Can the "Purple Suit" fix military medicine?

[mac61]

Just curious if any of the "Who's Who of SDN" have opinions.

It seems to me that the dichotomy of professional officership vs professional health care provider is at the root of most of the problems discussed on this forum: Physicians who either look out for thier career as an officer who sacrifice patient care, or physicians who sacrifice thier career as an officer in order to preserve patient care. Combined with "non-credentialed" managers managing patient care, it seems obvious why so many physicians on this forum are aggrevated with how thier combined careers went, or are going.

Will the impending dissolution of service specific medical assets and the creation of a military medical corps change anything? Please try to use a little optimism maybe like "If I were in charge..."

If you could design a system in which military medical assets were efficiently used in this setting, what would need to happen?

Should this system be run by MSC officers with input from physicians, or be run by physicians, nurses, PAs, etc. who have removed themselves from clinical practice?

All responses are welcome, however please refrain from responses of "It doesn't matter what we do because the system will always be broken, because the government/navy/AF/Army will always be a safe haven for *****s and sub-standard physicians."

Thanks for your time and experienced opinion.


Yours Truly,

---

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[DropkickMurphy]

If it were up to me:
The medical corps would be a seperate entity, answerable only to a board of senior practicing physicians, and rank would not apply in regards to non-medical officers, and the nurses, PA's, and NP's would answer to physicians regardless of administrative rank. Basically, in a clinical setting the deciding factor would be education and qualification, not rank.

I would also commission RT's (or at least make them warrant officers or some such intermediary status) because it is unfair to have someone with the same skill level as an RN in a subservient position.

 

[Ankylosed]

I would also commission RT's (or at least make them warrant officers or some such intermediary status) because it is unfair to have someone with the same skill level as an RN in a subservient position.

.

 

[DropkickMurphy]

As opposed to pathologists (assuming that's what you mean by "surgeon of the dead"). "Hmmmm......that looks suspicious, maybe even malignant. Oh, wait, it's a piece of the cookie I was eating when I prepped this slide."

 

[The White Coat Investor]

What skill is that? The ability to say, "push, breath, deeper, good, ok stop"? You have no real skills and you, your profession, and tens of thousands of posts on SDN are "laughable".

Totally inappropriate. A good RT is worth their weight in gold. When I need an RT neither a nurse, a tech, nor a paramedic can replace them. Perhaps you only use them to teach patients how to breath, I use them to set up ventilators, adjust ventilators, tape tubes, adjust tubes, teach patients how to use an inhaler (surprising difficult for some reason), and to teach patients about respiratory diseases.

"Push, breath, deeper, good, OK stop" sounds like something an obstetric NURSE might spend all day saying.

Not saying RTs can replace nurses, simply that they both have their place and area of expertise.

 

[mac61]

Got it. One more disgruntled user avoiding the opportunity to provide any useful information short of "You're dumb."

Still hopefully awaiting any of the experienced physician's (etc.) opinions. I truly hope the vociferous nature of experience doesn't fail to provide constructive input.

Thanks for the input Murph. I have to wonder if removal of rank from physicians would create more heirarchy or less among support staff. Perhaps physicians paid at a rate, with no assumption of rank would stop us from being treated as contractors, but would it cause us to lose what credibility the medical corps has among the rest of the military?

I think it's a great idea. Pay physicians a pay grade without the responsibility of rank. Your pay would reflect your experience. The competition for leadership positions could be based completely on your qualifications, not your time in service.

I do however think that this could only work if all of the commissioned medical officers are affected the same way, with the exception of MSC officers because the thier direct influence with line commanders. This could also create a more highly trained Med Platoon Leader, as he wouldn't have to worry about rank being pulled by the doc/PA in his platoon as he works to do his job while the doc is in clinic.

So: 1) Pay medical corps, nurse corps, specialty corps, vet corps, etc.a military grade (as opposed to GS) with no rank (i.e. wear just the appropriate cadusus/oak leaf thingy to indicate that you are a member of the military medical corps)
2) Base positions (chief of surgery, Residency director, etc.) on performace not pay grade.
3) Maintain MSC rank to facilitate communication with line.
4) Maintain a relationship with the MSC that dictates medical officers manage care and all things included with care, and the MSC manages assets on the battlefield with cross talk ensuring asset placement coincides with care management.

Just me talking out loud.

Oh yeah, I'm not familiar with RTs, however if OTs and PTs are commissioned I'm not sure why RTs are not. Then again, should radiology techs be placed in the mix? Where do you draw the line? Again, I have NO idea what I'm talking about, so be gentle and try not to make this the "RTs suck because" thread.

 

[Capt_Mac]

What skill is that? The ability to say, "push, breath, deeper, good, ok stop"? You have no real skills and you, your profession, and tens of thousands of posts on SDN are "laughable".

You have just proven to anyone here with half a functional brain that you are a *****. Next time keep you pie hole shut and let the rest of us just wonder if you are that stupid instead of prooving what we already suspected.

 

[island doc]

Pay should also be based upon productivity. One of the most significant flaws of military medicine is that everyone receives the same compensation (according to rank and years in service) regardless of how little or how much work they may or may not perform. This compensation structure promotes laziness. What incentive is there to work harder if one will not be compensated more for doing so? Yes, the military has "incentive pays", which are not an incentive to be more productive because they are in no way linked to production.

The private sector learned the importance of directly and promptly rewarding increased productivity long ago.

 

[The White Coat Investor]

I believe RTs aren't commissioned because they aren't required to complete a college degree as an RN would. Bear in mind that PT, OT, and pharmacy require a graduate degree beyond college. I believe RT school is a couple of years. Someone want to confirm that?

 

[mac61]

Please continue this conversation in a new thread concerning RTs. Tell ya what...I'll start the thread.

Thanks.

http://forums.studentdoctor.net/showthread.php?t=318921

 

[Ankylosed]

You have just proven to anyone here with half a functional brain that you are a *****. Next time keep you pie hole shut and let the rest of us just wonder if you are that stupid instead of prooving what we already suspected.

Sorry if I came across as stoopid, I'm really not dum. In hindsight I shouldn't have bashed the entire profession, but this jagoff makes it sound like RT's are so important while concurrently bashing nurses.. Some of his previous posts were to a resident stating he should have been called to intubate on a difficult intubation case in an OR where there are many anesthesia providers. I've worked in the OR for over seven years and have never seen an RT tech called to intubate, ANYONE. I realize they play an important role in the respiratory care of pts, but I wouldn't get to carried away this commisioning thing.. It takes a talented guy to "tape tubes, and educate pts on respirator use".

I am far from stupid and have earned my position in society much more than most.. I was a Navy Corpsman, emergency field technician, EMT, LPN, surgical technologist, surgical first assistant, lead cutter organ and tissue harvester, Army officer, and now a very successful dental student.

I didn't suckle my moms tities through college like I suspect most of you did.. Some of you need to grow ballzacks and quit bagging military medicine. It's not bad and in fact it's good..

 

[orbitsurgMD]

Sorry if I came across as stoopid, I'm really not dum. In hindsight I shouldn't have bashed the entire profession, but this jagoff makes it sound like RT's are so important while concurrently bashing nurses.. Some of his previous posts were to a resident stating he should have been called to intubate on a difficult intubation case in an OR where there are many anesthesia providers. I've worked in the OR for over seven years and have never seen an RT tech called to intubate, ANYONE. I realize they play an important role in the respiratory care of pts, but I wouldn't get to carried away this commisioning thing.. It takes a talented guy to "tape tubes, and educate pts on respirator use".

I am far from stupid and have earned my position in society much more than most.. I was a Navy Corpsman, emergency field technician, EMT, LPN, surgical technologist, surgical first assistant, lead cutter organ and tissue harvester, Army officer, and now a very successful dental student.

I didn't suckle my moms tities through college like I suspect most of you did.. Some of you need to grow ballzacks and quit bagging military medicine. It's not bad and in fact it's good..

You're such a class act. What a winning case you make for MilMed.

 

[DropkickMurphy]

I believe RTs aren't commissioned because they aren't required to complete a college degree as an RN would. Bear in mind that PT, OT, and pharmacy require a graduate degree beyond college. I believe RT school is a couple of years. Someone want to confirm that?

There are bachelor's RT programs. In the civilian world the minimum RT program is 2 years, just like a minimal RN program.

 

[DropkickMurphy]

Some of you need to grow ballzacks and quit bagging military medicine. It's not bad and in fact it's good..

As someone who worked in military medicine, I disagree, but I think that's obvious from my other posts.

but this jagoff makes it sound like RT's are so important while concurrently bashing nurses.. Some of his previous posts were to a resident stating he should have been called to intubate on a difficult intubation case in an OR where there are many anesthesia providers.

It was an FP resident, in an ER on a crashing asthmatic that he missed. I can't tell you the last time I saw an anesthesia provider in the ER and the last time I was in the OR intubating was when I was in school.

realize they play an important role in the respiratory care of pts, but I wouldn't get to carried away this commisioning thing.. It takes a talented guy to "tape tubes, and educate pts on respirator use".

and now a very successful dental student.

And it takes a real class act to be great at whitening and cosmetically bonding people's teeth. Of course, that's selling dentists short just like you're selling RT's short. By the way, it's a ventilator, not a respirator.

 

[island doc]

now a very successful dental student.

Need I remind you that this is the military "medicine" forum. In case you haven't heard medicine and dentistry are two separate and distinct professions, even in the military.

There is even a separate military dental forum on this site, which is a more appropriate place for you. Good luck over there.

 

[Ankylosed]

Need I remind you that this is the military "medicine" forum. In case you haven't heard medicine and dentistry are two separate and distinct professions, even in the military.

There is even a separate military dental forum on this site, which is a more appropriate place for you. Good luck over there.

You're right, it's the military medicine forum on the STUDENT DOCTOR network. It's not a place for washed up old ex-military docs to come and rant about how they didn't get their residency of choice or couldn't care for their pts properly. The reason these things happened is probably because you weren't smart enough to get all the things you wanted from the military. The only docs I've seen get treated the way y'all describe are the incompetent ones, which was a about 1 in 1000 in the military in my opinion. I think eight years as an HM in direct care gives me the right to voice my 2 cents on military medicine.. Also, I am studying "dental medicine", which I know it makes you feel warm fuzzy to make it seem separate all together. If it makes you feel any better, I will obtain my MD degree in the future, it's only going to take me two years to do it..

 

[colbgw02]

hold on while i go get my popcorn...this is gonna be fun

 

[mac61]

Thanks again for completely making a thread that gave the people ticked off about mil med a chance to throw in some constructive ideas into a site about how stupid someone else is, how worthless that people who haven't been miliary physicians are, etc.

I really felt like this forum could help me with some knowlege as I delve into military medicine. I was clearly wrong.

Only 1 physician stated any thoughts in this thread in 3 days. Any attempt to support military medicine would have received at least 5 former docs criticizing mil med in the first half hour. In fact my last line it only took 10 minutes after the thread started. It's interesting that an opportunity to use thier knowlege/experience to impart actual knowlege receive ZERO attention.

I'll check back in a few months, maybe something will change.

Homunculus: If you're out there, stop the madness. This place makes military medicine look like a circus. I guess Dr. Jones et. al. have accomplished thier mission, regardless of other people's experiences.

Until then: What's the difference between dentists and doctors?

Doctors don't want to be called dentists.

Props to current and former members of the 561st MED CO (Dental Services)
where I spent a little time.

I'm out like trout.

 

[USAFdoc]

You're right, it's the military medicine forum on the STUDENT DOCTOR network. It's not a place for washed up old ex-military docs to come and rant about how they didn't get their residency of choice or couldn't care for their pts properly. The reason these things happened is probably because you weren't smart enough to get all the things you wanted from the military. .

If this is what you believe after reading multiple threads describing problems listed by Admirals, Colonels, other docs; nearly 100% of physicians consistently raising concerns, etc...then the following is likely also true;

1) Thank God you are not my familys doc or dentist; your standards are way to low.
2) You are in the right organization that will live up (or should I say down) to your low standards.
3) thank God you are going into dentistry; likely much less harm you can give to your patients than if you were their physician with the low standards you have.
4) Interesting that someone such as yourself, a dentist seems to lack "wisdom teeth."
5) Do not take this list personnally; I do not know you, but your thread entry was about ridiculous as I have seen here in 1-2 years. I have no idea what you saw during your HM years, but it was obviously not representative of todays mostly broken milmed system.

 

[former military]

Sorry if I came across as stoopid, I'm really not dum. In hindsight I shouldn't have bashed the entire profession, but this jagoff makes it sound like RT's are so important while concurrently bashing nurses.. Some of his previous posts were to a resident stating he should have been called to intubate on a difficult intubation case in an OR where there are many anesthesia providers. I've worked in the OR for over seven years and have never seen an RT tech called to intubate, ANYONE. I realize they play an important role in the respiratory care of pts, but I wouldn't get to carried away this commisioning thing.. It takes a talented guy to "tape tubes, and educate pts on respirator use".

I am far from stupid and have earned my position in society much more than most.. I was a Navy Corpsman, emergency field technician, EMT, LPN, surgical technologist, surgical first assistant, lead cutter organ and tissue harvester, Army officer, and now a very successful dental student.

I didn't suckle my moms tities through college like I suspect most of you did.. Some of you need to grow ballzacks and quit bagging military medicine. It's not bad and in fact it's good..

You are a ********.

 

[DropkickMurphy]

Need I remind you that this is the military "medicine" forum. In case you haven't heard medicine and dentistry are two separate and distinct professions, even in the military.

There is even a separate military dental forum on this site, which is a more appropriate place for you. Good luck over there.

I've always held that dentistry and medicine are not as seperate as we tend to think. Perhaps you shouldn't attempt to reinforce that stereotype.

 

[island doc]

You're right, it's the military medicine forum on the STUDENT DOCTOR network. It's not a place for washed up old ex-military docs to come and rant about how they didn't get their residency of choice or couldn't care for their pts properly. The reason these things happened is probably because you weren't smart enough to get all the things you wanted from the military. The only docs I've seen get treated the way y'all describe are the incompetent ones, which was a about 1 in 1000 in the military in my opinion. I think eight years as an HM in direct care gives me the right to voice my 2 cents on military medicine.. Also, I am studying "dental medicine", which I know it makes you feel warm fuzzy to make it seem separate all together. If it makes you feel any better, I will obtain my MD degree in the future, it's only going to take me two years to do it..

So, just what point is it exactly that you are intending to make by personal attacks??? If the point is to reflect your own lack of maturity, well then you have certainly succeeded.

For some strange reason, you seem to have taken criticism of military medicine as though it were some type of personal criticism.

 

[island doc]

Homunculus: If you're out there, stop the madness.

Please don't provoke the caveman. His club is big and heavy, and he has a powerful swing.

 

[island doc]

I've always held that dentistry and medicine are not as seperate as we tend to think. Perhaps you shouldn't attempt to reinforce that stereotype.

From a pathophysiological standpoint I couldn't agree with you more, especially given the fact that many diseases directly affect the condition of the teeth. Cushing's Disease is just one that comes to mind. But as professions they are separate and distinct, as demonstrated by the fact that medicine and dentistry are governed by separate licensing boards in all 50 states, not to mention trained separately.

 

[DropkickMurphy]

Well, I tend to look at things strictly from a pathophysiological standpoint when splitting hairs, so that's why I said what I did. Regardless, they are still our colleagues and deserving of our respect (hence why I made the comment about selling dentists short if you assume they don't do anything).

 

[i want out]

Just curious if any of the "Who's Who of SDN" have opinions.

It seems to me that the dichotomy of professional officership vs professional health care provider is at the root of most of the problems discussed on this forum: Physicians who either look out for thier career as an officer who sacrifice patient care, or physicians who sacrifice thier career as an officer in order to preserve patient care. Combined with "non-credentialed" managers managing patient care, it seems obvious why so many physicians on this forum are aggrevated with how thier combined careers went, or are going.

Will the impending dissolution of service specific medical assets and the creation of a military medical corps change anything? Please try to use a little optimism maybe like "If I were in charge..."

If you could design a system in which military medical assets were efficiently used in this setting, what would need to happen?

Should this system be run by MSC officers with input from physicians, or be run by physicians, nurses, PAs, etc. who have removed themselves from clinical practice?

All responses are welcome, however please refrain from responses of "It doesn't matter what we do because the system will always be broken, because the government/navy/AF/Army will always be a safe haven for *****s and sub-standard physicians."

Thanks for your time and experienced opinion.


Yours Truly,

I just got home from spending six months in a purple suit in the sand...
Its going to be a long and painful transition to combined medical corps.
I won't say it can't work, but those of us that joined seperate services will be very unlikely to see it work in our lifetime.

It may limp along, but it won't truly function until there are folks that have grown up in that system, and that will take at least one complete generation.

i want out

 

[realysa]

as a soon to be dental corps officer, i'm rather embarrassed by comments made by ankylosed.

persons like you, give us dentists a bad name.

you should have gone to osteopathic school, your background and mentality seem to fit the profile.

 

[Ankylosed]

as a soon to be dental corps officer, i'm rather embarrassed by comments made by ankylosed.

persons like you, give us dentists a bad name.

you should have gone to osteopathic school, your background and mentality seem to fit the profile.

I'm not sure how my comments are embarrassing or give dentists a bad name..? These guys are constantly bagging on nurses, enlisted men (ie "thugs"), and military medicine which I have already been all three and a part of for over eight years. I'm just tired of this constant barrage of negativity that gets passed off as "patriotism". They are constantly discouraging quality potential military applicants, which is patriotic if you are in Al Qaeda in my opinion.. Please explain your osteopathic comment, I'm not sure how the two relate? Relax my fliend, we will be colleagues soon..

 

[DropkickMurphy]

you should have gone to osteopathic school, your background and mentality seem to fit the profile.

Are you sure you don't mean chiropractic? MD and DO are pretty much the same thing (the only difference being that DO's have professional training in scalp massage and back rubs). If he would make a lousy dentist, he'd make a lousy doc end of story- not that I think he would make a poor practitioner of any field, just that he apparently isn't the most verbally gifted amongst us and has a slight case of being obtuse.

These guys are constantly bagging on nurses, enlisted men (ie "thugs"), and military medicine which I have already been all three and a part of for over eight years.

If you read the negative comments on nurses, it's that a lot of military nurses seem to forget they are just that- nurses. As for enlisted being thugs, I would tend to agree (having worked with both the Air Force and the Army) that there is a decent percentage of the enlisted force that have had a hard time leaving behind the mentality they had growing up in the ghetto or the poor side of the tracks as the case may be.

I'm just tired of this constant barrage of negativity that gets passed off as "patriotism".

So, are you saying it's better to just ignore problems that can, will, and do cost the same soldiers, the ones you claim to support more than we do, their lives. Of course I imagine you also believe dissent regardless of reason or value is unpatriotic......

They are constantly discouraging quality potential military applicants, which is patriotic if you are in Al Qaeda in my opinion

I want Bin Laden's head on a pike as much as anyone, but I still don't believe continuing to fuel the conflagration that is military medicine is helping matters. The only way to bring about change is either stimulating massive public outrage (which you said is unpatriotic) or to cut off the supply of new docs and then get the boneheads in DC to realize the error of their ways.

 

[island doc]

which is patriotic if you are in Al Qaeda in my opinion.

Gee, now you're sounding like the republican congressman who accused the democrats of the same thing. He made himself look like a fool also

 

[USAFdoc]

I'm not sure how my comments are embarrassing or give dentists a bad name..? These guys are constantly bagging on nurses, enlisted men (ie "thugs"), and military medicine which I have already been all three and a part of for over eight years. I'm just tired of this constant barrage of negativity that gets passed off as "patriotism". They are constantly discouraging quality potential military applicants, which is patriotic if you are in Al Qaeda in my opinion.. Please explain your osteopathic comment, I'm not sure how the two relate? Relax my fliend, we will be colleagues soon..

1) Perhaps you should address those "guys" directly, rather than infer that all the physicians on this site are blasting away at all the non-physicians. Yes, I have read some statements that I disagree with regarding enlisted folks etc, but those are the minority. The majority of physicians are stating and supporting the idea that military medicine is a far cry from excellence and a close cousin to a broken failing system.

2) I do not think you give dentists a bad name; you just are well on your way to giving yourself a bad rep.

3) Discouraging applicants? Absolutely ! Until the military decides that they truly want to treat both patients and staff with a reasonable amount of professionalism, safety etc.......it would be a bold faced lie to tell prospective HPSPers anything different. The military will then either have to do the right thing and run a quality program or get out of the way and let civilians take over the job of caring for dependents and retirees.

 

[gtleeee]

as a soon to be dental corps officer, i'm rather embarrassed by comments made by ankylosed.

persons like you, give us dentists a bad name.

you should have gone to osteopathic school, your background and mentality seem to fit the profile.

An interesting observation. You will make yourself quite popular with the D.O. members of the medical corps with such rank stupidity. As Don Rickles used to say "you got guts".) That a member of the Dental corps would have such a silly opinion of a group that makes up a substantial portion of the medical corps of all 3 of Medical Departments under the Department of Defense. Well, good luck to you. You are going to need it if you are ever vocal with such personal embarressment on active duty.

 

[ExNavyRad]

as a soon to be dental corps officer, i'm rather embarrassed by comments made by ankylosed.

persons like you, give us dentists a bad name.

you should have gone to osteopathic school, your background and mentality seem to fit the profile.

Would you care to elaborate on that last sentence?

Enlighten me, please, on the "profile" of those who become osteopathic physicians.

ExNavyRad

 

[ExNavyRad]

Are you sure you don't mean chiropractic? MD and DO are pretty much the same thing (the only difference being that DO's have professional training in scalp massage and back rubs).

Great, another genius who seems to know everything about osteopathic medical training.

Care to enlighten us further, or should I save myself some time and write you off as just another know-nothing asshat running his pie-hole...


ExNavyRad

 

[DropkickMurphy]

Great, another genius who seems to know everything about osteopathic medical training.

Care to enlighten us further, or should I save myself some time and write you off as just another know-nothing asshat running his pie-hole...


ExNavyRad

Having worked with numerous DO's (including 2 neurosurgeons, a handful of anesthesiologists, a couple of orthopedic surgeons (including one whose father is senior faculty at Kirksville) a radiologist, two FP's, a pediatrician, and several EM docs) I know ONE of them that uses OMT in their practice. The backrub comment came straight out of the mouth of the orthopod with the dad on faculty at KCOM. I asked him what he meant, and he explained that outside of sports medicine and orthopedics OMT is only useful in that it gives you the ability to (AND I QUOTE): "give one hell of a backrub."

In my book, and the eyes of most of the MD's and DO's I know, there is no difference between the two degrees. It's just that the osteopathic schools teach OMT which is questionable utility outside of musculoskeletal complaints.

 

[ExNavyRad]

Having worked with numerous DO's (including 2 neurosurgeons, a handful of anesthesiologists, a couple of orthopedic surgeons (including one whose father is senior faculty at Kirksville) a radiologist, two FP's, a pediatrician, and several EM docs) I know ONE of them that uses OMT in their practice. The backrub comment came straight out of the mouth of the orthopod with the dad on faculty at KCOM. I asked him what he meant, and he explained that outside of sports medicine and orthopedics OMT is only useful in that it gives you the ability to (AND I QUOTE): "give one hell of a backrub."

In my book, and the eyes of most of the MD's and DO's I know, there is no difference between the two degrees. It's just that the osteopathic schools teach OMT which is questionable utility outside of musculoskeletal complaints.

Very well. Your explanation is noted, and your point taken. I apologize, and withdraw my previous snarky comment.

ExNavyRad

 

[USAFdoc]

Having worked with numerous DO's (including 2 neurosurgeons, a handful of anesthesiologists, a couple of orthopedic surgeons (including one whose father is senior faculty at Kirksville) a radiologist, two FP's, a pediatrician, and several EM docs) I know ONE of them that uses OMT in their practice. The backrub comment came straight out of the mouth of the orthopod with the dad on faculty at KCOM. I asked him what he meant, and he explained that outside of sports medicine and orthopedics OMT is only useful in that it gives you the ability to (AND I QUOTE): "give one hell of a backrub."

In my book, and the eyes of most of the MD's and DO's I know, there is no difference between the two degrees. It's just that the osteopathic schools teach OMT which is questionable utility outside of musculoskeletal complaints.

not being one to shy away from politically volitile topics, here goes;

1) MD schools tend to be more competative/higher MCATS etc than DO schools.

2) DOs tend to know more about anatomy/musculoskeletal stuff (duh)

3) After that, generalizations get poor. You can have great docs on either side. You could argue that MDs are higher achieving people in general; based on the level of grades etc that got them into a MD school, but that argument is pretty weak.

Military medicine is caustic to practicving MDs and DOs alike

 

[DropkickMurphy]

Very well. Your explanation is noted, and your point taken. I apologize, and withdraw my previous snarky comment.

ExNavyRad

No offense taken, just as none was meant. I figured I hadn't properly explained myself. Seeing as I will probably be a DO myself in a few years, I am far from maligning them.

 

[Homunculus]

just FYI-- i recent purchased a sweet Easton Limited Edition Composite Club that is aching for use. it's got nice balance, and if i may say so, a very LARGE sweet spot.

just a friendly reminder

--your friendly neighborhood overseeing caveman

 

[Homunculus]

getting back on topic:

http://www.military.com/features/0,15240,112706,00.html

so the air force is the branch draggin' their butt on this? shocking

--your friendly neighborhood purple people eating caveman

 

[NavyFP]

not being one to shy away from politically volitile topics, here goes;

1) MD schools tend to be more competative/higher MCATS etc than DO schools.

2) DOs tend to know more about anatomy/musculoskeletal stuff (duh)

3) After that, generalizations get poor. You can have great docs on either side. You could argue that MDs are higher achieving people in general; based on the level of grades etc that got them into a MD school, but that argument is pretty weak.

Military medicine is caustic to practicving MDs and DOs alike

I think sentence #1 of 3) says it all. I did not know there was such a thing as a DO until after I took the MCATs and started getting brochures. Over the past 12+ years of practice, I have known good and bad. It all boils down to the individual. If you were to take the top 10% of just about any school, you would find a fine pool of exceptional docs. The bottom 10%, a few diamonds in the rough, and a lot of coal.

 

[former military]

DO or DO not. This is no try....

 

[former military]

there is no try... screwed up the punchline

 

[NavyFP]

there is no try... screwed up the punchline

You also need to add Try not.

But even better:

"I don't believe it."

Yoda - "That is why you fail."

 

[dtn3t]

Um, I forgot, does anyone remember what this thread is about?

 

[st0rmin]

Um, I forgot, does anyone remember what this thread is about?

Sure, little green men in purple suits going about battling the dark forces of the evil military medicine empire. Right?

I think I saw that movie once...

 

[MedicalCorpse]

Um, I forgot, does anyone remember what this thread is about?

Was it: Can the "Purple Suit" fix military medicine?

Anyone who thinks that reorganization is a panacea for systemic problems in any outfit needs to read more Dilbert.

I quote from the cover of the Dilbert Book, Random Acts of Management, by Scott Adams (Kansas City: Andrews McMeel Publishing, 2000, ISBN 0-7407-0453-2):

(Scene: Pointy-Haired Boss is facing Dilbert across boss's desk)

Boss is about to spin an arrow around a wheel denoting four management options:
1) Yell
2) Hide
3) Be Unclear
4) Reorganize

If I have a bucket full of dung, I have four options:
1) Put the dung to a useful purpose (e.g., fertilizer)
2) Throw the dung away and fill bucket with more useful (and less noisome) items
3) Coach the dung to higher levels of performance, so that it alchemically morphs into something other than itself (e.g., motivational dung posters, feedback dung sessions, team-building dung exercises)
4) Reorganize dung

Tell me how reorganizing the dung makes the dung better?

What military medicine needs in order to fix it would fill a book.
Here are a few hints:

1) Better retention of qualified people by treating docs with respect
2) An increased number of qualified people (increased end-strength of M.D.s [by which I also mean D.O.s, of course])
3) Increased quality of people (M.D.s/D.O.s, not Assistants to Physician's Assistant's Assistants)
4) More money, spent wisely (docs not chairs); instantly double all bonuses, and make them tax-free
5) Better leadership willing to see beyond the visions of golf courses dancing in their heads, in order to break the downward spiral inherent in the status quo
6) An impregnable firewall between clinical medicine and petty politics (stop reprimanding physicians for trying to do the right thing/telling the truth)
7) An end to crazymakers (endless, meaningless, no-notice, do-by-COB-today-or-else, Computer Based Training, among others)
8) Increased number and quality of medical support personnel (nurses, techs, secretaries)
9) Increased number and quality of non-medical support personnel, so that finance and MPF don't have to shut down for days on end due to "minimal manning", and open only on alternate Tuesdays between 1000-1005.
10) Reinforcement from the top (SECDEF) that military physicians are physicians first, and officers second, so that they will no longer be asked to violate the Hippocratic Oath by acting in a way detrimental to human life (interrogating prisoners, poisoning pizzas, etc.) http://www.medicalcorpse.com/poisonedpizza.html
11) Even more money to implement all of the above
12) Leadership with the guts/balls/ovaries to stand up to the Powers that Be to say: "I am shutting this [hospital/clinic/ICU/hospital function] down until we get sufficient funding, personnel, and infrastructure to provide quality medical care. We have reached the point of mission failure. I will not endanger one patient's life to continue this charade of being a ["Medical Center"/clinic/ICU/hospital function] just so my superiors can get shiny OPR bullets that will earn them stars. If you don't like my clinical opinion, I will resign my [Command, Residency Directorship, Commission] immediately. I feel that this is the only way to get the attention of the Command, so that the severe, systemic dangers to patient safety inherent in our medical care activity as of (today's date) are fixed."
13) Even better senior leadership to accept e-mail such as 12) above without blowing an aneurysm, dragging the truth-telling subordinate into the Commander's office, and slapping him/her with a career-ending LOR for speaking truth to power.
14) More money to fund the skyrocketing cost of state-of-the-art medical care, due to advancements in expensive technology, and the unbridled greed of pharmaceutical companies which insist on gouging the sickest, oldest, youngest, and otherwise most vulnerable members of our military and civilian population.
15) Doctors' parking lots, separate from High Ranking Administrators' parking lots. Find me one civilian hospital which doesn't do something to ensure their physicians can find parking spaces, rather than circling endlessly around parking lots filled with contractors and clipboard-carriers, and I'll have found a hospital that is doomed. Doomed, I say.
16) More money. How many surgical procedures/childhood immunizations could be bought for the price of one fewer aircraft carrier, given that there is not one navy in the world which can come close to challenging our supremacy of the seas? Or one fewer stealth fighter, or spy satellite, or sooper dooper frying purple people heater ( http://www.globalsecurity.org/military/systems/ground/v-mads.htm ), etc.?
Either quality medical care for our troops, their families, and our honored retirees and dependents is worth spending money on, or it is not.

Reorganizing the underfunded, unled, unqualifed, unmotivated, and unsupported people in the military health care system will not result in the alchemical transmutation of dung into gold some people wish for. Luckily, by the time this fact is realized ten years hence, the generals and SECDEFs who came up with this brain dead "initiative" will have retired, died, or both. Goddess only knows how many patients will have died, as well...because the military is very good at covering up its medical blunders under the rubric of "Quality Assurance/Risk Management".

--
R
http://www.medicalcorpse.com

Hoping that Y'all Missed My Long Posts, but
Realizing that such Hope Is As Misplaced
As the Hope that Reorganization qua Reorganization
Will Do Anything To Resurrect Military Medicine
From Its Grave

 

[USAFdoc]

Um, I forgot, does anyone remember what this thread is about?

even better question; does anyone from the Surgeon Generals office remember what medicine is all about?

 

[MedicalCorpse]

even better question; does anyone from the Surgeon Generals office remember what medicine is all about?

Memorandum For: USAFdoc
From: The Tri-Service Surgeons General
Subject: Your Question

USAFdoc:

What is that "M" word? Does it have anything to do with "Health Care Providership"? Can we get it for $3.95/year/HCP? If not, is there a web site we could set up to provide "virtual" HCP care? We're thinking videos on DITY appys and DITY cranis, a la DITY moves.

Norman, please coordinate.

Sincerely,

The Tri-Service Surgeons General
Our Motto: "Yesterday's Health Care Tomorrow!"

 

[DropkickMurphy]

DITY cranis

"First, take your power drill.....put the keyhole bit in the chuck. Shave your child's head and wash the skin very thoroughly with antibacterial soap or any booze you have laying around...."