"Wow"

[IgD]

http://www.medicalcorpse.com/

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Members don't see this ad.

 

[IgD]

http://www.usmedicine.com/article.cfm?articleID=1324&issueID=88

June 2006

Letter To The Editor -

Closing MTFs May Be Slippery Slope For Care
With the imminent closing of Walter Reed Army Medical Center, [in Washington, D.C.] and the transfer of the inpatient function of Wilford Hall Medical Center [from Lackland Air Force Base in Texas] to Brooke Army Medical Center [at Fort Sam Houston, Texas], the death of U.S. military medicine should be evident to the casual observer. Now that my alma mater, Wilford Hall, has devolved into a clinic, what shall we call Andrews AFB [Air Force Base] hospital: a doc in the box (singular)?

Ten years from now, our active duty troops, their families, and our honored military retirees will be treated by civilian contractor FMG [foreign medical graduate] physicians and non-physician active duty "providers"-the bottom of the barrel caring for the "tip of the spear."

The few USU [Uniformed Services University]-graduate physicians will be shunted into ineffectual positions on the [organizational] chart, so that the all-powerful Nursing Corps can continue to champion "empowerment" of nurses to command physicians, as well as the independent (mal)practice of nurse anesthetists on our troops (which remains a felony outside of military bases in most states).

Politicians and generals will perseverate in touting the quality of health care in the military, while covering up sentinel events related directly to the lack of senior clinical physicians needed to provide "adult supervision" to the green staff MDs rotating in and out every four years. TRICARE (try and get care) will drop all pretenses of attempting to help military families; its goal of evolving into a for-profit cash cow for government contract agencies will be unmasked for all to see. And then, the final coup de grace: a nurse will be appointed as "surgeon general" of a military department.

After 19 years on active duty, 15 of which was as a physician, I walked away from all retirement benefits last year, precisely because military medicine has been mismanaged into an early grave by shortsighted Pentagon bureaucrats and their spineless military medical underlings. I have written a Web site detailing my post-mortem observations regarding what was once a proud profession: U.S. military medicine...not "allied health professional-ship"...not "providership"...[but] MEDICINE: www.medicalcorpse.com .

The mothers of those brave souls who are right now enlisting to defend our country deserve to know the truth: there will be no military medical system to care for them in a few short years, if current trends continue...and if there is one, it will be so dangerous due to lack of funding and qualified personnel, that self aid/buddy care would prove a far safer option.

Dr. Robert C. Jones
ex-Lt. Col., USAF, MC
ex-Medical Director of Anesthesia, David Grant Medical Center, Travis AFB, Calif.
ex-Assistant Chief Anesthesiologist, Malcolm Grow "Medical Center," Andrews AFB, Md.
Harvard 1985, USUHS 1990, WHMC Anesthesiology Residency 1994
Diplomat, American Board of Anesthesiology, 1995

 

[IgD]

Don't really understand the hyper-religious(?) stuff:
http://www.medicalcorpse.com/oneUSAFunderJesus.html

 

[dpill]

Don't really understand the hyper-religious(?) stuff:
http://www.medicalcorpse.com/oneUSAFunderJesus.html

At my last base (Air Force), a few commanders were notorious for conducting bible study during CC calls and staff meetings. And all prayers ended in "in Jesus name we pray", regardless of the religious diversity of the audience. Sounds like this person may have been exposed to the same.

 

[USAFdoc]

At my last base (Air Force), a few commanders were notorious for conducting bible study during CC calls and staff meetings. And all prayers ended in "in Jesus name we pray", regardless of the religious diversity of the audience. Sounds like this person may have been exposed to the same.

I understand the problem some may have with "Jesus" mentioned at Commanders call etc....................still, it seems like people are being a little too sensitive on this issue. Our money says "In God we trust", does that mean every athiest needs to be offended by that and sue for mental trauma?
No one should ever be forced to believe something, or threatened if they do not. At the same time, would those offended by the mentioning of Jesus be offended if somebody mentioned other topics in private or public.

We are all adults, and there is a difference between freedom of religion and freedom from religion.

 

[USAFdoc]

http://www.medicalcorpse.com/

wow is right. This guy really, really got pissed off by military medicine. Can't wait to read his book. Perhaps get a few ideas for my own book.

 

[chopper]

I understand the problem some may have with "Jesus" mentioned at Commanders call etc....................still, it seems like people are being a little too sensitive on this issue. Our money says "In God we trust", does that mean every athiest needs to be offended by that and sue for mental trauma?
No one should ever be forced to believe something, or threatened if they do not. At the same time, would those offended by the mentioning of Jesus be offended if somebody mentioned other topics in private or public.

We are all adults, and there is a difference between freedom of religion and freedom from religion.

I think you may be a little bit naive about the 'innocent' mention of this type of thing at official functions. The USAF academy has had some serious problems with fundamentalist christians pushing their views to the point of view (or those that don't agree with 'their' type of christianity) second class citizens or worse. 'Innocent' talks like this are only the first step down this road.

I am not offended of the mentioning of Jesus (or any other religious talk) in public. I'm highly worried that a commanding officer in the US military would even THINK this is an appropriate way to address his troops. By acting in this manner, he/she is providing an implied message that this is the way he thinks people should believe, with the implied threat of what happens to those who do not believe.

After all the talk about how your commanders 'own' you, I would think that you could see how this type of thing could be taken advantage of.

 

[dpill]

I understand the problem some may have with "Jesus" mentioned at Commanders call etc....................still, it seems like people are being a little too sensitive on this issue. Our money says "In God we trust", does that mean every athiest needs to be offended by that and sue for mental trauma?
No one should ever be forced to believe something, or threatened if they do not. At the same time, would those offended by the mentioning of Jesus be offended if somebody mentioned other topics in private or public.

We are all adults, and there is a difference between freedom of religion and freedom from religion.

I didn't say the commander(s) just "mentioned" Jesus during commander's call and staff meetings- they literally held bible study. I don’t want to get into this discussion further- I am simply pointing out something that was an issue at my last base and many people were uncomfortable with the situation. Personally, I believe there is a time and place for everything and I don't think commander’s call or staff meetings are appropriate venues for bible study- you aren't given a choice of whether or not to attend, so there isn't much freedom involved.

 

[former military]

I didn't say the commander(s) just "mentioned" Jesus during commander's call and staff meetings- they literally held bible study. I don’t want to get into this discussion further- I am simply pointing out something that was an issue at my last base and many people were uncomfortable with the situation. Personally, I believe there is a time and place for everything and I don't think commander’s call or staff meetings are appropriate venues for bible study- you aren't given a choice of whether or not to attend, so there isn't much freedom involved.

I didn't think there was a worse place to be stuck in commander's call than David Grant Medical Center- the "perineum" of the military, (listening to the don't drink and drive speech and clean up your dorm rooms speech) but that does seemingly beat the Rev Jim Jones's Bible study in commander's call! With people of all faiths and muslim military members the Bible crap is for the 1950s. I read the Bible on my own time and go to church on my own time.

 

[USAFdoc]

I think you may be a little bit naive about the 'innocent' mention of this type of thing at official functions. The USAF academy has had some serious problems with fundamentalist christians pushing their views to the point of view (or those that don't agree with 'their' type of christianity) second class citizens or worse. 'Innocent' talks like this are only the first step down this road.

I am not offended of the mentioning of Jesus (or any other religious talk) in public. I'm highly worried that a commanding officer in the US military would even THINK this is an appropriate way to address his troops. By acting in this manner, he/she is providing an implied message that this is the way he thinks people should believe, with the implied threat of what happens to those who do not believe.

After all the talk about how your commanders 'own' you, I would think that you could see how this type of thing could be taken advantage of.

1) holding bible study at commanders call is NOT appropriate.

2) I am not worried about a Commander mentioning/addressing his troops with a religious overtone. I understand that is where he is coming from, and respect that it is that important to how he makes decsions, treats people etc. As a Christian man/woman, of course they would also believe/hope that all people believed as he/she does. But that is a far cry from what you are claiming. That he/she plans retribution if you do not repent and join them in praising the Lord. Now radical Islam will have you nuked and cooked if you do not convert.

This is a Christian country. The wonderful thing about that is that both our Constitution and Christian values PROTECT religious freedom. They walk hand in hand and DO NOT conflict with each other. They support each other.

3) I do not see the implied threat of a Commander saying "Praise Allah" or "Praise Jesus". I will see if there is a threat before I react to one that is not there. I have not, nor do I know of anyone who lost a job, promotion etc because they were not "Born Again, Bible believing Christians".

 

[bogatyr]

I think this guy's opinions on religion hurt his supposed main cause- the impending failure of military medicine. The fact is that 85% of the US population self-identifies as Christian, and while most of them might be sympathetic to his opinions on the state of medicine in the air force, most will immediately dismiss him as a quack and read no further when they encounter his paganism.

 

[USAFdoc]

I think this guy's opinions on religion hurt his supposed main cause- the impending failure of military medicine. The fact is that 85% of the US population self-identifies as Christian, and while most of them might be sympathetic to his opinions on the state of medicine in the air force, most will immediately dismiss him as a quack and read no further when they encounter his paganism.

good point.

principle in life; people will believe what they want to believe to a ceratain point. Peolple who do NOT want to believe military med has critical problems will look for some reason (religion, race, rhetoric, rank, etc) to dismiss the docs raising the issues, no matter if the are irrevelent or not to the basic issue.

for more insight speak to OJ Simpson.

 

[IgD]

Did you see his quotes page? http://www.medicalcorpse.com/fithexcerpt.html
It's pretty funny I've often thought of compiling something like this.

 

[Mirror Form]

This guy is pretty much FOS. Sure there is truth behind a some of his points, but he's greatly exagerating and dramatizing things. Obviously with a book to sell, he wants to stir up some publicity.

It's ******ed how he talks about how WRAMC is closing, yet fails to mention that an addition is being built onto the naval hospital, and that an entirely new hospital being built at Fort Belvoir. And I'd have to say that it makes sense to combine Wilford Hall with BAMC.

 

[ExNavyRad]

I think he hurts his credibility a little with his pagan / Zen buddhist schtick.

I mean, he's a Harvard-educated anesthesiologist, a man of science, and he converts from Baptist to paganism!? That's just....odd.

He also flirts with "BDS" (Bush Derangement Syndrome) with all the snarky comments about Bush and Halliburton.

It would've been fun to watch him in action, making the higher-ups squirm every chance he got, though...

ExNavyRad

 

[chopper]

This guy is pretty much FOS. Sure there is truth behind a some of his points, but he's greatly exagerating and dramatizing things. Obviously with a book to sell, he wants to stir up some publicity.

It's ******ed how he talks about how WRAMC is closing, yet fails to mention that an addition is being built onto the naval hospital, and that an entirely new hospital being built at Fort Belvoir. And I'd have to say that it makes sense to combine Wilford Hall with BAMC.

I agree. It sounds like he is one of those people who goes out of his way to piss people off, then sit on his high horse and poke jabs at people trying to get things done. Much different from someone who does try to actually make something happen in a difficult situation.

What do they say 'with friends like these, who needs enemies?'. If I was trying to make changes in milmed, I would want him about a million miles away from me.

 

[island doc]

You'll have to admit that reading his stuff is hilarious!

 

[deuist]

I remember seeing a flight commander at COT who wore a "What Would Jesus Do?" bracelet while in uniform. I thought that religious displays except for the yarmulka were forbidden.

 

[Galo]

WOW,

That website is totally awesome.

I think everybody needs to lay of the religion one way or the other. I do not think it detracts at all from him message that military medicine is dead. He has put a huge effort to document some of the stuff we have all gone through.

I also can't wait to read his book.

What suprises me the most is that idg placed the link for it. Did you take meds for a day??

 

[delicatefade]

What suprises me the most is that idg placed the link for it. Did you take meds for a day??

Seriously. We all know that you disagree with IgD. Does that mean you have to be an @ss??? I'd say that detracts from the credibility of YOUR mission.

 

[island doc]

WOW,

That website is totally awesome.

I think everybody needs to lay of the religion one way or the other. I do not think it detracts at all from him message that military medicine is dead. He has put a huge effort to document some of the stuff we have all gone through.

I also can't wait to read his book.

What suprises me the most is that idg placed the link for it. Did you take meds for a day??

No, I think that perhaps IgD may actually be starting to come to a knowledge of the truth and that his journey to the dark side may not be as complete as we had thought.

 

[Galo]

Seriously. We all know that you disagree with IgD. Does that mean you have to be an @ss??? I'd say that detracts from the credibility of YOUR mission.

Idg needs to be squashed till he can no longer spout his BS. That detracts from my mission. Loosely stated that it to educate people about what military medicine is truly like. NOT to allow some snot nosed greenhorn pass judgement on my or anybody elses honorable service and our collective experiences, and lie to people about what they should expect in todays military as a physician.

So no I don't think it detracts. But if you feel inclined to feel so, read others posts, and talk to active duty physicians.

 

[fozziewan]

I remember seeing a flight commander at COT who wore a "What Would Jesus Do?" bracelet while in uniform. I thought that religious displays except for the yarmulka were forbidden.

I had him as a Flt/CC this summer. Being prior-enlisted, I was wondering the same thing about his bracelet and a couple other non-issue items being worn by some of the other staff. C'est la vie...

 

[delicatefade]

Idg needs to be squashed till he can no longer spout his BS. That detracts from my mission. Loosely stated that it to educate people about what military medicine is truly like. NOT to allow some snot nosed greenhorn pass judgement on my or anybody elses honorable service and our collective experiences, and lie to people about what they should expect in todays military as a physician.

So no I don't think it detracts. But if you feel inclined to feel so, read others posts, and talk to active duty physicians.

I'm not saying you can't educate potential students about the realities of military medicine. What I am saying is that in general, the more you act like an @ss, regardless of what IgD says or how he says it, the less credible you look.

 

[pgg]

WOW,

That website is totally awesome.

Based on the site's design, I find myself wondering if his book will be published with yellow type on glossy magenta paper. Ow, my eyes ... my eyes ...

 

[delicatefade]

 

[HumptyDumptyMil]

Do people just not understand how difficult it is to make and arguement when they interlace it with so much personal opinion and bashing?

I understand that it is a personal website, but when the majority of the website is opinion and bashing of "inferior" nurses, he's going to lose some audiences.

 

[island doc]

Do people just not understand how difficult it is to make and arguement when they interlace it with so much personal opinion and bashing?

I understand that it is a personal website, but when the majority of the website is opinion and bashing of "inferior" nurses, he's going to lose some audiences.

Being a civilian med student (and you are still a civilian), you have no clue what it is like to be a military physician commanded by nurses who also have no clue.

 

[MedicalCorpse]

I understand the problem some may have with "Jesus" mentioned at Commanders call etc....................still, it seems like people are being a little too sensitive on this issue. Our money says "In God we trust", does that mean every athiest needs to be offended by that and sue for mental trauma?
No one should ever be forced to believe something, or threatened if they do not. At the same time, would those offended by the mentioning of Jesus be offended if somebody mentioned other topics in private or public.

We are all adults, and there is a difference between freedom of religion and freedom from religion.

O.K., I tried not to get into this. I tried to focus on medicine. I even edited my site today based on IgD's advice to tone down the extent to which I emphasized how the unconstitutional Christianization of the USAF contributed to my gutwrenching decision to leave after 19 years on active duty.

However...

Consider this from my perspective, USAF Doc. Your commander is a Pagan. A really, really commited Pagan. She sends out e-mail, via the NCOICs, insisting that the Squadron contribute canned goods for the Pagan holiday Beltane. She arranges to have fliers with pentagrams put up all over the hospital in celebration of Samhain...not Halloween...Samhain: the Pagan time of Remembrance of those who have died. She sets up a "Karmic Optimization Committee" to encourage her subordinates to do good deeds to gain positive karma for their next incarnation. Finally, at a commander's call, she casts a Wiccan circle and invokes the goddess Isis to protect our brave airmen as they serve overseas. How long would she keep her command?
How would you feel serving under her...if she wrote your OPR? If she insisted on having superiors talk about religion/spirituality with their subordinates during official feedback sessions?

Exactly.

Since 2001, starting with the nidus of infection at the USAFA, the entire body of the Air Force has been overwhelmed by the toxic bacteria of rabid, evangelizing, fire-and-brimstone Christians, who see fit to force ME to contribute for Christmas, who put Baby Jesus up on the walls of Andrews AFB hospital, who, as General officers, start "Spiritual Life Committees" as an official MILITARY committee of the hospital, and who routinely invoke God and, yes, Jesus in front of their subordinates. It only seems normal to *Christians*. For those of us who have been non-Christian for a long time (Jewish, Hindu, Sikh, Muslim, Atheist, and, yes, Pagan), the change in the USAF since Bush took office has been striking...and sickening.

Check out these links:

http://www.washingtonpost.com/wp-dyn/content/article/2006/07/15/AR2006071501032_pf.html

http://www.amazon.com/gp/product/03...ef=sr_1_12/102-8969624-2024962?_encoding=UTF8

http://atheism.about.com/b/a/257997.htm?nl=1

See: it's not just "kooky" and "spooky" Pagans like myself who have been subjected to inappropriate and unconstitutional intrusion of ONE religion into the USAF...Jews, atheists, agnostics, Muslims, and anyone NOT fundamentalist Christian feels the same...only Active Duty CANNOT speak out, and those who leave, well, probably try to forget their traumatic experiences (except Mikey Weinstein, who has been on national news on this topic, and with whom I have corresponded at length).

All we non-Christians ask is for the USAF to return to the doctrine promulgated by the Little Blue Book in 1997:

From the official Air Force Core Values handbook ("The Little Blue Book"), Jan 1997, page 5

Section 2: Excellence in All We Do / Subsection: Discipline and Self-Control/Religious Toleration (sic):

"Military professionals must remember that religious choice is a matter of individual conscience. Professionals, and especially commanders, must not take it upon themselves to change or coercively influence the religious views of subordinates"

I raised my right hand to support and defend the Constitution, including the Bill of Rights, foremost among which is my Right not to have the U.S. government establish an official religion. When the Commander of the USAFA leads the cadets in making the J for Jesus sign; when the AFMC Command Surgeon institutes "Spiritual Wellness Month (July 06)"-- there's something really wrong going on which must be stopped.

I am not taking down my page: http://www.medicalcorpse.com/oneUSAFunderJesus.html

Everything I wrote there is the truth. If people get "spooked" by it, sobeit.

I have, however, diminished the overt links from my news.html and index.html pages, so, if people don't use Google to look for the info, it is more likely that they will read my opinions about crappy military medical care, rather than General Germann's attempt to "exercise the spiritual biceps" of those trapped under his command, and to have my supervisors quiz me about my relationship with my Goddess, the Tao, and Emptiness.

--
Rob Jones, M.D.
http://www.medicalcorpse.com
Zen Buddhist since 1983
Pagan and Proud since 1985
http://www.notbob.com/pagan/

 

[MedicalCorpse]

This is a Christian country.

The United States of America is not, and never has been, a Christian
country. This fact has been documented in international treaties, which are the law of the land:

http://www.medicalcorpse.com/Notchristiannation.doc

To say otherwise reflects pure ignorance of our history as a nation.

The wonderful thing about that is that both our Constitution and Christian values PROTECT religious freedom. They walk hand in hand and DO NOT conflict with each other. They support each other.

Tell it to the Cathars...and the Huguenots...the Puritans...the Protestants under the early Stuarts and Queen Mary I...and the Catholics under Henry VIII (remember the Dissolution of the Monasteries?), Elizabeth I and her successors through the Hanoverians...the Catholics and Protestants who were my ancestors during the Thirty Years' War...not to mention the Jews under the Inquisition, those accused of witchcraft under the Inquistion (only a small fraction of which actually practiced the Craft; most were innocent victims of jealous rivals, etc.), or Muslims subjected to multiple rounds of Crusades throughout history. And I haven't left the 1700s yet...dare I mention the Catholic church's well-documented complicity in Hitler's Final Solution for the Jews? Arbeit Macht Frei, if that's the kind of Religious Freedom you mean.

USAF Doc, I agree with much of what you say outside of religion and history, but, man, please study your history books before coming out with these generalizations. Religious freedom protected by Christianity (snort). Show me where in the Christian Bible it states that religious freedom must be protected, rather than that is a Christian's duty to convert unbelievers to Him who is the ONLY "Way, the Truth, and the Light...no man cometh unto the Father but by me". (See, my father was and is a Baptist preacher, thus I know your Christian Bible backwards, forwards, and sideways, and partially in German, as well).

As long as otherwise highly educated people spout such nonsense ("Christian Nation"), there can be no understanding of the depth to which the commingling of religion with military service is nauseating to non-Evangelical Christians of all stripes.

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

 

[MedicalCorpse]

This guy is pretty much FOS. Sure there is truth behind a some of his points, but he's greatly exagerating and dramatizing things. Obviously with a book to sell, he wants to stir up some publicity.

It's ******ed how he talks about how WRAMC is closing, yet fails to mention that an addition is being built onto the naval hospital, and that an entirely new hospital being built at Fort Belvoir. And I'd have to say that it makes sense to combine Wilford Hall with BAMC.

One billion dollars of taxpayer money, and thousands of additional cars on Northern Virginia roads every day, just because D.C. voted for Kerry. They just finished building a state of the art rehab center for amputees at WRAMC...now it's being closed? Pure politics...and, if you knew anything about Beltway traffic, you would realize how impossible it will be for the sickest of the sick Andrews patients to make it around the Beltway EITHER to NHB or this new hospital, even with lights flashing and all. I'm a Prince George's County native, so don't even start with me about traffic...

I haven't even finished writing the book. I may never finish, at this rate.
I am not in it for the money. You should realize that, if you have read even one word I have written.

--
Nemo Me Impune Lacessit, Y'all.

 

[MedicalCorpse]

Based on the site's design, I find myself wondering if his book will be published with yellow type on glossy magenta paper. Ow, my eyes ... my eyes ...

I was thinking emerald on purple, but your idea is good too.

--
R

 

[notdeadyet]

This is a Christian country.

Ack. Do you consider America a "white" country as well?

 

[MedicalCorpse]

Ack. Do you consider America a "white" country as well?

My point exactly. I was coming back this evening to make just that point. The U.S. of A. is no more a "Christian Nation" than it is a "White Nation".

Moreover...

The majority of a population holding an opinion does not make it right. Need I point out the examples of Germany under Hitler, China under Mao, the Soviet Union under Stalin? Do I need to review the history of the Nazi Endeloesung, the Chinese Cultural Revolution, and the millions of Jews and others slaughtered under Stalin's pogroms? How about Rome under Nero?

By the way, if a person converts from paganism (say, a native African animist religion) to Christianity by virtue of listening to a missionary, is that "kooky" or "strange"? If not, why not? If I had converted from being Southern Baptist to Jewish, would that be strange? Oh, right, Judeochristian religions are O.K., because they are correct, but others like Wicca, Hinduism, Islam, etc., are "spooky", because a) most people know less than nothing about their true teachings and b) most people are so tied up in the religious Matrix of their own faith, that they can't see outside of its comforting cocoon, complete with anesthetizing electrodes and feeding tubes (for propaganda). I know, because I was caught in the Southern Baptist Matrix from birth to age 17, when I went away to college, and finally met people with radically different cultural backgrounds and worldviews from my own.

Again, I want to leave you folks with the following bottom line messages I am trying to communicate with my website (and books, if I ever get around to finishing them):

1) Military medicine is dead-- a victim of premeditated murder
2) Lack of retention of experienced clinicians is a major reason for #1
3) There are hundreds of reasons for #2; I gave 33 in a separate thread
4) One of the reasons, which I chose to redact at IgD's request, was the inappropriate, unconstitutional Christianization of what used to be a secular organization: the USAF
5) #4 is a major reason I left...but by no means the only one
6) I want military medicine to be fixed, to help support our warfighters, their families, and our honored retirees and their families
7) I also want religion yanked out of the USAF and made a personal matter between each service member, his Deity of Choice (if any), and the chaplain, if the service member wishes to utilize his/her services. The Commander should have no role in fostering, encouraging, or giving testimony about religion in front of his subordinates in his/her official role-- ever. The Little Blue Book of Air Force Core Values should trump the desire of certain individuals to proselytize others while on active duty.
8) Wanting number 7 should not detract from the message of number 6, any more than my saying I want our country to address global warming should "detract" from the message that I want our country to address our crime/budget/immigration issues in a rational fashion. Intelligent people can have more than one goal simultaneously.

Just to clarify: at one point, I used the word "ignorant". I did not intend this as a personal, ad hominem attack. Everyone on this message board is either a physician, a medical student, or (as I have found out) a CRNA or other "provider"; thus, everyone is intelligent and reasonably educated. Even the most intelligent and educated person can have areas of life about which they are ignorant. My areas of ignorance are manifold (music, sports, popular culture among the largest lacunae); world history, and, in particular, the history of religion, would not fall into that category.

Hope this clarifies my stance on these issues. Now, back to our regularly scheduled program, already in progress: How to Fix Military Medicine, and How to Convince College and Medical Students that Military Medicine, as of 2006, is broken to the point of mission failure.

--
Rob Jones, M.D.
webmaster_at_medicalcorpse_D0T_com
http://www.medicalcorpse.com

 

[Mirror Form]

One billion dollars of taxpayer money, and thousands of additional cars on Northern Virginia roads every day, just because D.C. voted for Kerry.

You should look at a map of that shows population densities of people who use the military medical system. There are tons that live south of the DC.

Therefore, it makes much more sense to have one large inpatient hospital down there, and one large inpatient hospital north of DC. The current configuration (i.e., two large inpatient hospitals next door) is pointless. The military's solution actually makes much more sense then 99% of military decisions.

And DC has ALWAYS voted democratic.

They just finished building a state of the art rehab center for amputees at WRAMC...now it's being closed?

Hopefully not, just b/c the hospital is being closed doesn't mean that every out-patient facility and function there will be torn down. It would still be reasonably close to the new Walter Reed. However, I wouldn't be that surprised if they were stupid enough to tear it down though.

Pure politics...and, if you knew anything about Beltway traffic, you would realize how impossible it will be for the sickest of the sick Andrews patients to make it around the Beltway EITHER to NHB or this new hospital, even with lights flashing and all. I'm a Prince George's County native, so don't even start with me about traffic...

Pure politics? Walter Reed's current location sucks and the Army has been waiting to move the heck out of there for awhile. And I'm familiar with the capital beltway. Although I'm not familiar with transporting unstable patients from Andrews to bethesda or WRAMC. What does that have to do with moving WRAMC? If a patient's unstable, they should be taken to the nearest ED (that's one of the few things tricare will pay for).

 

[MedicalCorpse]

You should look at a map of that shows population densities of people who use the military medical system. There are tons that live south of the DC.

And if you'd been reading the Washington Post every day the way I have for the past 6 years, you would know that N. Va. is already in gridlock; any additional traffic will just break the camel's back. The idea of replicating WRAMC at Ft. Belvoir is purely political...so the generals and admirals can walk off the golf courses of N. Va. with their MIs into a nearby facility...and to punish D.C. in a vindictive fashion. My wife went through WRAMC internship, and my three sons have received care there. It is still "state of the art" compared to most MTFs. And, as we all know, a hospital can have brand spanking new equipment and gleaming hallways; if it is staffed with demoralized, overworked, stress-out, underpaid, overdeployed docs, nurses, and techs, how much quality care will ensue?

Although I'm not familiar with transporting unstable patients from Andrews to bethesda or WRAMC. What does that have to do with moving WRAMC? If a patient's unstable, they should be taken to the nearest ED (that's one of the few things tricare will pay for).

Now we get to the point. In today's MilMed environment, Commands are given buckets of money by MAJCOMs to spend for health care. Every an enrolled beneficiary is sent downtown, you can hear the massive sucking sound of dollars being drained out of that bucket. Thus, starting around 1998 with the implementation of TRICARE, physicians on the wards, including especially surgeons and anesthesiologists, were under great pressure to avoid sending patients out. Even transfers to WRAMC or NHB from Andrews are done by AAA Transport (civilian), because there usually aren't enough bodies in the MGMC E.D. to spare for an ambulance run (if any of the ones on duty have the appropriate license). These civilian services cost the hospital money, and are frowned upon by the pencil pushing, bean counting MDG Command staff.

Here's an example: At Andrews, a patient was made to wait several days with a platelet count of 7000 (medical emergency), because the hospital was unwilling to pay the couple hundred bucks to the Red Cross for platelets. They made this poor patient wait, with constant threat of spontaneous intracranial hemorrhage and death, until NHB finally coughed up the platelets days later.

One of the key problems I document in my book (and website) is that clinicians on the ground are being second-guessed, overruled, and reprimanded by non-specialty trained (and, often, non-physician) administrators, when the competent clinicians advise transferring a patient out to a hospital with a higher level of care. There are several reasons for this sad phenomenon:

1) MRB: Maximum Resident Benefit. Buddy of mine was told that peds residents needed to care for more neuro cases, so he had to go kill a two year old posturing with increased ICP in the E.D. by depressing her respirations with propofol in the MRI scanner, just so the residents could get a little check mark on a training list. He refused, and got reprimanded; kid was transferred to UCSF, and did well.

2) Ego: Colonels get big woodies throwing around their command and SGH power. It's especially gratifying to make a board-certified subspecialist squirm, when you're not board-certified, and haven't touched a patient for years. Double woody when the Colonel is a non-physician.

3) Most Importantly: Money. Administrators try to browbeat clinicians to violate accepted standards of care by keeping patients "in house", thus avoiding all the money suckage out of their budgets when people go downtown for indicated care. Example: Non-intensivist internists told by SGH they had to cover intubated ICU patients for 24 hours prior to transfer elsewhere, even if internists did not feel comfortable doing so (e.g., hematologist, allergist, etc.). If patient died while in house...GREAT! Saves money, less filling.

Do I seem bitter about this topic?

--
Rob Jones, M.D.
http://www.medicalcorpse.com

 

[Mirror Form]

And if you'd been reading the Washington Post every day the way I have for the past 6 years, you would know that N. Va. is already in gridlock; any additional traffic will just break the camel's back. The idea of replicating WRAMC at Ft. Belvoir is purely political...so the generals and admirals can walk off the golf courses of N. Va. with their MIs into a nearby facility...and to punish D.C. in a vindictive fashion. My wife went through WRAMC internship, and my three sons have received care there. It is still "state of the art" compared to most MTFs. And, as we all know, a hospital can have brand spanking new equipment and gleaming hallways; if it is staffed with demoralized, overworked, stress-out, underpaid, overdeployed docs, nurses, and techs, how much quality care will ensue?

I don't know about traffic in VA being a reason to make patients who live there drive all they way from there to DC. Also, at least people who live too far away from north DC can now actually get care at Ft Belvoir (instead of not being able to find it with tricare).

And as far as punishing DC goes, it's not just about that. Why should we keep our major hospital in a location where one legged marines get mugged the second they walk outside? WRAMC's location sucks according to everyone, so moving it isn't a surprise.

Actually, I'm not sure if this is true or not . . . but I heard that in the seventies (when the "new" hospital was built), they were going to move WRAMC at that point, but were promised a subway stop by marion bary if they left the hospital in the district (this was before his credibility was established).

 

[MedicalCorpse]

I don't know about traffic in VA being a reason to make patients who live there drive all they way from there to DC. Also, at least people who live too far away from north DC can now actually get care at Ft Belvoir (instead of not being able to find it with tricare).

Well, time will tell if you are correct. I estimate about 10 years until the replacement hospital is capable of replicating WRAMC's current functionality (as opposed to when the new hospital has its ribbon cut, which is a different matter entirely).

The important part of my post was the latter 2/3rds. Patients who go to Andrews will be hosed, no matter what (north or south, they won't survive the ambulance trip). I guess I still (still) have a soft spot in my heart for Andrews: my Grandfather, a vet of WWII and Korea, who retired as SMSgt after 30 years, got excellent care at MGMC in the 1970s. I distinctly remember from visiting him that the chow hall was better then, too.

I also did my internship there, as my website states; the last 5 years of my service were spent there, but, by that time, it seemed (as others in a different thread have mentioned) more like a prison sentence than an uplifting opportunity to serve in defense of my country.

Peace out,

--
Rob