Officer first, doctor second?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

choip0817

Member
10+ Year Member
5+ Year Member
15+ Year Member
Joined
Dec 2, 2004
Messages
27
Reaction score
0
I've read/heard many things where as a military physician, you are an officer first and a doctor second, and that it would be incorrect to believe that "you're going to be a doctor who just happens to be in the military." What exactly does this mean? Does being an officer actually affect the quality of care to patients?
I apologize for so many questions; I have to make a decision relatively soon.

Members don't see this ad.
 
What it means is that your rank is more important than your skills as a physician.

Every nurse who outranks you will try to use rank to get you to do what THEY want you to do.

Every line commander will look at you based on your rank, and not your MD.....meaning a higher ranking doctor must know more than a lower ranking doctor.

Search my threads...I have one out there that specifically talks about how rank screws up the medical system.
 
Members don't see this ad :)
militarymd said:
Every nurse who outranks you will try to use rank to get you to do what THEY want you to do.

in my experience this is 100% wrong. not even once has a nurse tried to use rank to scut me out out or make me "do what they want". (and i'm an intern-- my *life* is scut, lol) perhaps when you were in the navy this was true, but at Walter Reed i've actually had an easier time than i did during medschool rotations-- precisely because of the rank structure you describe. the "techs" or are mostly privates and specialists, and follow instructions a helluva lot better than any civilian tech i've run across. and that holds true for National Naval Medical Center as well (at least the NICU and MICC where i've worked)

and even if your statement were true (which i think it't not) surely you don't think nurses attempting to "get you to do what they want" is a uniquely military phenomenon do you?


militarymd said:
Every line commander will look at you based on your rank, and not your MD.....meaning a higher ranking doctor must know more than a lower ranking doctor.

in the case of doctors this is pretty true. in the Army CPT's are residents, fellows, or fresh out of residency, MAJ are staff and LTC/COL are usually attendings with much more experience than any of the former, and are often department chairs and subspecialists.

--your friendly neighborhood nurse mind control avoiding caveman
 
Homunculus said:
LTC/COL are usually attendings with much more experience than any of the former, and are often department chairs and subspecialists.

Yeah, but I have to agree with mil-md that it's silly for patients to think the COL must be the better doctor b/c he's higher ranking. In reality, it just means the person has been in army longer. I remember once (in my very limited experience) when a patient was all happy b/c he was having a COL do his operation instead of the LT COL. Meanwhile, that COL had been spending most of his time doing research for the past several years and was incompetent in the OR. Fortunately the COL made sure that the LT COL was there in the OR to help him do the case, but he might as well have been a resident in training.
 
Homunculus said:
in my experience this is 100% wrong.
--your friendly neighborhood nurse mind control avoiding caveman

6 whole months on active duty right? Give it time.
 
militarymd said:
6 whole months on active duty right? Give it time.

yup, 6 months. it's all i have to go on at the moment.

the thing is, if every nurse tries to do it, you'd think i'd run into it *at least* once in the past 6 months, right? or that at least one of my intern-mates would? as of yet, i'm still waiting.

again, it is part of nursing for them to try to make their job easier. if you haven't run into this in the civilian world, you will. that's normal. however, for you to state they are always using their rank as a tool to make physicians do things, you're grossly exaggerating at best.

--your friendly neighborhood scut running caveman
 
I have friends who have been in 10+ years as military physicians. Nurses do not pull rank as often as MilMD makes it seems to be.

I respect that your experience in the Navy sucked MilMD and that the military was not right for you; however, do not rain on the parade of others who want to serve as physicians, officers, and leaders in the military.
 
Andrew_Doan said:
I have friends who have been in 10+ years as military physicians. Nurses do not pull rank as often as MilMD makes it seems to be.

I respect that your experience in the Navy sucked MilMD and that the military was not right for you; however, do not rain on the parade of others who want to serve as physicians, officers, and leaders in the military.

Give it time. You haven't done one day yet. I did 11 years. 2nd hand info, or sleeping at the Holiday Inn Express is not the same.
 
Homunculus said:
yup, 6 months. it's all i have to go on at the moment.

the thing is, if every nurse tries to do it, you'd think i'd run into it *at least* once in the past 6 months, right? or that at least one of my intern-mates would? as of yet, i'm still waiting.

again, it is part of nursing for them to try to make their job easier. if you haven't run into this in the civilian world, you will. that's normal. however, for you to state they are always using their rank as a tool to make physicians do things, you're grossly exaggerating at best.

--your friendly neighborhood scut running caveman

Do your current attendings enjoy getting advice and insight from you as much as I do?

So far, I'm the only "been there, done that" military physician who has been stationed at multiple duty stations who consistently come to this board to balance out the "no experience" go getters talking up military medicine to potential HPSPer's.

6 months into internship at Walter Reed.......11 years and now in private practice heaven after 6 different commands and 1 war.

My posts are information to potential HPSP'ers.....not debate points trying to get you to think things suck for you......If you are happy with military medicine, then good for you.
 
In my limitted experience of 6 months I have also not had any problems with nurses "pulling rank" on me. Even the 0-5 and 0-6 nursing supervisors have respected my role (and I theirs). I anticipate this won't always be true. I also would imagine that less BS is tolerated at the MEDCENs than the MEDACs.

Ed
 
militarymd said:
Do your current attendings enjoy getting advice and insight from you as much as I do?

i get along very well with my attendings. i'm not giving any advice, simply disagreeing with you. did your residents enjoy your negativity as much as i do? :p

militarymd said:
So far, I'm the only "been there, done that" military physician who has been stationed at multiple duty stations who consistently come to this board to balance out the "no experience" go getters talking up military medicine to potential HPSPer's.

exactly. we have an N of 1 for long term career-ish docs (and from the navy no less). how can you say your word is "it" when it comes to these issues? personally i'd like a variety of people from all stages of their careers to comment on this, but at the moment we're stuck with what we've got.

militarymd said:
My posts are information to potential HPSP'ers.....not debate points trying to get you to think things suck for you......If you are happy with military medicine, then good for you.

my posts are for their information as well. your experiences in the navy are fine for you to comment on, but to make blanket statements like you've made isn't beneficial to them any more than the recruiters that paint everything all rosy and wonderful. i'm glad you're happy with civilian life, but don't artificially "suckify" ( :thumbup: for invented words) the military. it has enough sucky stuff the way it is without creating stuff to complain about. :laugh:

--your friendly neighborhood finally got a day off caveman
 
Homunculus said:
i get along very well with my attendings. i'm not giving any advice, simply disagreeing with you. did your residents enjoy your negativity as much as i do? :p



exactly. we have an N of 1 for long term career-ish docs (and from the navy no less). how can you say your word is "it" when it comes to these issues? personally i'd like a variety of people from all stages of their careers to comment on this, but at the moment we're stuck with what we've got.



my posts are for their information as well. your experiences in the navy are fine for you to comment on, but to make blanket statements like you've made isn't beneficial to them any more than the recruiters that paint everything all rosy and wonderful. i'm glad you're happy with civilian life, but don't artificially "suckify" ( :thumbup: for invented words) the military. it has enough sucky stuff the way it is without creating stuff to complain about. :laugh:

--your friendly neighborhood finally got a day off caveman

The main thing about military medicine as a physician is to be confident, collected, and cool when and if you deal with higher non-physician powers that outrank you. Don't lose your cool because they will use that against you. In terms of your medical decisions, stand behind them 100% but politely do so. Its easy to want to lay into an arrogant nurse when they try and have you do something differently, but start from day one by showing that your way is the way things will be done. Its okay to listen to recommendations, but let it be known that all decisions come from you. Now non-patient care decisions will defer to the person who has the highest rank, as it rightly should. This can be a gray area so tread carefully and defend your positions if need be here as well. But ultimately a military physician is a physician...bottom line, not truly an officer in all respects. As a physician you will receive special privileges be it right or not, including the "flexible tape measure" to some degree, and the PT avoidance if you care to. You will still need to pass your PFT but except for that, you are hardly an officer unless you choose to put yourself in that position. Line officers squawk at physicians thinking they are real officers, but respect you for what you do. Don't try to do their job when you are in a real unit one day, because unfortunately their mission usually takes precedence over yours. You guys will all catch on and be fine medical officers. Stay safe and have a happy holiday.
 
Members don't see this ad :)
I too am not sure why MilMD finds it his duty to warn all those would-be HPSP students of the negatives of mil medicine. The advice tends to be very one sided. I appreciate his service but the constant negativity has runs it course.

Although I'm not a doc yet, I've been in the Navy for 14 years. I've met many aviators who were bitchin' from day one and 12 years later, they were still bitchin'.....and I'm sure they are still bitchin' while flying for the commercial airlines....some are simply prone to complain and feel it there duty to point out all negatives to others.

As with anyone offering free advice, take it as a single data point and get advice from others. Suckify is a great word, you should submit that to Webster's. :thumbup:

BTW, Merry Christmas!
 
Homunculus said:
exactly. we have an N of 1 for long term career-ish docs (and from the navy no less). how can you say your word is "it" when it comes to these issues? personally i'd like a variety of people from all stages of their careers to comment on this, but at the moment we're stuck with what we've got.
--your friendly neighborhood finally got a day off caveman

Glad you're having a good time at Reed. Never been there myself, although I have a few friends who are fellows there.

I've been lurking around here for a while...generally I read forums when I'm feeling too good about myself and enjoying my career too much. Once I read MilMD's posts, I realize once again that I'm a second-rate doctor working in a second-rate system. Oh, only if I had someone like him to warn me earlier in life!

I don't have MilMD's 11 years of active duty, just a lowly 5.5 years. Still, I suppose that gives me some street credibility here. I'm a Navy IM resident, waiting to start my ID fellowship this upcoming summer. Between my R-1 and R-2 years, I was a carrier air wing flight surgeon and deployed for Noble Eagle and Enduring Freedom. So here goes:

It sounds like MilMD got screwed. Now, I don't know why or under what circumstances; nor do I particularly care. I'm sure he means well and is trying to dissuade people from getting screwed like he did. The problem is, he's become the sole voice of experienced military physicians on this forum, and I'm afraid he's poisoned the well.

Now, I've never had the pleasure of meeting MilMD in person (probably...it is a small Navy). But think about this for a moment: when someone spends eleven years in a large organization and insists that everyone else was an incompetent failure out to screw him, there is a possibility that there is another side to the story.

When I first found out about the GMO requirement in the Navy, my first thought was "crap", followed by "****", followed by a series of other obscenities. In the end, I decided to do the FS thing, and I've never looked back...great time, great friends, and a great experience for me as a physician. I'm a better doctor, and specifically a better internist, for the experience.

I have never in my going-on-six-years had a nurse pull rank on me. I have had nurses pull experience on me when I was an intern and quasi-clueless, at least in the beginning. As a senior resident, it never happens (and that includes interactions with Nurse Corps commanders and captains). Perhaps it's because I have good relations with my colleagues. Perhaps it's because the wings and ribbons make me look more officer-ish than they do. Perhaps it's because I don't whip out my ego and swing it around the room every time I talk to the nursing staff. Who knows?

I have misgivings about the military, for sure. Anyone who doesn't have their doubts about the Navy is insane, but the quality of attendings and fellows with whom I've worked has been great. Our department is well-integrated with the local civilian academic community, we do some decent research, and we make good internists and subspecialists. I can't comment intelligently about the surgical programs, but I've spent a fair amount of time bitching to my surgical counterparts on call, and they seem every bit as irritated and surly as me.

I am worried about some of the changes, specifically in pediatrics...I hope we can salvage that community. Uniformed military pediatricians taking care of Iraqi and Afghan kids would do make a strong impression on the world. The impact on IM has been pretty minor, thankfully.

So to summarize:
-GMO tours are often fun and can be good for you as a doctor. (Incidentally, you always have backup, with some very rare exceptions.)
-The Navy is an imperfect organization and might expect you to perform some military duties in exchange for the money they're giving you.
-Doctors in the military are a cross-section of medical practice: there are some great ones, a few bad ones, and a great middle ground of competent physicians.
-The Navy has some jerks in it.
-So does the real world.
 
Interesting what each person reads and remembers of what I write. First of all, I'm not all negative. I have recommended to members who have asked, to stay in the military because it would appear to be the best for them.

I have specifically commented on how Navy IM residencies are well-regarded and that you do get good training......how interesting that no one remembers me saying that.

I have specifically mentioned that I know nothing about the west coast navy....which as anyone in the navy knows....is very different from the east coast navy.

I specifically discussed how rank distorts the practice of medicine.....which it clearly does, and it has turned into "every nurse is going to pull rank and tell you how to practice medicine"

Read carefully what I write.....ask if it is unclear....I'm giving it to you straight. Like I said, I have been through enough commands to know that, the military experience is NOT for ME....and not for most people who want to be PHYSICIANS....NOT officers in the military....who are short on cash when going to medical school.

I was at a teaching program where I served both as an anesthesiologist and intensivist....I was the chairmen of the education committee of our residency....I was the assistant medical director of the OR....I ran the morbidity and mortality conference for our department.....

I was in a unique situation to teach, work with, and evualte residents in every specialty in the military except pediatrics because of me spending 1 week in 4 attending in a closed ICU.

I work closely with attendings in every medical and surgical specialties in the military....because of my work in the ICU.

My observations are based on my experiences of someone who believes that I am a physicians first, and officer a distant second.
 
I guess I used the phrase "Every nurse..." in a previous post.....let me correct myself...."nurses will...."
 
Globus P said:
I too am not sure why MilMD finds it his duty to warn all those would-be HPSP students of the negatives of mil medicine. The advice tends to be very one sided.

BTW, Merry Christmas!

But everyone else is SOOO positive..............
 
I'm not one to usually agree with militarymd but from my limited experience I must agree with him. I'm seen nurses ordering interns on a number of occasions. I do think it varies per branch(I've done rotations with all three branches) with the Navy being the most malignant. I see it most often in the OR...and I think one reason for it is b/c the nurses see the residents and attendings treating the interns like crap so they tend to follow the trend.

rotatores
 
rotatores said:
I'm not one to usually agree with militarymd but from my limited experience I must agree with him. I'm seen nurses ordering interns on a number of occasions. I do think it varies per branch(I've done rotations with all three branches) with the Navy being the most malignant. I see it most often in the OR...and I think one reason for it is b/c the nurses see the residents and attendings treating the interns like crap so they tend to follow the trend.

rotatores

i like having milmd around, and i agree with him alot as well. but stuff like what you mention here is not unique to the military. civilian programs (*especially* surgery) have nurses that will order interns around essentially because at that stage of the game they know more than the interns do. scrub nurses will chew you up and spit you out before you know what hit you :laugh: and i've seen nurses that assist on CABG cases do everything except sew the grafts down. this is far different than being ordered to do something because of rank. USUHS students i've talked to don't get much civilian exposure, but things are pretty similar at the teaching institutions if you were to rotate there.

to milmd, i would agree that nurses may try this occasionally, but it is far from the norm in my experience. nothing personal, and i can separate a disagreement from personal animosity. i won't hold it against you or anything . this isn't the everyone forum, after all (thank god) :)

--your friendly neighborhood has surgery nightmares caveman
 
I guess I made it sound like every nurse who outranks you will try to order you around everyday. They don't do that everyday.

From my experience, it happened to me maybe 3 times in my 11 years where a non-physician who outranked me applied pressure to have certain things done that was either medically not indicated or plain wrong.

And those events happened in the last 3 years of my 11 (The housestaff and medical students didn't even know about it). Maybe the number is low, but I find that an environment that allows that to happen even once is unacceptable.

I have said this before....I was really happy with military medicine for the first 7 years or so....
 
I would guess that about 4 out of 5 staff docs I have known in my 2.5 years as an active duty physician in the AF would generally agree with MilMD. This includes some of the most positive, dynamic people I have ever known, as well as a few "negative" people who would probably be miserable anywhere. The staff docs are leaving the AF with such fury that it is becoming extremely difficult to maintain GME and continuity of patient care. When you also throw the insanely high deployment rate in the mix, as well as the well-documented bureaucratic garbage that goes on, it makes for a pretty dismal practice environment. If more of the staff docs took time to express their feelings on this forum, you would see that MilMDs views are part of the majority (at least in my exp in the AF).

As far as the nurse thing goes, the biggest frustration I have observed is not directly at the patient care level, but at the command level. The commander of NNMC Bethesda, for example is a one-star nurse. This is becoming more common throughout departments and medical centers, because the nursing corps is so top heavy with rank because they rarely separate from the military. Where else in the world can you pull down 80-100k as a nurse without ever touching a patient? Plus they get a lot of power with their rank that they wouldn't normally get in the civilian sector. So, while you may not be seeing a lot of nurses pulling rank at the bedside, the larger problem is that more and more nurses and MSC officers are calling the shots from the command level.
 
Rudy said:
The commander of NNMC Bethesda, for example is a one-star nurse.

:confused:

http://www.bethesda.med.navy.mil/Visitor/About_Us/Leadership.aspx

"Rear Admiral Robinson is a native of Louisville, Kentucky. He entered the naval service in 1977 and holds a Doctor of Medicine degree from the Indiana University School of Medicine, Indianapolis, through the Armed Forces Health Professions Scholarship Program."

"A native of Milwaukee, Wisconsin, Captain Olesen received his bachelor of sciences degree from the University of Wisconsin-Milwaukee and his doctorate of medicine from the Medical College of Wisconsin."

they both look like docs to me. :)

maybe the commander you are talking about is a nursing commander or something, and not of all of NNMC.

--your friendly neighborhood investigative caveman
 
Homunculus said:
:confused:

http://www.bethesda.med.navy.mil/Visitor/About_Us/Leadership.aspx

"Rear Admiral Robinson is a native of Louisville, Kentucky. He entered the naval service in 1977 and holds a Doctor of Medicine degree from the Indiana University School of Medicine, Indianapolis, through the Armed Forces Health Professions Scholarship Program."

"A native of Milwaukee, Wisconsin, Captain Olesen received his bachelor of sciences degree from the University of Wisconsin-Milwaukee and his doctorate of medicine from the Medical College of Wisconsin."

they both look like docs to me. :)

maybe the commander you are talking about is a nursing commander or something, and not of all of NNMC.

--your friendly neighborhood investigative caveman

Rudy was referring to the previous commander.
 
I was talking with an AF 0-6 the other day and he said the military is considering (or at least getting a lot of pressure from the nursing corps) to put a nurse or someone in the medical service corps as a surgeon general. Is this true? I guess it makes sense b/c they are just administrative...but wouldn't they have to change it to nursing general??
 
militarymd said:
Rudy was referring to the previous commander.

ahhh. the "is" instead of "was" before commander confused me. i don't doubt the previous commander was a nurse-- it's just that i was pretty sure the current one was a doc from conversations i've heard around the hospital.

--your friendly nieghborhood point taken caveman
 
militarymd said:
Now there's a real winner :thumbdown:


That's it! I am revoking your membership in the Vice Admiral Donald C. Arthur Fan Club. And you can forget about getting the Christmas card this year.
 
of NNMC Bethesda Kathleen Martin, NC. She was in charge from 1999-2002.

Here is the link:

http://www.chinfo.navy.mil/navpalib/people/flags/biographies/martinkl.html

I am glad to hear that the Navy decided to bring a doc back in as commander, but as you get out into the field you will see many non-physicians in charge. My dept is headed by an MSC officer who has never set foot in medical school. It causes a lot of problems because of the lack of understanding of what a residency is all about and what GME requires to be successful.

As far as the whole "officer first, doctor second" craziness, it has never made sense to me because without my medical training, I am of no use to the military. So in my mind, I am a physician first, and be being the best physician I can be, I therefore best serve my country and fellow servicemembers. What you will see a TON of are high ranking officers (O-5s, O-6s) who are horrible, incompetent physicians, but stay on active duty because they are trying to suck down a military retirement. They have become institutionalized and no longer are compatible with the pace and demands of civilian practice. In my mind, these officers are not useful to the military or their country, no matter how hard they push papers on their desks doing their admin jobs as "officers first".

It would be great to get some additional input on this forum besides overly defensive interns and HPSP students.
 
Rudy said:
It would be great to get some additional input on this forum besides overly defensive interns and HPSP students.

. . . or disgruntled Navy docs thinking they know all about the Army :p :laugh:

i agree that we need more posters- from all services and experiences.

besides, i'm not overly defensive, i'm only pointing out inaccuracies and exaggerations :cool:

--your friendly neighborhood young and naive caveman
 
militarymd said:
What it means is that your rank is more important than your skills as a physician.

Every nurse who outranks you will try to use rank to get you to do what THEY want you to do.

Every line commander will look at you based on your rank, and not your MD.....meaning a higher ranking doctor must know more than a lower ranking doctor.

Search my threads...I have one out there that specifically talks about how rank screws up the medical system.


OK, here's some input from an Army O4.
1. I have never seen this nurse-pulling-rank thing happen, or even know of it happening. As MilMD stated later in this thread, this maybe happened 3x in his 11 year career. That's rare enough to be, well, pretty rare. Frankly, I side with the other poster who noted that and experienced nurse can save your ass sometimes. If an O6 nurse "suggests" something, it's probably not a bad idea to at least think about it. If you don't like it, explain why it's wrong. If it does come down to a direct order (again, this is pretty hard for me to imagine), document it.

2. I don't think any line officer looks at me based on my rank. Now, maybe I'm somewhat spoiled by the fact that I'm the only provider in my specialty at my current post, so they don't have much choice about going over my head, but still, I don't get the sense that they're second guessing me when I make reccs on their troops. But just to play devil's advocate, lets put the shoe on the other foot. If you had some "military" issue, who would you rather listen to: the 2LT right out of ROTC or some O5 or O6? Frankly, I'm not afraid to admit that, yes, most docs who outrank me do know more than I do (at least within my field). But still, no line officer is gonna come back to me and say "the O5 nurse says you should do things different."

3. As for being an "officer first," my take is that you are an "officer first" only in the eyes of those who run the personnel systems. Of course, that unfortunately includes lots of things including assignments, deployments, promotions, etc. This can obviously make things a pain in the butt for you. But pretty much everyone else is going to view you as a doc first (including most line officers). I'm sure there are some docs (mostly prior service and West Point types) who see themselves as officers first, and that's fine, but I think they're in the minority.

4. Those things being said, I am still a MilMD partisan. He's not lying to you, folks: there's a lot of crap in the military medical system that is incredibly frustrating. I didn't come to this with blinders on (despite signing up before this wonderful website was available -- as I've said before: if SDN were around in 1993, I wouldn't be in uniform today). Yes, my primary reasons were economic, but I was open to seeing what military life and military medicine were like, providing some service to my country, and I was fully accepting of the chances of deployment etc. Now, after HPSP, Army residency and assignment as an attending, I have come to the point of counting down the days until I never have to deal with the military medical system again. Caveat emptor.

RMD 1-6-2
 
militarymd said:
I guess I made it sound like every nurse who outranks you will try to order you around everyday. They don't do that everyday.

From my experience, it happened to me maybe 3 times in my 11 years where a non-physician who outranked me applied pressure to have certain things done that was either medically not indicated or plain wrong.

And those events happened in the last 3 years of my 11 (The housestaff and medical students didn't even know about it). Maybe the number is low, but I find that an environment that allows that to happen even once is unacceptable.

I have said this before....I was really happy with military medicine for the first 7 years or so....

Just to add some more perspective:

First some background-I have served 13 years as both active duty and reserve enlisted and officer (Army MSC, 71B); I have a PhD in Biochemistry and am now an MSII and HPSP recipient. Most recently I served as Company Commander for a headquarters company in a medical brigade in Kuwait. Previously I was the company XO at a CSH. Enlisted medic at an army general hospital.

At the brigade my chain of command was the brigade commander (BG/O-7). However, that did not stop everyone on the staff at one point or another, including the O-6 chief nurse, from trying to get me to do things their way. That being said, anyone in the Army who has made it to a medical brigade staff position knows that their comments are merely suggestions and in the end, absent an order from the Brigade Commander, it was my call. Similarly, in the CSH I saw nurses attempt to bully physicians (usually new O-3's), but almost never about patient care issues/orders (only twice that I can think of).

The docs that I saw that had the most heartburn were generally pissed that a nurse in any setting was questioning them. An O-6 nurse is still an O-6; they often have years of experience in the Army that may be worth listening to. Annoying, often times yes. There are lots of annoying things about the military, physicians included. However, I have yet to meet a brigade or hospital commander, regardless of specialty, that backed-up a nurse giving orders to a physician. A polite 'no maam' often suffices along with a reminder that these are your orders for the patient. If that doesn't work take it up the chain later. In my experience, docs were the final arbitors when it came to patient care.
 
What's the big deal with the hospital commander being a doc anyway? Civilians work for non-docs all the time. Hospital administrators are almost never docs. Insurance executives are only sometimes docs.

Ed
 
edmadison said:
What's the big deal with the hospital commander being a doc anyway? Civilians work for non-docs all the time. Hospital administrators are almost never docs. Insurance executives are only sometimes docs.

Ed

Aviators do not get commanded by non-aviators. Submariners do not get commanded by non-submariners, therefore it only makes sense for physicians to be commanded by non-physicians?

Civilians do NOT work for non-physicians. We work for our patients. We get paid by insurance companies, and hospitals CEO's are always trying to find ways to please physicians, because if we are not happy with a hospital, we don't bring our patients to that particular hospital, and guess what happens.....the hospital goes out of business....Now of course, I'm talking private practice....not some teaching hospital...which has significant similarities to the military.
 
militarymd said:
Give it time. You haven't done one day yet. I did 11 years. 2nd hand info, or sleeping at the Holiday Inn Express is not the same.


This seems to be your obligatory response to anyone who disagrees with you. Its a little tiresome to make a statement and then defend it by repeatedly telling other posters that they just don't know as much as you. We all know about your extensive experience as a Navy Anesthesiologist. All I am is a GMO who did a bunch of military rotations in med school and a Navy internship, so if I also deserve to be dismissed for my inexperience, I can live with that.

Now...1. Do military nurses occasionally try to pull rank? Yes, rarely. The bad ones do. So what. Civilian nurses can complain about you too and make your life just as bad. The bigger problem with military nurses is that most are too junior to pull rank and so you have interns on the wards without the old experienced nurses to keep them out of trouble.

2. Line commanders trust THEIR doc implicitly and distrust everyone else, whatever your rank. This is even true when their doc is an IDC and you are a physician. Its a unit thing.

3. There is no conflict between being an officer and a physician. If you think there is, then you probably don't understand your obligations as a medical officer.

4. Aviators are commanded by nonaviators all the time and that is not unique to the military. As an anesthesiologist, you have no work unless surgeons bring it to you. I know anesthesiologists who have been pressured to not cancel procedures because it was inconvenient to the surgeon. Preventing bad choices due to these kind of external pressures from people who don't always know best are precisely the reason you're there.
 
GMO_52 said:
This seems to be your obligatory response to anyone who disagrees with you. Its a little tiresome to make a statement and then defend it by repeatedly telling other posters that they just don't know as much as you. We all know about your extensive experience as a Navy Anesthesiologist. All I am is a GMO who did a bunch of military rotations in med school and a Navy internship, so if I also deserve to be dismissed for my inexperience, I can live with that.

Now...1. Do military nurses occasionally try to pull rank? Yes, rarely. The bad ones do. So what. Civilian nurses can complain about you too and make your life just as bad. The bigger problem with military nurses is that most are too junior to pull rank and so you have interns on the wards without the old experienced nurses to keep them out of trouble.

2. Line commanders trust THEIR doc implicitly and distrust everyone else, whatever your rank. This is even true when their doc is an IDC and you are a physician. Its a unit thing.

3. There is no conflict between being an officer and a physician. If you think there is, then you probably don't understand your obligations as a medical officer.

4. Aviators are commanded by nonaviators all the time and that is not unique to the military. As an anesthesiologist, you have no work unless surgeons bring it to you. I know anesthesiologists who have been pressured to not cancel procedures because it was inconvenient to the surgeon. Preventing bad choices due to these kind of external pressures from people who don't always know best are precisely the reason you're there.

If you say so....
 
GMO_52 said:
4. Aviators are commanded by nonaviators all the time and that is not unique to the military.

Not true, in my experience. I can't even begin to imagine which operational unit is employing such a tactic. Seems to be a recipe for disaster, IMHO.
 
Heeed! said:
Not true, in my experience. I can't even begin to imagine which operational unit is employing such a tactic. Seems to be a recipe for disaster, IMHO.


Well...Carrier Battle Groups and ESGs are commanded by either a SWO or an Aviator (they alternate). Aviators take command at sea on ships with minimal aviation assets (like oilers) so that they have command at sea experience before they command a carrier. This can be their first time on a ship other than a carrier and they are in command. Individual squadrons are always commanded by aviators but once you get to those more senior billets (who are making lots of decisions about types of missions, where to fly, etc), they share them between those 2 communities. Smallboys with embarked air assets (DDGs, Frigates, etc) have a couple of SH-60s and, while the pilots are technically part of a squadron with an aviator CO, they are under the operational command of the ship's CO.
 
I firmly believe the officer first, physicain second is a good way to look at the military when considering the pros and cons of the HPSP. Certainly your place in the military revolves around being a doc..... but if you know the "game" includes some LT/CPT MSC type coming up to you and telling you that you have to take a APFT by the end of the week (and it's thursday afternoon) or that you have to spend your first day off in a couple weeks out at the 9M range shooting (or better, just throwing) a worthless weapon, you may find you are better able to roll with the punches compared to someone who envisioned their only obligation in the military would be to take care of soldiers/sailors/airmen.
 
Is this going to be a pattern, bumping discussions which died in 2004? Two today.
 
Resurrecting these old threads is great.

And for the record... Doctor first. Officer maybe top ten.
 
I am a Doctor first, second and third. I do maintain military bearing and enjoy most of the military protocols but my main passion is medicine.

Think about it:

1) Eight years of higher education = MD/DO (without residency)
2) One signature in the HPSP contract= Officer Commission

How am I supposed to consider my commission more important than my profession?
 
Now that you mention it, that's what I'm going to start doing from now on.

Well it will save you the time of having to type the same thing over and over.

Question asked (many, many times) and answered.

On the overall thread:

In 14 years of active service, I still have yet to encounter a conflict between my role as an officer and my role as a physician. Perhaps it is just good luck.
 
Top