My Navy Medicine Experiences

[jetproppilot]

My objection to your posts had nothing to do with criticizing propaganda, and everything to do with an accusation that the OP was fabricating his story (your first post) and a gratuitous ad hominem attack (militarymd's first post).

Neither of you were actually criticizing the substance of the OP's story. You called the OP a liar, and military MD called him an loser. How insightful. How interesting. What great contributions to the thread.


Precisely what am I delusionary about?

I think you should reconsider your newfound hostility towards me, because I agree with the majority of what you post. I was simply unimpressed with the snide, demonstrably false accusation you levelled in your first post. That is all.

OK. And this is not a back pedaling statement.

You read into my first post, which was about 5 words long. Remember when you were 10 years old and you'd say I SWEAR! Well, I promise you at no time did I think the dude was lying.

What I did think was heres a dude, albeit with an exciting story, who never posts here and admitted he wont again (READ: ADVERTISEMENT), who to me, sounded like a recruiter, who was using his (I admit..and in previous post said I was personally enviable of his flying experiences) memorable story for recruiting purposes which, in my humble opinion, is frought with dishonesty.

Honest story? Yes. Contributing to a military tactic called recruiting that is full of dishonesty? Also, yes.

It was not a false, snide remark, nor was it a false accusation, in my humble opinion.

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[pgg]

It was not a false, snide remark, nor was it a false accusation, in my humble opinion.

OK, fair enough. Looks like I read too much into your post, especially given the followups clarifying your position. My apologies.

 

[militarymd]

OK, fair enough. Looks like I read too much into your post, especially given the followups clarifying your position. My apologies.

My remarks are snide, and I still think he is a loser...maybe not anymore, but he sure was a LOSER, with capital letters, when he DROPPED OUT, with capital letters, of the training pathway.

And I still think the Navy medical system sucks, because it accepts LOSERS, with capital letters, and gives them cool jobs at the expense of all involved.

While I was in Guanatamo, I worked with a orthopod who joined the Navy because "I couldn't cut it in private practice"...His words.

What do you call an orthopedic surgeon who couldn't cut it in private practice????

Do I need to spell it out for you....

I won't insult anyone's intelligence, but I will tell you that all the orthopedic surgeons that I anesthetize for right now drives Porsches and owns airplanes.

 

[militarymd]

The Navy medical system will welcome with open arms people who don't measure up in the civilian medical community and give them jobs.

The OP who DROPPED out of a training program and didn't have the foresight in his 4 years of college, and 4 years of medical school to decide what to do with his life gets a free pass in the Navy riding around in jets and wasting government money.

My orthopedic surgeon in Guantanamo Bay, Cuba who couldn't cut it in private practice because of malpractice and incompetence gets a free pass in Cuba where he didn't do anything except commit more malpractice without worries at the expense of quite a few young marines....all while getting out of work at 1300 and going to the beach.

I will continue to bash Navy medicine and all who use it to their own personal gain because of their own poor planning, lack of maturity, incompetence, or whatever you want to call it......because at the end of the day....what this all means is that the MOST DESERVING PEOPLE IN THIS COUNTRY ARE GETTING CRAPPY CARE in the Navy medical system, and no one wants to do anything about it....

These DESERVING people include members of my family who are active duty now and who have retired after 30 years of service.

Navy medicine needs to die and be remade.

 

[MoosePilot]

Do I need to spell it out for you....

I won't insult anyone's intelligence, but I will tell you that all the orthopedic surgeons that I anesthetize for right now drives Porsches and owns airplanes.

Because the money makes them better people. I'm not even sure I'm allowed to talk to you, you make so much money. Maybe someone who makes in the mid $100s can act as a go-between.

 

[militarymd]

Because the money makes them better people.

Wrong, my friend.

Better people (physicians) make more money...as the way it should be.

 

[jetproppilot]

Because the money makes them better people. I'm not even sure I'm allowed to talk to you, you make so much money. Maybe someone who makes in the mid $100s can act as a go-between.

OK, Moose. I'm gonna bite. Mil's response is full of innuendos...

but if you look past that, what he is saying is that people who are great at what they do are gonna look at the best deal for themselves.

Face it, there are very few sacrificial, gifted physicians on the planet...if you're good. you are looking at maximizing your return, especially with med-school student loan debt being where it is today. Its not about the Porsches and airplanes...its that those physicians who are capable, will make the transition to better themselves and their family.

SO lets say I'm a gifted anesthesiologist who gets his rocks off playing pilot on his off time. All the Navy would have to do to secure my LIFELONG (not 4 years mandatory) service would be to BE HONEST with my deployments with no surprises, offer me a salary at least competitive with today's private practice anesthesiologists, and remove the subordinate-hierarchial superiority (READ: chief RNs who treat MDs like dirt) from the mix.

Essentially, treat me like a doctor, let me practice medicine like I know my board certified self can, and REMOVE ALL THE BUREAUCRATIC B ULL****.

I think what Mil is saying is, accomplish this, and you'll have an influx of competent, board certified physicians, that would revel in the intangibles (i.e. like me, who would give his left nut to be assigned to a fighter squadron, if the $/practice conditions were good enough).

And that brings up another good question....any Chief of a medical department/CEO/Head Coach of an NFL football team, after a lenghthy, consistent bombardment of critisicm, would rationally reconsider said present guidelines and protocols...

and our military is supposed to be this god-like, impenetrable force...

then why in the f uck dont they listen to their subordinates/officers/doctors/critics?

If we are in fact the most powerful nation on the planet, why can't we pay military specialists (ortho, surgery, anesthesia) 250K a year, OH, and since you are willing to deploy to bum- f uck egypt, we'll up the ante by 100K, and when you retire, we'll absorb the health insurance of you and yours?

Don't give me an explanation of why this hasnt happened, because if you do, you are another victim of military costcutting. Look at the money our country spends abroad on foreign relations/campaigns. And yet we cant ensure that the finest doctors of our nation are in the military???

The military (read: the US) can afford to replenish their ranks with competent, board certified MDs. I, for one, would jump at the chance. They could exploit my irrational desire to fly jets into a career choice by a competent, board certified specialist with 10 years civilian experience.

They choose not to.

And even though they choose not to, we're supposed to hail the intern that got assigned to the Blue Angels?

Just writing this thread disgusts me.

Where is the quality of control, and the allegiance to superior health care in the military???

 

[jetproppilot]

OK, Moose. I'm gonna bite. Mil's response is full of innuendos...

but if you look past that, what he is saying is that people who are great at what they do are gonna look at the best deal for themselves.

Face it, there are very few sacrificial, gifted physicians on the planet...if you're good. you are looking at maximizing your return, especially with med-school student loan debt being where it is today. Its not about the Porsches and airplanes...its that those physicians who are capable, will make the transition to better themselves and their family.

SO lets say I'm a gifted anesthesiologist who gets his rocks off playing pilot on his off time. All the Navy would have to do to secure my LIFELONG (not 4 years mandatory) service would be to BE HONEST with my deployments with no surprises, offer me a salary at least competitive with today's private practice anesthesiologists, and remove the subordinate-hierarchial superiority (READ: chief RNs who treat MDs like dirt) from the mix.

Essentially, treat me like a doctor, let me practice medicine like I know my board certified self can, and REMOVE ALL THE BUREAUCRATIC B ULL****.

I think what Mil is saying is, accomplish this, and you'll have an influx of competent, board certified physicians, that would revel in the intangibles (i.e. like me, who would give his left nut to be assigned to a fighter squadron, if the $/practice conditions were good enough).

And that brings up another good question....any Chief of a medical department/CEO/Head Coach of an NFL football team, after a lenghthy, consistent bombardment of critisicm, would rationally reconsider said present guidelines and protocols...

and our military is supposed to be this god-like, impenetrable force...

then why in the f uck dont they listen to their subordinates/officers/doctors/critics?

If we are in fact the most powerful nation on the planet, why can't we pay military specialists (ortho, surgery, anesthesia) 250K a year, OH, and since you are willing to deploy to bum- f uck egypt, we'll up the ante by 100K, and when you retire, we'll absorb the health insurance of you and yours?

Don't give me an explanation of why this hasnt happened, because if you do, you are another victim of military costcutting. Look at the money our country spends abroad on foreign relations/campaigns. And yet we cant ensure that the finest doctors of our nation are in the military???

The military (read: the US) can afford to replenish their ranks with competent, board certified MDs. I, for one, would jump at the chance. They could exploit my irrational desire to fly jets into a career choice by a competent, board certified specialist with 10 years civilian experience.

They choose not to.

And even though they choose not to, we're supposed to hail the intern that got assigned to the Blue Angels?

Just writing this thread disgusts me.

Where is the quality of control, and the allegiance to superior health care in the military???

Recruiter: "MilMD, we see, and respect your accomplishments. You've completed an anesthesia residency, are board certified in both anesthesia and critical care medicine, and you abviously know your s hit. We also recognize your previous 11 years in the Navy."

"SO, based on your crudentials, we are gonna offer you the package of a lifetime. We'll match your current private practice salary, plus 10%. We'll provide lifelong health insurance for you and your family. We'll make sure your retirement fund is well funded. Oh, and you like motorcycles? Geez...you're not gonna believe this..but Nicky Hayden is a paid marketing consultant of ours, and we'll arrange for you to take a cuppla lessons from him..."

"Whatcha think, Mil?"

SO I ASK YOU GUYS,

THINK OUTSIDE THE BOX.

WHY DOESNT THE MILITARY THINK LIKE CORPORATE AMERICA WHEN IT COMES TO ATTRACTING FRANCHISE PLAYERS? Dontcha think recruiting, and subsequently retaining, a board certified critical care physician would be worth it? Or that F-18 pilot who can stand the plane on a near stall at 100 knots? Or the platoon leader who has consistently turned grunts into officers?

HUH??

Stop the propeganda. Step up to the mike, and recognize/pay franchise players, consistent with the (alleged) impenetrable military force we portray.

 

[RichL025]

Actually, if Vale Rossi was giving lessons, you migt have me (obligatory medical reference: his nickname is "the doctor").

Seriously, you guys are living in a fantasy land, and statements like these only demonstrate that no matter how much service you have, you don't understand how the military works.

WHY DOESNT THE MILITARY THINK LIKE CORPORATE AMERICA WHEN IT COMES TO ATTRACTING FRANCHISE PLAYERS? Dontcha think recruiting, and subsequently retaining, a board certified critical care physician would be worth it?

Because the military _isn't_ corporate america, that's why. It's not profit driven. As long as they _have_ board certified critical care physicians, they aren't going to go gaga with crazy recruiting ideas to get new ones.

Or that F-18 pilot who can stand the plane on a near stall at 100 knots? Or the platoon leader who has consistently turned grunts into officers?

Well, I can't speak for the airdales, but what you describe for that platoon leader says nothing about how good a platoon leader he is.

Oh, and the military is NOT about "franchise players". It's about "team players". If you need more info than that, we better start a seperate thread....

 

[jetproppilot]

Actually, if Vale Rossi was giving lessons, you migt have me (obligatory medical reference: his nickname is "the doctor").

Seriously, you guys are living in a fantasy land, and statements like these only demonstrate that no matter how much service you have, you don't understand how the military works.



Because the military _isn't_ corporate america, that's why. It's not profit driven. As long as they _have_ board certified critical care physicians, they aren't going to go gaga with crazy recruiting ideas to get new ones.


Well, I can't speak for the airdales, but what you describe for that platoon leader says nothing about how good a platoon leader he is.

Oh, and the military is NOT about "franchise players". It's about "team players". If you need more info than that, we better start a seperate thread....

Sorry,

I'm a franchise player. I'm the chief of our anesthesia department.

I'm also a team player.

I push stretchers, assist getting "done" surgey patients on the gurney to facilitate getting them to the PACU, if I'm in the room and the circulator is (temporarily) gone I'll open sutures,

in essence,

I'll do anything to get the job done.

But wait.

I'm well respected in my OR, I put up with minimal beaurocratic BS secondary to the respect our department has earned , and I'm very satisfied with my position/earnings/retirement/future.

You are kidding yourself.

Any successful entity, whether its the US military or a miniscule anesthesia practice, needs leadership. Hey, I'm all for doing what it takes to get the job done. I still push stretchers. But franchise players are needed to lead the pack...denying this means you are in denial.

The world/miniscule companies/MacDonalds/fighter squadrons/ need leaders to make decisions. And sometimes a precarious decision is better than a bunch of feuding people stuck in indecision.

 

[jetproppilot]

Seriously, you guys are living in a fantasy land, and statements like these only demonstrate that no matter how much service you have, you don't understand how the military works.

Yeah, but my point is, WHY ISNT THERE CHANGE? Software companies/cities/NFL teams/FEMA change according to the environment.

What makes the military so omnipotent that they cant reconsider their ploys concerning retaining military physicians?

Even the President of the United States occasionally faulters, recognizes a mistake, and changes it.

Recruitment is at an alltime low.

If I were CEO, I'd be making changes.

And healthcare for my pilots/officers/grunts would be at the forefront.

Hey, defend "how the military works" all you want. But when it comes to healthcare, Dude, the system is broken.

SO, why do people defend a broken system? And why isnt there change, when a problem is obvious?????

 

[jetproppilot]

Oh, and the military is NOT about "franchise players". It's about "team players". If you need more info than that, we better start a seperate thread....

Ahhh. Another rhetorical response to a major problem. Save your propeganda for your future career as a recreiter, Dude.

I am a team player. The ubiquitous "team player" marketing campaigns by the US military havent worked, so stop the manipulative comments. There are obviously team player candidates out there who have consciously chosen to follow another path, not because of anti-patriotism, but because of greener pastures, and the fact that the military has a broken down medical system.

Your propeganda is doing nothing to fix the problem. Gimme a f ucking break. Believe me, Staff Sergeant, I know the meaning, and the relevance of TEAM.

SO, is your patriotism gonna fix the incessant military health care issues? Think outside what has been drilled into your head, just for a minute. And you'll recognize, and wanna work on, the pitfalls.

 

[RichL025]

JetProp,

You're gonna wear yourself out with so many replies to one message!

Believe me, Staff Sergeant, I know the meaning, and the relevance of TEAM.

Apparently not, because otherwise:
1. You wouldn't "protest too much"
2. You wouldn't use someone's rank unless you knew what it was
3. You wouldn't use someone's rank in a condescending manner
4. You would know that, "Staff sergeant" is a rank, not a title, and not an appropriate term of address.

Well, strike #4, that really falls under knowledge of military courtesies, not being a team player.

Look, I have no doubt that you're an excellent anesthesiologist, a great chief, and all your underlings love you (cue Mel Brooks routine... "nonsense, my people love me, I am their king!...... PULL!)

Any successful entity, whether its the US military or a miniscule anesthesia practice, needs leadership.....

Absolutely!

But franchise players are needed to lead the pack...

Wrong. The military is quite content to grow its own leadership, it doesn't feel the need to import any. I'm not arguing whether this is right or wrong, I'm just saying what is.

Since you started with this sports-"franchise player" analogy, let me see if I can shed a little more light (not being much of a sports guy, forgive me if I mess up some details):

Do you remember the last olympics, with the US basketball "dream team". Stocked with a gazillion NBA players, a bunch of big names.... "franchise players"??????

What, did they get the bronze or something? They were beat by teams that had team players..... THAT is something that rung home with every serviceman out there....

(Don't bother trying to refute the analogy, if it's a poor one it's only due to my infamiliarity with sports.... I'm not trying to _argue_ with you, I'm trying to help you understand)

The military would not look at you and say "perfect, we just happen to need a chief of anesthesia at hospital X.... sign this guy up!".... the military would say "we need a chief of anesthesia, who can we promote up to that position?"

SO, why do people defend a broken system? And why isnt there change, when a problem is obvious?????

I'm not defending anything, I'm merely pointing out that your suggested "fix" of bringing in "franchise players" isn't gonna happen. Sorry to be the wet blanket and all....

 

[MoosePilot]

I'm not defending anything, I'm merely pointing out that your suggested "fix" of bringing in "franchise players" isn't gonna happen. Sorry to be the wet blanket and all....

Why would it? Why would they pay *more* when right now they pay *less* and still get by?

 

[USAFdoc]

Because the military _isn't_ corporate america, that's why. It's not profit driven. As long as they _have_ board certified critical care physicians, they aren't going to go gaga with crazy recruiting ideas to get new ones.


Not profit driven??????
RichLO25, obviously you have no idea what is going on in military medicine, at least in this regard. It is ALL ABOUT the money. Nearly every single decision I saw made by admin had money at the root. But don't take my word for it, below is a quote from your Surgeon General.
``In general,'' said Carlton, ``the characterization is correct. I think we got so involved in the process that we forgot there's a product. The provider on the outside has a product -- and its called money.''

http://www.fra.org/mil-up/milup-archive/08-10-00-milup.html

 

[militarymd]

Why would it? Why would they pay *more* when right now they pay *less* and still get by?

Because they probably won't be able to "get by" much longer.....

 

[MoosePilot]

Because they probably won't be able to "get by" much longer.....

Well, you and I will both wait and watch then, because I would swear that the Air Force can't continue to treat its pilots this way. In other moments, I wonder if someone like me would have said that in every decade.

 

[militarymd]

Well, you and I will both wait and watch then, because I would swear that the Air Force can't continue to treat its pilots this way. In other moments, I wonder if someone like me would have said that in every decade.

Maybe so......My plan is to continue to do my part until I'm cold and dead to help make Navy medicine cold and dead by discouraging any possible HPSP applicant until they start to rectify the way Navy Medicine is run.

 

[MoosePilot]

Maybe so......My plan is to continue to do my part until I'm cold and dead to help make Navy medicine cold and dead by discouraging any possible HPSP applicant until they start to rectify the way Navy Medicine is run.

I'm not exactly recruiting pilots either

 

[RichL025]

Because the military _isn't_ corporate america, that's why. It's not profit driven. As long as they _have_ board certified critical care physicians, they aren't going to go gaga with crazy recruiting ideas to get new ones.


Not profit driven??????
RichLO25, obviously you have no idea what is going on in military medicine, at least in this regard. It is ALL ABOUT the money. Nearly every single decision I saw made by admin had money at the root. But don't take my word for it, below is a quote from your Surgeon General.
``In general,'' said Carlton, ``the characterization is correct. I think we got so involved in the process that we forgot there's a product. The provider on the outside has a product -- and its called money.''

http://www.fra.org/mil-up/milup-archive/08-10-00-milup.html

Link broken.

And pinching pennies does NOT mean "profit driven" - the military is not beholden to stockowners and expected to make a profit.

 

[USAFdoc]

Link broken.

And pinching pennies does NOT mean "profit driven" - the military is not beholden to stockowners and expected to make a profit.

I'll try and get an active link. Till then, repeat this word...TRICARE, TRICARE, TRICARE. These are civilians who are running much of the show, and our commanders are bowing down to their wishes. But it is not ALL them either. We had TRICARE/HUMANA approval to get such much needed help in our clinic in terms of providers. TRICARE approved the move, MAJCOM vetoed it.

 

[USAFdoc]

I'll try and get an active link. Till then, repeat this word...TRICARE, TRICARE, TRICARE. These are civilians who are running much of the show, and our commanders are bowing down to their wishes. But it is not ALL them either. We had TRICARE/HUMANA approval to get such much needed help in our clinic in terms of providers. TRICARE approved the move, MAJCOM vetoed it.

AIR FORCE MEDICAL CHIEF
LEADS OVERHAUL IN HEALTH CARE DELIVERY



August 10, 2000

Military hospitals and clinics have skilled doctors, nurses, technicians and state-of-the-art equipment. But delivery of peacetime military health care often is so inefficient, says the Air Force surgeon general, that it deprives both patients and taxpayers of the kind of ``best value'' medical care that is now commonplace in the private sector.

Reforms are underway, however, said Lt. Gen. Paul K. Carlton Jr., a 53-year-old surgeon who took charge of the Air Force Medical System last December.

For the Air Force, the changes involve re-balancing its mix of health care providers, expanding medical support staffs, assigning patients to specific ``primary care'' teams, and requiring that those teams, from technician through physician, get to know their patients and aggressively conduct illness prevention and wellness programs.

On mix of providers, the Air Force wants more primary care physicians and fewer specialists or physician assistants. It promises more clerical support so physicians can see more patients. It expects nurses and medical technicians to assume a greater role in overall patient care.

The bureaucratic term for all of this is ``primary care optimization.'' By Oct. 1, at least one PCO team will be started at every Air Force hospital facility. But Carlton said it could take until 2007 to implement service wide. At the urging of Defense Department officials, the Army and Navy are embracing their own versions of a PCO concept.

Carlton, in an interview, said the ``culture'' of military medicine is still influenced by attitudes and practices ingrained as far back as World War II. ``Are we really `best value' health care, or are we the way we were in 1942, when we were designed? I think there's an awful lot of 1942 left in us,'' he said.

The system focuses too much on ``process'' and not enough on ``product,'' he said. The number of patients seen per provider compares unfavorably with civilian care programs. For example, the typical Air Force provider -- physician, nurse or physician assistant -- sees 13 to 16 patients a day. A provider ``outside the gate'' sees an average of 25, said Carlton. That figure is now the Air Force goal.

The average number of enrollees in TRICARE Prime per health care provider at Air Force treatment facilities was only 700 last year. That number is now up to 1000 but Carlton wants to match the private sector average of 1500 enrollees per provider.

Of 2.3 million persons eligible for TRICARE Prime who live near an Air Force base, only 900,000 have enrolled with the military treatment facility. With 52,000 medics and support personnel assigned to 87 medical facilities worldwide, the Air Force should be able to at least double current enrollment, and still have staff to treat many thousands of service elderly who remain ineligible to enroll in military managed care, Carlton said.

It's time military health care saw itself as competing with civilian providers. Fueling primary care optimization, he said, is ``an unrelenting focus on the customer.''

Surgeons general usually would balk at comparing numbers of patients seen by military health care providers with those of civilian providers. Military doctors, after all, we also must train for war.

But Carlton, who completed 32 combat support missions during the Persian Gulf War commanding a refueling wing hospital, finds such comparisons useful. He said improvements in delivery of peacetime care could only enhance a team's capabilities in wartime. He also declined to dismiss one critic's view that non-deployed military doctors often have had less demanding work schedules than their civilian peers.

``In general,'' said Carlton, ``the characterization is correct. I think we got so involved in the process that we forgot there's a product. The provider on the outside has a product -- and its called money.''

For the military, the product must remain good health. But that is best achieved, Carlton argues, through more efficient use of staff, facilities and knowledge. Some doctors, for example, still want to write their own patient histories. Carlton said it's more efficient to have another member of the team do it, assuming its thorough and legible.

``What we want to do is optimize our system [and] understand that the world has changed around us and we're in competition,'' said Carlton.

Military medicine isn't at peak efficiency, in primary care or wartime readiness, Carlton suggested. Small-scale contingencies over the last decade appear to be the U.S. military's future, he said. Medical units and equipment must be configured for a rapid initial response followed by a phased expansion of capability, as the situation requires and as airlift allows. The services only recently began to reduce their reliance on large air transportable hospitals, ``designed for a set-piece war like Korea,'' said Carlton.

``The Tet Offensive is the last time we stretched the medical system,'' he added. Unless military health care becomes more efficient, and more relevant, Carlton said, its capabilities are at risk. ``So we're changing,'' he said.

Efficiency in primary care begins with right-sizing staffs. Carlton noted that an F-16 squadron with 24 aircraft has 245 personnel assigned. ``You don't get 445. You don't get 145. You get 245. It's the same in every squadron.''

Air Force hospitals need the same kind of staffing predictability based on patient population. For every 6000 patients, Carlton said, ``you [should] get 22 people.''

Facilities with larger staffs will have to explain what value they add or the staff will be cut. At Barksdale Air Force Base, La., for example, hospital staff will fall from 450 to just over 200 ``to meet this model,'' Carlton said. ``It's not rocket science.''

Likewise, hospitals that can't enroll or keep enough TRICARE Prime beneficiaries will see staff cuts. The money saved, Carlton said, can help pay civilian providers who treat military patients off base under TRICARE Prime support contracts.

``It's a straight up, cost-competitive, all-out focus on the customer,'' he said.

not sure why the link didn't work, but heres the story above. The story should be lableled under "fiction". The SG broke nearly every promise made above, except sending 400% more patients.

"It's a straight up, cost-competative, all-out focus on how to do more and more with less and less, it's all about $$$$$" would have been a more accurate quote.

 

[MoosePilot]

AIR FORCE MEDICAL CHIEF
LEADS OVERHAUL IN HEALTH CARE DELIVERY



August 10, 2000

The system focuses too much on ``process'' and not enough on ``product,'' he said. The number of patients seen per provider compares unfavorably with civilian care programs. For example, the typical Air Force provider -- physician, nurse or physician assistant -- sees 13 to 16 patients a day. A provider ``outside the gate'' sees an average of 25, said Carlton. That figure is now the Air Force goal.

The average number of enrollees in TRICARE Prime per health care provider at Air Force treatment facilities was only 700 last year. That number is now up to 1000 but Carlton wants to match the private sector average of 1500 enrollees per provider.

I hate the way that business types make it sound like docs not seeing enough patients somehow hurts the patient. The military had more docs per patient than civilian and they have to fix that?

BTW, orange is really tough to read.

 

[dpill]

"It's a straight up, cost-competative, all-out focus on how to do more and more with less and less, it's all about $$$$$" would have been a more accurate quote.[/COLOR]

Everything in recent years has been about "doing more with less" and it is only going to get worse for the Air Force with QDR. 40,000 more AF personnel are slated to be cut- it just makes you wonder, "where's the excess?" The've already slashed support personnel (re: finance, admin). So I am sure a portion of the cuts will be the very people that were supposed to provide "support" to the primary care providers. Shifting baseline theory- despite the fact the plan wasn't implemented properly, what is in place now is the new "standard"- cuts mean things are only going to get worse. We had med techs manning the gate at my last base- efficient use of resources, huh.

 

[militarymd]

We had med techs manning the gate at my last base- efficient use of resources, huh.

But....there will be never a shortage of adminstrators telling doctors what they can or cannot do at a level that is unheard of in civilian practice.

 

[GMO_52]

Wrong, my friend.

Better people (physicians) make more money...as the way it should be.

OK, my turn to finally get irritated again:
By this incredible logic:
cardiologist = better person than pulmonologist
anesthesiologist = better person than...Mother Teresa

whatever.

the fact that you could actually use the phrase "better people make more money" is a pretty sad testament.

 

[militarymd]

OK, my turn to finally get irritated again:
By this incredible logic:
cardiologist = better person than pulmonologist
anesthesiologist = better person than...Mother Teresa

whatever.

the fact that you could actually use the phrase "better people make more money" is a pretty sad testament.

I love the way some of you junior folks love to take WHATEVER I say and turn it negative.

Let me rephrase and be more specific so as not to "irritate" your delicate and gentile psyches.

Better orthopedic surgeons make more money than orthopedic surgeons who are slow, commit malpractice each time they operate, and who get into the Navy.

Is that better?

 

[orbitsurgMD]

OK, my turn to finally get irritated again:
By this incredible logic:
cardiologist = better person than pulmonologist
anesthesiologist = better person than...Mother Teresa

whatever.

the fact that you could actually use the phrase "better people make more money" is a pretty sad testament.

I suppose in a community where people can and will choose to go to the doctors that have the best reputations, and those reputations are based on solid professional ground: better developed surgical skills, better training, better clinical acumen, better outcomes, then I suppose, all other things being equal, they should attract a better share of business and thus earn more.

But all other things are rarely equal. Lousy plans may not attract many doctors, some patients will not pay out of pocket for superior quality care when they can get adequate care paid entirely by their insurers. Access to information about quality of care is incomplete. Patients' impressions of quality of care is often incorrect or colored by extraneous and insignificant qualities (the physician who gives the warm reassurances but doesn't work up a potentially serious complaint is not always seen as inferior to one who does). I have seen some surprisingly bad physicians do very well for themselves while far better, more ethical and consciencious doctors struggle. So no, I do not believe medicine is at home in John Calvin's world.

 

[jetproppilot]

I love the way some of you junior folks love to take WHATEVER I say and turn it negative.

Let me rephrase and be more specific so as not to "irritate" your delicate and gentile psyches.

Better orthopedic surgeons make more money than orthopedic surgeons who are slow, commit malpractice each time they operate, and who get into the Navy.

Is that better?

I endorse this post.

 

[RichL025]

I endorse this post.

Errrr, aren't you the one who has no military experience?