 3 straight years with a grossely undermanned clinic and at times, incompetent admin. We were not even "in the ballpark" as to be able to provide excellent timely care under those circumstaces. The "just get it done" attitude is great, but eventually if you continue to erode your manning and infrastructure, hard work alone won't "get it done". As a example from war; if you are part of a brigade missioned to charge a hill defended by 1000 enemy troops and then you find out that YOUR 1000 troops has been reduced to 500, and the enemy troops are actually 2000, and then you find out there will be no "air cover" available, and then you find out half of your ammo is defective, and etc. etc...you get the idea, eventually your troops are headed on a suicide mission. I won't call our clinic a suiicide mission, but again, with what we had, taking excellent care of that many patients on a daily basis was inevitably going to lead to burnout of staff, frustrated patients, and poor patient outcomes and frequent near misses. As the physician, even a military physician being less likely to be sued, it is still MY RESPONSIBILITY for the care of those patients, and as bad as things were, I would NEVER let my parents be a patient in my own USAF clinic.

Do I hope things change for the better, absolutely, but I am not going to hold my breath waiting, and if the fact that the USAF is now 150 Family Docs short this year says anything, it's that other docs are not going to wait either.

The USAF may no longer consider excellent health care, integrity and safety top priorities, but I do. The USAF is all about "M&Ms".........money & metrics.

 

[USAFdoc]

i don't know if i'd go that far. just because it's a "popular" thread doesn't in and of itself make it true. besides, USAFdoc has almost a third of the posts in this thread. combine that with you and milmd, and almost 50% the posts in this thread belong to 3 users. i doubt it is accurate as much as it is post padding

--your friendly neighborhood investigative caveman

It has been many months now, and I am still waiting for some primary care docs from the USAF to talk about how GOOD the current primary care platform in the USAF really is (since many have decided that all of the docs who take the time to inform you all that it is terrible).

I have extreme confidence as to the accuracy of the posts coming from DOCS on this site; why? because we were there and we are NOT recruiters or commanders that have an alterior motive; we just want the truth to be known and let those who have the chance to make a BETTER informed decision, make one. If that is to join and serve, God Bless 'em.

 

[RichL025]

USAFDoc (and the 2 or 3 others who continually hit on this theme).

No one is questioning the "accuracy" of your personal observations. What we are questioning is how representative your personal observations are of miliary medicine as a whole.

You have experience in primary care in the USAF, yet you continually generalize to include ALL of military medicine in your posts.

This is a bulletin board for student doctors. One of you (maybe you, maybe milmd) made the comment that the only reason you are here on this board is to warn others of the sorry state of primary care in the USAF. That's a laudable goal, but if that's your motive, why would you expect to find other board-certified physicians here if they weren't dissatisfied?

By definition (your own), anyone who was happy in your position would not post!

Oh, yeah, there are 4-5 other BC physicians who post here regularly.... (slumming ? ) in a smattering of specialities. By and large THEY seem rather happy, but none of them are in AF primary care (too small a sample size)

So OK, let's pretend this is a court of law. We will stipulate that USAF primary care has some problems, and many dissatisfied physicians.

Now for Pete's sake please STOP flogging this horse!!!! If you wish to hang out here with us STUDENTS and contribute to the community, you're welcome, and if someone (who would have to be a newbie!) pops up with a question about USAF primary care, your input would be welcome, but frankly, this is getting a little tiring.

Your point is made.

 

[rotatores]

i don't know if i'd go that far. just because it's a "popular" thread doesn't in and of itself make it true. besides, USAFdoc has almost a third of the posts in this thread. combine that with you and milmd, and almost 50% the posts in this thread belong to 3 users. i doubt it is accurate as much as it is post padding

Homunculus,

Is there any way we could start a sticky for USAFDoc and milmd and some how copy and paste all of their prior posts...that way we don't have to keep on reading the same complaints over and over again.

rotatores
USUHS 2006

 

[Globus P]

Homunculus,

Is there any way we could start a sticky for USAFDoc and milmd and some how copy and paste all of their prior posts...that way we don't have to keep on reading the same complaints over and over again.

rotatores
USUHS 2006

Agreed, great recommendation.

 

[USAFdoc]

Homunculus,

Is there any way we could start a sticky for USAFDoc and milmd and some how copy and paste all of their prior posts...that way we don't have to keep on reading the same complaints over and over again.

rotatores
USUHS 2006

better yet; could we finally get a post started with a list of all the primary care docs that have elected NOT to separate from the USAF and remain in patient care (not go admin)????? I know of ZERO docs that have elected to stay and those docs know of ZERO people who have stayed...I know of one doc who stayed and went admin.

FYI; I will NOT stop voicing my concerns until the USAF changes its ways for the sake of the patients and the staff working the clinics, so everybody get used to it,..and by the way, stop being so accepting of mediocre healthcare system (at best), a reckless healthcare system at worst.

 

[delicatefade]

It's not that you are unwelcome to your opinion and to share your experience. It's just that we keep hearing the same damn thing from you every time you post. USAF Primary Care is broken. WE KNOW. You were understaffed and overworked. WE KNOW. Your administrators didn't listen to your recommendations and you were threatened. WE KNOW. Metric-driven policies are hogwash. WE KNOW.

I'm happy you are here and that you can share your experience. Really. It's just that you come off like a broken record. I mean, MilMD was separated from his wife by the Navy for a few years, but we don't hear him bitching about it every week unless someone asks him about it.

 

[USAFdoc]

It's not that you are unwelcome to your opinion and to share your experience. It's just that we keep hearing the same damn thing from you every time you post. USAF Primary Care is broken. WE KNOW. You were understaffed and overworked. WE KNOW. Your administrators didn't listen to your recommendations and you were threatened. WE KNOW. Metric-driven policies are hogwash. WE KNOW.

I'm happy you are here and that you can share your experience. Really. It's just that you come off like a broken record. I mean, MilMD was separated from his wife by the Navy for a few years, but we don't hear him bitching about it every week unless someone asks him about it.

this venue (SDN) is one of the ways I can try to make the system change for the better. I spoke with a USN recruiter at a recent CME event,and they were aware of this site and had read some of the negative postings on USN medicine. I have and will continue to work through congress and contacts I have within the USAF Wash DC admin. Listen, what I saw and lived wasn't just "a bad 3 years", and now I need to just get on with it. Yea, that would be the easy way,but that is not my way, the way of an officer, or the way of a good physician. I saw a 31 yo s/p STROKE....why? because our clinic refilled his BP meds for almost 3 years without ever seeing him (his last BP in the chart..248/148 !!!!! and many others (although usually with less severe outcomes than that one). I understand that as a student, and especially as a student that isn't going to USAF primary care, this may not interest you directly, but you should still give a damn that MINE and YOUR military decided to run a clinic that way. I will continue to voice my concerns, and SDN is just one of the ways. The care that was given (and not given) concerns me alot more than your frustration level at reading these entries.

 

[LO281OK]

PROS: military benefits (health insurance, dental, cheap stuff at the exchange, etc), cheap housing, etc.
PROS come down to money...

Any thoughts? Hope this helps those of you in my position!
Also, any input about raising a family as a military doc????

~Corday
QUOTE]

There are other ways to get your schooling paid for if you are sure you want primary care. Many rural and urban areas will pay your tuition in return for time in their underserved communities.

As far as I know your benefits are only for your family during Active Training periods. Depending on where you serve the cheap housing may be justly so.

I grew up a military brat and served as an officer in the Navy. I think you are right to try and get every bit of information before signing up for HPSP. I am leaning away from it for a few reasons (residency choices, military-wide issues/mgt, etc.)

 

[FizbanZymogen]

USAFdoc, I am gald you can speak so openly about these issues. Your experiece is firsthand and this is important. My Father was a pilot (flew F-15's) and taught physics at the Air Force Academy. I had a few procedures surgical and non while I was a dependant and have to say to those who are knocking the Air Force Docs, I can't speak for your experiences but mine have always been very positive. The Air Force docs I have interacted with have been on average far more compitent and hard working than the average civilian docs I've interacted with. My hats off to all of you who work so hard and so long. I hope you have a better future in medicine and with the military. Thats just my 2 cents.

 

[militarymd]

The Air Force docs I have interacted with have been on average far more compitent and hard working than the average civilian docs I've interacted with..

Consumers of healthcare are notoriously poor judges of quality. Patients confuse bedside manner with competance and skill.

 

[Heeed!]

My Father was a pilot (flew F-15's) and taught physics at the Air Force Academy.

I loved my F-15 but those USAFA physics classes:

 

[USAFdoc]

Consumers of healthcare are notoriously poor judges of quality. Patients confuse bedside manner with competance and skill.

in defending our clinic, the commander also fell back on the wonderful "patient satisfaction" record our clinic had......

one time I read through the "100% patient satisfaction" response list and found that one of the responses complained that the PA was terrible and made the patient feel like they were a *****.........our commander interpreted that response as a satisfied customer! No wonder we had such a high patient satisfaction rate!

Another was a lady who I saw that the clinic failed to notify her that she was a diabetic, had markedly elevated liver enzymes, blood in the urine and a few other things, all from labs 6 months old. She also stated that but thanked me that I was now "fixing" the problems. That also was a satisfied patient on the list.

In other words, dear pts; "enter a USAF primary care clinic at your own risk"

 

[Mirror Form]

Consumers of healthcare are notoriously poor judges of quality. Patients confuse bedside manner with competance and skill.

That's a very good point. I see tons of patients who love incompetent docs b/c of good bedside manner. It runs the gamut from FP to surgery. Now a days it's easy to think the patients must just not be that smart, but if you don't have a medical education you really have no way of knowing your doc is full of ****.

I used love my FP doc, thought he was the greatest thing since sliced bread. Heck, he even helped motivate me to want to become a doctor. After starting med school I finally realized how wrong most of his treatments had been for me. He definitely did MUCH more harm then good.

 

[grayce79]

Hi all,

So, here's the breakdown of what I've discovered so far about Navy HPSP:

- I was 'field selected' for this program based on my gpa/mcat scores;
- I am applying to med school in fall 2006
- I want to ultimately go into primary care and have a family
- I haven't signed anything yet, but this is what I know so far and would really like input from current military mds, etc.

So, for all other pre-meds out there, hopefully this helps:

The HPSP program: you apply, you get accepted, you are commisioned as an officer (O1 in whatever branch) and you go off to med school, you do 45 adt every year, you go to OIS, you owe year-for-year service; which as I understand it (for emergency medicine) from my recruiter is 1 GMO tour, followed by 3 yr military residency, and commitment would be 3 years (4 yr HPSP -1yr GMO tour).

So, the summary:

PROS: no med school debt, no worry about money in med school, military benefits (health insurance, dental, cheap stuff at the exchange, etc), pride/prestige of being a military officer, cheap housing, etc., no malpractice fees, you don't worry about patients paying you, your patients don't worry about filling scripts, your patients aren't insubordinate (because they are reported to their CO), paid to study for USMLE/boards, bonus for passing boards, specialty pay
PROS come down to money...

CONS: you owe years of your life, you could be deployed during GMO/Reserves, military training time, limited hospitals to work at (military/VA), Apparently some administrative issues (understaffing, etc), malpractice= time in the brig instead of lawsuit, did I miss some?

CONS come down to time and frustration...

So, here I am, trying to decide whether or not to do this... After all, I just want to practice medicine, earn enough money to make my family comfortable, and live in a nice area. I am not in the military at all-- I just know the system well because I happen to be dating a hospital corpsman. He regrets his decision to join up, but is glad that he has his license at the end of it all.

I have worked extensively in the civilian healthcare sector as an EMT, and I can tell you that I was astonished at the mismanagement there. In the ER I worked in, the management was fired, replaced, sued, and then fired again countless times. The country is in a healthcare crisis all around, so I doubt that issues earlier in this thread are unique to the military. I also spoke with military docs that seemed mixed about it. Some mentioned that no liability and obedient patients was the best. Some didn't like the constraints and rules.

Any thoughts? Hope this helps those of you in my position!
Also, any input about raising a family as a military doc????

~Corday




See one, do one, teach one.

Just wanted to clarify a few things:
First, your assumption is that you will get an ER residency. ER is competitive in the civilian world, but even more so in the military world. Be prepared to get good grades and board scores. (Which I'm sure you will.)

Second, everyone will owe at least 8 years. For some reason this is the minimum sign-on. What happens is that you serve 3-4 years active duty and then you have 4-5 years of being in the individual ready reserve. During this time, you are not paid, but can be called up at anytime to serve. The military is having a hard time holding on to its doctors right now, so I wouldn't be surprised if they ended up calling up some people. Also, you are assuming that they will let you get out at all. You can also get caught up in a a "stop loss" where they get to keep you because of their severe shortages.

Also, keep in mind that you do not have military health benefits during medical school. You only get those benefits when you are active duty. The military will ONLY pay for your health insurance if it is required by your school. And they will only pay the minimum amount. They will not cover dental insurance.

In addition, the military will only pay for required books. Recommended books are not covered. During my 3rd/4th year rotations, there are no required books. (You get to choose which ones you want to use.) Therefore, I have had to buy all of my textbooks for 3rd/4th year out of pocket.

There were also other things that came up occasionally that they would not reimburse me for such as a parking pass, etc.

Another misconception that I had is that your patients cannot sue you in the military. This is not true. The truth is that when you are sued, you don't have to pay out of your own pocket. The military pays and that is why you don't have to have malpractice insurance. This is an important distinction because it still goes on your record. I have heard of military physicians who were sued 3 times and then were unable to get malpractice insurance when they got out of the military. They were not able to open a practice and their career was ruined.
If 3 times sounds like a lot, it's not. It is rare to find a physician these days who has practiced for >10 years without ever being sued.

Anyways, what I've written is just some things that I would have liked to know the truth about before signing on.
Good luck!

 

[USAFdoc]

PROS: military benefits (health insurance, dental, cheap stuff at the exchange, etc), cheap housing, etc.
PROS come down to money...

Any thoughts? Hope this helps those of you in my position!
Also, any input about raising a family as a military doc????

~Corday
QUOTE]

There are other ways to get your schooling paid for if you are sure you want primary care. Many rural and urban areas will pay your tuition in return for time in their underserved communities.

As far as I know your benefits are only for your family during Active Training periods. Depending on where you serve the cheap housing may be justly so.

I grew up a military brat and served as an officer in the Navy. I think you are right to try and get every bit of information before signing up for HPSP. I am leaning away from it for a few reasons (residency choices, military-wide issues/mgt, etc.)

rest assured, you are probably leaning the right way.

 

[orbitsurgMD]

If doing a quality residency in a reasonable time frame is a priority, and these days it should be, then I would think very carefully about alternatives to HPSP.

Unfortunately the military has little respect for the importance of residency training for their physicians. The reliance on GMOs with only one year of postgraduate training is glaring evidence for this, now decades after the civilian practice community adopted requirements for residency completion and board eligibility. It is nothing more than institutionalized contempt for the value of training, for the doctors in their scholarship programs and for their patients, and it is morally if not legally inexcusable. As a taxpayer, I object to having my taxes misspent that way.

When I served in the Naval aviation community, I used the analogy of taking a pilot fresh from primary training and making him PPC and mission commander. A line CO would get bounced for that. But that is SOP for medical, and no one says anything.

 

[USAFdoc]

If doing a quality residency in a reasonable time frame is a priority, and these days it should be, then I would think very carefully about alternatives to HPSP.

Unfortunately the military has little respect for the importance of residency training for their physicians. The reliance on GMOs with only one year of postgraduate training is glaring evidence for this, now decades after the civilian practice community adopted requirements for residency completion and board eligibility. It is nothing more than institutionalized contempt for the value of training, for the doctors in their scholarship programs and for their patients, and it is morally if not legally inexcusable. As a taxpayer, I object to having my taxes misspent that way.

When I served in the Naval aviation community, I used the analogy of taking a pilot fresh from primary training and making him PPC and mission commander. A line CO would get bounced for that. But that is SOP for medical, and no one says anything.

great to read your entries (your experience) at discribing additional angles of the BROKEN military healthcare system. I especially agree with you inclusion about the ethical/moral aspect of the military doing what they do in terms of designing/running a healthcare system.

ONLY ONLY ONLY! in the military could they consistently "get away" with how they do "business". In the civilian world, EVERY single doc would resign with the type of mismanagement I witnessed (and placing patient in uneeded harms way). Again, 100% of civilain nurses QUIT, 9 of 10 civilian doctors QUIT/Left, and 100% of military docs separated (although one did stay but to go admin) during my USAF career experience.

I pray that the USAF pulls its head out, and begins to at least try and live up to the wonderful mottos that they quote on a regular basis; excellence, integrity, right person in the right job at the right time,..."retention is the oxygen of the AFMS" and many others.

ALL of these mottos are really just a joke for those "in the know"; at least that is the reality of how the USAF does business.

 

[FizbanZymogen]

You all missed my point. I don't think the military Doc's are good because they come across friendly or competent although most do (except for this one derm.) I say I am impressed with them in general after having interacted with a lot of physicians. Also you don't need to be a pre-med student or even a physician to know when one is full of ****. Its usually pretty obvious who's good and who's full of crap, or maybe its just me.

 

[USAFdoc]

You all missed my point. I don't think the military Doc's are good because they come across friendly or competent although most do (except for this one derm.) I say I am impressed with them in general after having interacted with a lot of physicians. Also you don't need to be a pre-med student or even a physician to know when one is full of ****. Its usually pretty obvious who's good and who's full of crap, or maybe its just me.

I didnt miss your point. I agree with you, the USAF docs I worked with I considered very hard working (250-300 hours month) and better than average in terms of their competency and desire to give excellent care. The problems start after that. Despite being above average (my opinion), we were still manned with 100% docs out of residency (no senior clinic docs with experience), half the PAs were right out of PA school, the support staff techs were about 1-2 years removed from high school, chart availability 10-40%, and you can read other entries about the poor admin and staff support of our clinic. Now add to that 3000 patients per provider (6000 per doc) and you begin to get the picture of a clinic operating in failure mode. It doesnt matter if you have a great doc just out of residency, in these condition you will burn out staff and give poor care to patients (those still able to get appts).

so, back to the claim that the USAF docs were good and worked hard...yes and yes...they work very hard and they are very good NEW docs,...but a new doc is not as good as a doc with some experience, even just a few years experience make a world of difference. And do the patients realize the care they are getting, or not getting? 90% of the time thay have no idea of the "bad" stuff they are getting.

 

[Mirror Form]

You all missed my point. I don't think the military Doc's are good because they come across friendly or competent although most do (except for this one derm.) I say I am impressed with them in general after having interacted with a lot of physicians. Also you don't need to be a pre-med student or even a physician to know when one is full of ****. Its usually pretty obvious who's good and who's full of crap, or maybe its just me.

I definitely agree that most military doctors are good, but not all though. I also know you're wrong in your assessment that a laymen can really tell if their doctor is good or not. Sometimes it's obvious, but usually the patient has no idea whatsoever. Social skills are mistaken for clinical skills. Research has actually shown that one of the the number one factors in whether patient's like their FP doc is if the doctor takes their BP himself.

If a doctor appears confident and very sure of what he is doing, then it usually takes some pretty blatant mismanagment for the patient to realize that the doc is an idiot.

 

[militarymd]

You all missed my point. I don't think the military Doc's are good because they come across friendly or competent although most do (except for this one derm.) I say I am impressed with them in general after having interacted with a lot of physicians. Also you don't need to be a pre-med student or even a physician to know when one is full of ****. Its usually pretty obvious who's good and who's full of crap, or maybe its just me.

Consumers of healthcare are notoriously poor judges of quality.

 

[USAFdoc]

Consumers of healthcare are notoriously poor judges of quality.

apparently so are the current military surgeon generals....................

 

[A_Dull_Boy]

I considered HPSP.
Serve my country? Sounds great.
Get med school paid for? Even better.
I didn't sign up because it all seemed too open on the back end. I didn't like the idea of someone else having so much control over my future--I'd worked too hard to get into med school for that.

Took out my first year's loans: $43,000. Wondered if i made a mistake. Watched war in Iraq: really wondered if I'd made a mistake. Reconsidered signing up. Talked to HPSP classmates. Everyone had a different commitment expectation (even within the same branch). Student's required health insurance was covered, dependants' coverage was not. Required texts and equipment were covered, recommended texts and equipment were not. On and on. They were discovering all of the things the recruiters neglected to mention. I figured I'd made the right decision.

Yet the desire to serve lingered.
Talked with Army and Air Force EM residents. All were frustrated by lengthy interruptions in training during civilian residencies. Talked with Attending EM physician, recently out of USAF. Had many of the same concerns as others have expressed: gross-understaffing, even more primary care than civilian ED's d/t overflow from under-staffed primary care clinics, inability to get adequate ER supplies to do a proper job (e.g. sending simple lacs to the OR because no suture/very-wrong-suture available in the ED). At least double the hours and double the hassles of civilian EM docs.

Still really want to serve. Almost $200,000 in debt.
Watched my HPSP classmates and the military match. "GMO here. Flight Surgery there. X years down the road I'll finally start my residency." Seriously, does anybody match what they want?

Still want to serve and perhaps still will. But for now, thanks to all of you (ex)military docs willing to share your from your experience.

And how about a little counterpoint for those recruiting ads: http://www.ifilm.com/ifilmdetail/2644450

 

[USAFdoc]

great thread.

The desire for myself and others (AND YOU DULL BOY) to serve our great country is strong, and it speaks to how bad things are that so many of us with that desire to serve as military docs still made the decision to separate rather than continue.

It is nice to see so many recent threads from you and others support the claims of myself, milMD, Island doc and others that there are serious reforms that need to be done asap in military medicine.

The internet has now made it possible for previously unsuspecting students (as I was) to at least make informed decisions and realize that the recruiter may not be telling the whole truth (the recruiter, and all the mil med ads I see making mil med sound like the best thing next to being a rock star).

 

[majleap]

USAF doc,

I am new to this site, and while I respect your opinion it seems to me that if you have been serving for 22 years and you have these complaints, you are part of the problem. You obviously haven't been part of the solution. While I admire you for serving so long, who knows, you might have delivered my firstborn, for you to be so disparaging towards AF medicine is disheartening. And if I may ask, what has kept you in for so long. Something about the AF lifestlye has kept you from leaving. You wouldn't be one of those unmotivated individuals who can't make it outside the Air Force would you? I say that to make a point, you probably don't fall in to that last category, so why have you stayed in? One of the problems you mentioned is not haveing the proper staff, do you think you are helping are hurting that problem? Just look at some of the replies, I hope you feel like you have accomplished something. I am sure you know how incredibly hard it is to find a doctor who is willing to serve their country as opposed to reaping the huge financial reward in the civilian world. Your post is very damaging. Now, the truth is the truth, but explain why you stayed in for us, and by the way, with that attitude, I hope I never have to salute you. Good day.

 

[delicatefade]

Um....I'm going to get some popcorn for this one.

 

[USAFdoc]

USAF doc,

I am new to this site, and while I respect your opinion it seems to me that if you have been serving for 22 years and you have these complaints, you are part of the problem. You obviously haven't been part of the solution. While I admire you for serving so long, who knows, you might have delivered my firstborn, for you to be so disparaging towards AF medicine is disheartening. And if I may ask, what has kept you in for so long. Something about the AF lifestlye has kept you from leaving. You wouldn't be one of those unmotivated individuals who can't make it outside the Air Force would you? I say that to make a point, you probably don't fall in to that last category, so why have you stayed in? One of the problems you mentioned is not haveing the proper staff, do you think you are helping are hurting that problem? Just look at some of the replies, I hope you feel like you have accomplished something. I am sure you know how incredibly hard it is to find a doctor who is willing to serve their country as opposed to reaping the huge financial reward in the civilian world. Your post is very damaging. Now, the truth is the truth, but explain why you stayed in for us, and by the way, with that attitude, I hope I never have to salute you. Good day.

Nothing kept me in that long; I separated from the USAF at my first date of separation. It took me a few months into my active duty USAF career to realize how broken the system was, I then spent the next 2.5 years trying to fix the problem. Admin seemed nonresponsive, and in fact, continued to make things worse, so I left. The reason I have many years (not 22) is because of previous USN enlisted time and some reserve time.

Is it easy to find a doc willing to serve their country? YES, absolutely. The question is can the USAF STOP from running a healthcare system so poorly that every single doc exits at the first opportunity. EVERY doc at my last base had STRONG desires to become a career USAF provider, yet EVERY single doc left (some with 18 years in), although 1 did re-up but went admin (wanted no more to do with patient care.)

It continues to be interesting to see some people such as yourself try and characterize the docs that leave as "unmotivated" or "not cut out for the military" etc. Again, I guess that must be an easier explaination to stomach than to consider that the system is broken (and refuses to let the docs fix it). Nobody I know makes it through residency and medical school being lazy. I am highly motivated, love being a family doc, love to be involved with my community (Big Brothers'Sisters for 20 years), involved with my church, was a Regent Scholar at the Univ of California etc....

As far as being part of the solution; I gave it all I had for my time in, and I regret today the effect it had on my family, me being at work 300 hours/month, but I took an oath, and I upheld my end of that oath. I would challenge the USAF that they have failed to live up to their promises; both to patients and staff. USAF core values seemed not to apply within USAF Primary care. You make it sound that YOU could have changed the system if just you had the chance. My final decision to leave the USAF came after a conversation with several USAF Colonels working at the Pentagon, and hearing the same frustration from them that senior USAF personnel (Surgeon Generals etc) were continuing to ignore what needed fixing.

 

[orbitsurgMD]

USAF doc,

I am new to this site, and while I respect your opinion it seems to me that if you have been serving for 22 years and you have these complaints, you are part of the problem. You obviously haven't been part of the solution. While I admire you for serving so long, who knows, you might have delivered my firstborn, for you to be so disparaging towards AF medicine is disheartening. And if I may ask, what has kept you in for so long. Something about the AF lifestlye has kept you from leaving. You wouldn't be one of those unmotivated individuals who can't make it outside the Air Force would you? I say that to make a point, you probably don't fall in to that last category, so why have you stayed in? One of the problems you mentioned is not haveing the proper staff, do you think you are helping are hurting that problem? Just look at some of the replies, I hope you feel like you have accomplished something. I am sure you know how incredibly hard it is to find a doctor who is willing to serve their country as opposed to reaping the huge financial reward in the civilian world. Your post is very damaging. Now, the truth is the truth, but explain why you stayed in for us, and by the way, with that attitude, I hope I never have to salute you. Good day.

majleap, you said:

"I am sure you know how incredibly hard it is to find a doctor who is willing to serve their country as opposed to reaping the huge financial reward in the civilian world. Your post is very damaging.'

USAFdoc has posted his gripes about his experience as a practitioner in Air Force primary care clinics. He has cited numerous examples he has witnessed as to why he thinks something is wrong and what ought to be fixed. Are you suggesting that neither he or anyone else should complain about poor working conditions and mismanagement because why, that information might be harmful in recruitment? Tough luck.


I think he has done the prospective applicants--the ones who do and the ones who don't sign on--an enormous service. Now that the truth about what goes on is a little more public, the misleading practices of the recruiters and the medical departments are going to get a little more exposure. Or perhaps you think hiding the faults of the system is the better way to go? Funny thing is, that is the situation that existed before information about HPSP, military practice, GMO tasking and other controversial matters was available on the web, and the services pretty much ignored most of the initiatives for change. Until it hits them where they can't ignore it anymore, in recruitment, they have little incentive to address these very real problems.

If it takes bottoming out the pool of medical students to force change, then so be it. If that is a problem for the services, it is a problem of their own making and made worse by their own contempt and neglect.

 

[bobbyseal]

"GMO here. Flight Surgery there. X years down the road I'll finally start my residency." Seriously, does anybody match what they want?

I got a full deferment. I matched where I wanted to. I'll serve my 4 years and probably be done. Sure it may be a pain in the neck for those 4 years, but I very well may be better off for taking the HPSP. I went to a private med school with tuition >$35k per year, plus health insurance, plus fees, plus books, plus, $15-16k per year in stipend. That's like $200k right there from the military. For anyone right out of residency $50k a year after taxes is somewhat hard to swallow to pay that back.

But then again, there are many more people who were screwed by the military than those who got the good deal. The screw may have just not turned on me yet.

 

[USAFdoc]

the dollars and cents of going military primary care IS actually pretty decent, and your example above notes that. Again, I would argue that most of us that chose to go military primary care didn't choose it for the money anyways, and the reason there is an EXODUS from military primary care has little to do with dollars and much to do about quality (of life and care).

 

[USAFdoc]

majleap, you said:


I think he has done the prospective applicants--the ones who do and the ones who don't sign on--an enormous service. Now that the truth about what goes on is a little more public, the misleading practices of the recruiters and the medical departments are going to get a little more exposure. Or perhaps you think hiding the faults of the system is the better way to go? Funny thing is, that is the situation that existed before information about HPSP, military practice, GMO tasking and other controversial matters was available on the web, and the services pretty much ignored most of the initiatives for change. Until it hits them where they can't ignore it anymore, in recruitment, they have little incentive to address these very real problems.

If it takes bottoming out the pool of medical students to force change, then so be it. If that is a problem for the services, it is a problem of their own making and made worse by their own contempt and neglect.

My aim is not necessarily to "bottom out" applicants, although that may be what it takes. My aim is to motivate people to DEMAND a change to how many aspects of military medicine are currently being run (to the detriment of patients, staff, and ultimately to the military as well). I do not beleieve this change will happen if everyone looks the other way (as some on this site promote) and it will not happen if nobody knows about the problems (something this site helps address in a small way). I hope that when some of these students make it to "the front line" in their military medical career, that either things are fixed by then, or that they stand up and fight for a better healthcare system as well.

 

[midn]

I got a full deferment. I matched where I wanted to. I'll serve my 4 years and probably be done. Sure it may be a pain in the neck for those 4 years, but I very well may be better off for taking the HPSP. I went to a private med school with tuition >$35k per year, plus health insurance, plus fees, plus books, plus, $15-16k per year in stipend. That's like $200k right there from the military. For anyone right out of residency $50k a year after taxes is somewhat hard to swallow to pay that back.

But then again, there are many more people who were screwed by the military than those who got the good deal. The screw may have just not turned on me yet.

This is off-topic, but someone else told me HPSP does not give health insurance. Did you get health insurance from the HPSP scholarship?

 

[MoosePilot]

This is off-topic, but someone else told me HPSP does not give health insurance. Did you get health insurance from the HPSP scholarship?

They'll pay for health insurance for the student/officer, but not for family.

 

[majleap]

I am not saying that he shouldn't voice his concerns, nothing gets fixed that way. But he makes it sound like he is speaking for every AF doctor at every base. You yourself said that he gripes about his experience at Air Force primary care clinics (plural), how many did he practice medicine at? I bet if you asked 100 civilian doctors, some would have bad things to say about one certain hospital, as opposed to having wonderful experiences with another one. I spoke with 3 AF doctors last week, confidentialy, and asked them these things. While they have concerns with staffing at times, by and large they are extremely happy with ther choices. One doc had 18 years in, one had 7, and one only 2 months. I know everybody is not going to have a great time in the Air Force, I'd bet the satisfaction level is just about equal if you polled 10 CURRENT AF docs and 10 civilian docs. All I am saying about this USAFdoc is to qualify his remarks and not paint every AF hospital, doc, etc with the same brush.

 

[Mirror Form]

I'd bet the satisfaction level is just about equal if you polled 10 CURRENT AF docs and 10 civilian docs.

You're not the first person to have this notion. I dare you to take a poll.

 

[USAFdoc]

I am not saying that he shouldn't voice his concerns, nothing gets fixed that way. But he makes it sound like he is speaking for every AF doctor at every base. You yourself said that he gripes about his experience at Air Force primary care clinics (plural), how many did he practice medicine at? I bet if you asked 100 civilian doctors, some would have bad things to say about one certain hospital, as opposed to having wonderful experiences with another one. I spoke with 3 AF doctors last week, confidentialy, and asked them these things. While they have concerns with staffing at times, by and large they are extremely happy with ther choices. One doc had 18 years in, one had 7, and one only 2 months. I know everybody is not going to have a great time in the Air Force, I'd bet the satisfaction level is just about equal if you polled 10 CURRENT AF docs and 10 civilian docs. All I am saying about this USAFdoc is to qualify his remarks and not paint every AF hospital, doc, etc with the same brush.

ask and you shall receive;

I speak for all the docs at that base, 100% that separated asap for the past 10-15 years (1 doc stayed and went the admin route)

I speak for 9 of 10 civilian docs at that base that quit.

I speak for the docs that I met at a mil confernece represented by 8 bases; all clinics in chaos, all doc frustrated.

I speak for the docs I personally knew at Fairchild and Offutt; the description thay gave me of their clinic made theirs sound even worse than mine.

I speak after having attended USAF Primary care optimization orientation course in TX; all but overseas clinic personnel described "broken" clinics. Even the course lectures stated the system has failed and is overrun.

I speak about the conversations with all of the last 3 USAF FP reps to the Pentagon that described their own frustration at the current system.

and I could go on. Other than the USAF Academy and overseas; all personnel I spoke with described things as "broken" and completely unacceptable. There is a reason the USAF is 150 FP docs short this year and likely spending millions on advertising to lure new docs to the system. The system is broke.

And as stated in previous threads, there will always be people like MAJLEAP that will ignore all the facts and all the first hand accounts and still declare that "OJ is INNOCENT".

I wish the best for all those in the system, I really want milmed to be great, but those in charge have designed a failing system and seem intent on stating just the oppposite.

 

[island doc]

I am counted among those 100% who left ASAP. You are "preaching to the choir". And I didn't think things could get any worse, obviously it did.

 

[majleap]

Thank you for qualafying your remarks, now I at least can see where you are coming from. However, I guess it is safe to assume that the position you are in now is trouble free? I guess it is safe to say that your time as an AF doc was totally a waste? I would conclude that other than professionally, your time in the AF away from work was totally horrible. Do we have problems? Yes. Are we short on docs? Absolutely, that is a problem from the top, and they are now working to change that. I would say that a staff fully manned would solve many problems you faced. Didn't you say you were in the Navy, got out, joined the AF, got out? Some people can't be pleased. Well USAF doc, I am sorry your AF time was so bad. (Why do you use the title USAF doc?) Do you try to hide your AF service when you talk to other physicians. You wouldn't use this horrible experience to further your career would you? If after everything you say, if you keep your service to your country off your resume, then I will respect you.