Military Doctors, What's Different From You And A Regular Doc?

serious military docks what are some interesting differences between military and civilian medicine army surgeons in early days of iraq got quoted in it saying major diff between military and civilian patients is the troops are in perfect health up until the moment they are injured in combat it makes for easy almost textbook perfect surgeries nobody has other chronic problems that would complicate matters other thing they mentioned was that if they requested medical equipment it was flown in 36 hours later no questions asked they'd never seen operating rooms with so much redundant equipment all of its state of the art but no need to delay for a few hours a medical procedure until a facility or piece of equipment was available medics learn a lot of stuff on the job that they would never be allowed to do on civilian streets suturing injections etc i'm vietnam era and rotated through several hospitals in germany doctors were happy to teach oh and i helped with several deliveries traditionally military dentists can work freaking voodoo magic with amalgam for dental work in the civilian world we just use resin composite the tooth colored stuff with a bonding agent the reason i say voodoo is that amalgam silver fillings don't actually bond to anything it's a held in with physical friction and structure you have to drill the tooth a certain way to make sure it doesn't fall out and i've seen some work on veterans that are over 20 years old and i have no idea how they made it stay in place in the first place i found the opposite i'm currently several thousand dollars into fixing the questionable dental work i was forced to get in the military they wanted to replace a couple of childhood fillings i had somehow i ended up needing surgery to repair my jaw four caps and two root canals there is no confidentiality or rather it is very limited if a patient tells you they use drugs or did something against regulations that impacts performance you're obligated to report it but it's more than that i haven't been on a military base for some time but back in the day it was common for people to check the online scheduling system via chcs to see which co-workers had appointments with certain doctors unlike epic there was no record kept of these searches so what would happen is a bottle clique at work would treat a person differently all of a sudden and it would be a sign that they checked chcs it's not fair but in the military being active duty and seeing a shrink is not viewed compassionately it led to a lot of resentment to us in the mental health clinics which i can totally understand we were trying to help but even stepping foot in our office would endanger their career to be fair administration would do what they could but ultimately changing the culture and the computer programs takes a lot of time and effort the patient population tends to be much younger and healthier the flip side is that they tend to be much more reckless so self-destructive behavior like smoking and engaging in risk-taking activities is rampant there also tend to be either massive over-utilizers or underutilizers of healthcare the over-utilizers go in for minor aches and pains because there's no co-pay and it will get them out of work or certain aspects of their duties they find undeservable the underutilizers are the young men and women who try and tough things out or fear consequences if they seek medical care so they tend to avoid docs another huge aspect of military medicine is the career implications you can impose on someone as a doctor in civilian practice there's little issue of giving someone a diagnosis however putting certain diagnosis in a servicemember's record can be a career killer imagine being in 17 years three years from retirement then some doc puts fibromyalgia in your chart and now all of a sudden you're being looked at for medical separation medical was underutilized on the ships i was on because the solution to anything wrong with you was to get put up in your rack for a day and drink lots of fluids so now you're stuck in your rack all day but you still feel like crap and nothing was actually done to solve the issue it depends on if you are in garrison on base in your home country or deployed in garrison medical procedures are rather complementary to civilian counterparts it is when you are deployed that you have a more carte blanche method of medicine i was a 20 year old corpsman doing chest tubes and pericardial synthesis pyricadiocentesis tyudochevok on marines and civilians in iraq with no doctor supervision however in those cases it is purely about stabilizing the patients so they can make it to the next level echelon of care as a former soldier who knew quite a few medics i'm going to just assume it was both when you find a person who you need to help according to military medicine they put check for massive bleedings first but in civilian medicine we check for clear airways first because in the civilian life the chances for having something down your throat is more likely than being shot and bleeding out i was the combat medic who did urgent care after the army the biggest change to me was demographic treating solely athletic young males can make you blind to sign symptoms and treatments that might be dangerous to people of more variant sex and age one example is you can cause neurological damage to an older person if you infuse them too quickly with an iv something to so with hypotonicity and damaging myelin which can be reduced in the elderly or that smaller people are more prone to air embolism from a quick and dirty ivy that would be harmless to a soldier medics are trained mostly to stop bleeding and trauma but you also pick up plenty of non-emergent stuff along the way working for pas and physicians most procedural stuff i got yelled at for doing wrong when i first moved to clinical from military i later found out from a former emt now physician wasn't wrong but more commonly seen by emts you do hire a former medic though because they are very versatile and usually can handle not only emt clinical and lab-based work but also the logistical stuff like supply and management because in the military all of those jobs are filled with medic oh except receptionist didn't know crap about how medical insurance worked when i first got out my dad was stationed in texas for his military service as an orthopedic he said every now and then someone from the special from the special forces would come in presumably from south america somewhere and he will drop everything to do surgery on them first there would be no paperwork whatsoever and then the person would be shipped back out also military doctors receive a heck of a lot more respect than civilian docs respect thing is probably bc when deployed you only got this one doc to help you while you can just go to another hospital in civil they're more protected from medical maltreatment or whatever it's called all private jamie can't sue the doc if stuff goes wrong interesting i work in the uk myself and rarely see malpractice suits although i hear it's much commoner in the private sector the thing is there are so many safeguards that doctors use to make sure they are on the right side of the law most of the ones on the news are just examples of gross negligence i'm not a doctor but i'm a career submariner the docs on u.s submarines are not actual doctors but independent juti corpsmen they attend a one-year school that's basically a crash course they learn two years or medical school in that year once the sub departs that e6 or e7 is the only guy capable of keeping the crew alive should something happen i've seen them do some amazing stuff they are truly the unsung heroes of the sub force i got told this by a friend who was submarine officer he said maybe put its best core men on subs with the fuckups getting assigned to the marines i'm a civilian emt but in the national guard i'm an mp in army basic they teach every pvt regardless of their mos how to do interventions like the needle chest decompression something myself and my colleagues are unable to legally do in the civilian world until we are at least paramedic level yep i was a clerk typist but i learned how to bandage a sucking chest wound and basic training i used to be a doc before transitioning to a civilian urgent care what acceptable levels of clean are when i got trained on ivs the doc teaching me literally held it in his mouth while situating everything the gloves are a good part of medicine too but it's more of a suggestion in the military also the amount of expired meds we carry around is ridiculous we very rarely get new stuff and so you're supposed to make it last in our defense though needles don't really get less sharp with age but still i watched a sergeant spit on an npa to jam it down a guy's nose yesterday in a civilian hospital i watched staff throw out a whole heap of meds because they were a day out of date your priority in a combat zone for triggers to figure out who can still shoot when you play someone with trauma to their lower limbs on a litter leave their arms unrestricted just because your legs don't work doesn't mean you can't fire their downrange my dad knew a dentist in the military who said it was boring as heck it was all young healthy men who already had any major problems fixed so he just ended up doing a lot of feelings he quit the military when he could just so he could do more interesting civilian cases medics also have a few specialties i was an army medic orthopedic specialist the scope of practice and experience is dependent on how knowledgeable and competent the surgeons feel you are on deployment it was essentially no holds bar as far as what what procedures we were allowed to do a benefit to no insurance or liability this included actual surgery on wounded and routine cases on active duty military personnel yes that is cutting and suturing under the watch of the surgeons it is a little hard for me to remember but as other people have stated we were definitely doing things that would only be done by a physician in the states you can have immense responsibility as a refi sergeant if you are up for the task that includes being responsible for ordering and fitting millions of dollars of equipment striker der oil casting supplies etc you can be the the casting clinical supervisor and when the orthopedic clinic supervisor goes on leave you're in charge of that as well other responsibilities can include key custodian msds book making sure everything is sanitary jcho compliance etc basically jobs that would be done by multiple people in the civilian world done by one soldier you can also side train and work with prosthetics physical therapy and occupational therapy to ensure the continuity of care the surgeons i worked with in the military were great including hospitals and clinics in germany walter reed and brook army medical center on a side note the va care i get is amazing frontline triggers backward from civilian life if someone with a broken pinky and another person with a sucking chest wound come through the door at the same time we're fixing the broken pinky first that way you can hand him his gun and send him back out the door to win the fight lest we all become casualties it's back to normal once you're away from combat but in the heat of battle the immediate concern is to get people back into action as soon as possible my dad was an ophthalmologist in the air force he mentioned how there was a big difference between the civilian practice and military mostly the culture of it all it was doctor last name not major last name as a military doc you're normally treated like a civilian more than any other officer and you get big bonuses for retention it's because it's more cost effective to pay bonuses to the less common medical specialties to stay in and work when they are paid 2 3x less than a civilian counterpart than to send patients off base and deal with trick-or-paperwork the payoff is the preparation though typically you come out of a commitment without school debt especially if you hit 20 years you can say things bluntly to your patients like look sucker of course you're not getting better because you're doing nothing i freaking told you to as some people have stated a major difference is that certain diagnosis can change your entire career however i personally never saw anyone's career ended by a diagnosis i saw many people unable to get a proper diagnosis because it would end their career i worked on a submarine and the nuclear weapons personnel and nuclear engineering personnel had some of the most strict medical requirements in the military additionally their communities were all critically undermanned fleet-wide the only treatment any of them ever received for anything not life-threatening was mega doses of ibuprofen fractures second-degree burns torn ligaments a panoply of dermatological problems here's a bucket of ibuprofen non-nuclear personnel with the same problems would receive much more thorough treatment and civilians with the same problems would receive much more thorough treatment i work in an impatient ward on a military base coming into the air force i had no idea we even had those i take care of older veterans i wipe butts help feed bathe and dress them i sometimes forget i'm even in the military since i only wear scrubs sometimes we get younger active duty patients but they are usually there to recover from surgery in the air force all of the enlisted medical technicians are emt certified yet they can work anywhere from a ward a clinic or front desk martrine and water cures everything in the us army headache drink water take martyrin sick drink lots of water take margarine twisted your ankle here's a bunch of martyrin now go drink some water gunshot wound apply martyrin directly to gsw and then pour water on top same for the navy marines on the emergency trauma side tourniquets are a huge no-no for civilians for medics and corpsmen a tourniquet is often the very first intervention wife was a military clinical doc and is now civilian in the military her department had eight doctors and two nurses sometimes one of the nurses would be deployed so there would be one nurse for eight doctors in civilian practice each doctor has their own nurse in the military rank was sometimes more important than ability she had occasions where a high-ranking patient would want someone else to see him since she was only a captain never mind that the colonel he ended up seeing spent most of his time doing administration and saw very few patients i think the biggest difference is that in military medicine people will come and for the smallest things stuff that they could handle on their own with just a little common sense and every time we say something about it it's always the same response why would i pay for it i'm only an e nothing i don't have money to spend on meds listen buddy if you can't buy four dollars worth of dayquil you seriously need to re-evaluate your budget we also couldn't just call in sick we had to go to medical army bh provider here having worked both in and out of the active duty hospital setting and field environment and done uninternships in the civilian world the biggest difference i'd say is accountability for quality of care in my opinion in the civilian world because of how insurance works your doctor has financial incentive to want you to like them you're a consumer you can theoretically take your money elsewhere in the military you get what you get don't like me too bad file a nice complaint to make yourself feel better unless i break the law or provide some type of an ethical treatment neither me nor my civilian counterparts are going anywhere other than the fact that i truly give a crap about my patients i have zero motivation to provide anything outside of the bare minimum of standard of care i want to do right by you you're the reason i come to work every day your hurt drives me to be better to do better and one day between meeting my army obligations and additional duties on top of the sheer number of patients i see in a day and the administrative bulls and sheer amount of time i spend writing an 18-page note in your medical record i might burn out and i hope to god that at that moment i have the insight to see that i'm starting to fail you and i do us both a favor and drop my refred packet or maybe i won't notice and i'll become that typical army provider you all are angry at having to come to see that pushes pills and says see you next month and you file that ice complaint that no one will actually give a crap about i could do whatever was deemed necessary to a military personnel civilian side i had a license and i could get a revoked find or possibly even go to prison if i performed an intervention that was not on my license even if it worked also military is habc army medic and now civilian nurse scope of practice is a big one in military medicine for the most part you can do what you know how to do so the scope gets pretty wide if you put work in and learn stuff in civilian medicine your scope is pretty strictly what your license certifications are as an army medic i could and did do ivs intubation ng tubes push all sorts of iv drugs etc in civilian medicine a ton of that is paramedic rn even md level so you can't touch it unless that's what you are mom having me in the air force saluted the doctor was in the hospital four weeks with preeclampsia and still had to get up every day and make her bed mean nurses mom having my sister after the air force everything done for her no making the bed nurses were nicer the only people that do good shoulder instability surgery are military orthopods and sports medicine fellowship trained surgeons my dad said he went from opening up people in shape to opening up obese people he said the military was much less work aha the scope of practice for non-doctor medical folks as a civilian i am only an emtb barely qualified to drive an ambulance as an army medic i have assisted in chest tube insertion and removal emergency trauma surgeries i can carry and administer major narcotics and basically anything that my medical practitioner says i can do the ability to operate fairly independently in the field is something you won't see as much outside of the military this probably won't even get seen but from a patient standpoint one difference i know of first hand is military docs pick and choose what they want their patients to know i took my husband to omaka while he was still active duty because he thought he was having a heart attack we find out it's a really bad anxiety attack after he gets an ekg and nothing is physically wrong with him fast forward three four years and i'm going through his medical documents after he has been discharged because he's now in heart failure and i find the ekg from that a visit clearly listed is the two heart diseases he's recently been diagnosed with by a civilian doctor in my husband's heart failure and even possibly his open-heart surgery could have been avoided if the army docs had told him what was going on and didn't put his body through so much physical and emotion stress that his heart couldn't handle he's now 100 disabled and doesn't trust doctors at all i worked labor and delivery early in my navy corpsman career now that i'm out i am no longer in medicine so this'll be a bit more of what i've heard about the civilian world of labor and delivery but i've seen posts about people getting charged for skin-to-skin contact after birth and other ridiculous things in the navy as long as everything was okay we encourage it i also really focused on getting the dad involved and making it a great experience memory for example helping me clean the newborn getting prints showing him how to make a newborn burrito etc to me it seems that we had a lot more freedom in the civilian world it seems that there are price tags attached to everything if you work civilian labor and delivery let me know if i'm wrong another thing i've experienced and i imagine is not acceptable in the civilian world is how we get to practice it wasn't uncommon to find a room full of corman practicing ivs or blood draws randomly docs and nurses also let us try things that were probably a bit outside our scope which was always awesome and helped us become more well-rounded i think the military patience we have also makes it easier to be allowed to practice and learn very rarely did i bring a new guy in and have a patient lose their mind and demand someone more experienced more often than not they either encourage the trainee or tease them with me as they were nervously trying to find a vein but as a purveyor of military medical services for the last 18 years and counting i can say almost for sure that military doctors care more about ensuring you can deploy than they do your actual health i literally have to lie my butt off symptom wise to get anything more than martyrin and to take a few days off from doing that thing that bothers you speech i could have cancer or who knows what else i will never know unless i see actual doctors if you are new to the channel you can subscribe i publish new videos every day until then check another video [Music] bye for now

Channel: UE Stories

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Keywords: military doctor, doctors, soldiers, field doctor, medicine, medical, nurses, war doctor, #updootst, updoot, reddit, r/askreddit, askreddit, ask reddit, r/, \r, r\, best of reddit, reddit stories, reddit story, top posts, funniest posts, funny, funny posts, funny reddit stories, funny askreddit, reddit funny, askreddit funny, askreddit stories, reddit stories 2019, people of reddit, sub, reddit cringe, memes, toadfilms, updoot everything, updoot reddit, story, stories, rslash, comedy, fresh

Id: _7dbtAM36fQ

Length: 22min 20sec (1340 seconds)

Published: Tue Dec 15 2020