Posted on January 12, 2019 Updated on January 11, 2019
Here is an article about the cuts, also discussed in my POM20 post:
More Than 17,000 Uniformed Medical Jobs Eyed for Elimination
This entry was posted in Manning, POM20 and tagged Manning, POM20.
Wow. As if it wasn’t already hard enough to attract and retain quality CIV and Mil personnel. This article has the potential to spook not only the remaining medical staff but the patients as well. DHA needs to work with BUMED, MEDCOM and the USAF to quickly retake control of the narrative otherwise we can all start interviewing for our next CIV job. They seriously need to hurry up.
This^… They SERIOUSLY need to hurry up.
You make an excellent point, but I think that any attempt to control this process may have passed BUMED.
There have been several warning shots across the bow of the Navy Medicine in the past few years that have gone unheeded. Congress has legislated reform, and the line has asked us to get onboard with their vision for a more operational force, but we have stalled. DHA implementation has been delayed and delayed. Even in the DHA MTF’s very little has changed structurally: increased readiness means that there is now an extra UIC that the same people doing the same job fall under – that’s about it. From what I have seen, it looks like the non-operational specialties (Peds, Rads, OB/Gyn…) have lost about one GME spot per location per year. Promotions are still preferentially given to doctors who hold specialist, administrative, and training positions over operational billets. For most specialties, being operational is the price you pay by doing a GMO tour before you go into a non-operational career in GME or at the Big 3 Medical Centers.
It appears to me that BUMED has attempted to drag its feet on implementing structural changes (shutting down GME programs, making non-deploying specialties civilian, making promotions based on being operational, downgrading facilities from hospitals to ACC’s when they are not cost effective…) in hopes that this phase of “operational focus” will pass. When I saw these cuts announced, my first thought was that we had gone a bridge too far in blowing off our line bosses, and now we are going to pay. We didn’t put our house in order the way our bosses wanted, and now someone else will.
We should have listened last year when the Senate tried to get rid of BUMED – listened by implemnting structural change. We didn’t do it when we were still in charge of our own destiny, and now someone else will do it for us. It will be painful.
Talk about a horrible plan:
#1 The reason we were able to “Save” so many folks injured in combat in Afghanistan and Iraq is because of our medical capabilities. I am sorry, but you cant buy or even draft the right mix of qualified medical staff to accomplish this. Evidence: We couldn’t give away free medical scholarships to USUHS and HPSP in 2006 and 2007 – you think when WWIII occurs people will sign up? No way. Medical Drafts – “Watch MASH lately?”
#2 Contrary to what folks think , Military Treatment Facilities actually save the tax payers money in the long run. Yes, individual surgeries and other procedures may cost less when performed at some civilian facilities however it is clear that many surgeries and procedures were probably not needed or at least more conservative options – i.e. physical therapy, etc are often not attempted because there is a financial incentive to do surgery. This has been noted to be true in the field of dermatology where MOHS patients will have more skin removed (because more $$ can be billed) yet this is often unnecessary and doesn’t lead to better health care outcomes. ENT patients are more likely to have FESS Sinus surgery than needed (again skipping conservative options first). Tonsils and adenoids are more quickly removed than indicated. Thousands of patients are starting on unnecessary allergy shots by civilian allergists because they can get away with it. Once we give the checkbook to the civilian medical community we have lost all control over the costs.
#3 There is NO WAY that the civilian medical community can speak to fitness for duty. This is a critical issue. We disqualify hundreds of folks that we paid top dollar to train (pilots, submariners etc) because we rely on some outside physician who doesn’t get it! No you cant just carry an epipen and avoid shrimp on a Submarine ! No you cant go downrange with your psych medications and opiates. No you cant have insulin for your diabetes in theatre.
#4 Tricare health benefit will likely become worthless – Lets face it – it pays doctors peanuts – no one will take it. (Just look at how far your dental plan goes…and how far you need to drive to find someone with decent reviews that will accept it….) We can not play around with the healthcare benefit of anyone – especially our troops! This is a readiness issue.
#5 This country already has a physician shortage….well this is going to only add to that pain once we stop training hundreds of primary care physicians a year… This will effect every American – not just military families.
#6 You cant run a hospital with just ER, anesthesia and surgery – you need the complement of support staff to run a hospital.
Who do you think refers the patient with appendicitis to the surgeon? No its not a self referral. The cuts suggested are ridiculous in nature and do not allow for any MTF to continue normal business operations.
#7 Healthcare costs in this country continue to increase and yes although military medicine has gotten more expensive over time, it has not increased any where near the rate that we see on the civilian side.
Overall, the repercussions of this plan are unimaginable and will have dire consequences to those in and out of uniform, this country as a whole will feel the impact due to rising expenses,less health care providers, and returning to the days of our active duty dying on the battlefield. The DoD’s recruiting problems will only worsen now that you have alienated another segment of the population by telling their parents we aren’t going to have the right resources to care for their children should they enlist.
Hopefully enough folks will contact Congress and tell them to stop the madness for the future of our great nation and those who defend it.
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