From: des@helix.nih.gov (David E. Scheim)
Subject: Re: "Incompetent [military] doctors"
Organization: NIH
Date: Mon, 14 Sep 1992 19:15:27 GMT

In article <1992Sep12.104412.6745@nmrdc1.nmrdc.nnmc.navy.mil> rdc45@nmrdc1.nmrdc.nnmc.navy.mil (Code-45 CDR Peter Kent) writes:

>In article <BALDWIN.92Sep10165448@csservera.scs.usna.navy.mil> baldwin@csservera.scs.usna.navy.mil (J.D. Baldwin) writes:
>>I've seen and heard first- and second-hand, but I can't let this pass
>>without stating that the stereotype--like most stereotypes--didn't 
>>happen by accident; there is a reason for it.
>>
>>As for military doctors, I don't know what the rate of incompetence
>>is, compared to private sector medicine (side note: is there any such
>>thing in America anymore?), but I can tell you that the accountability
>>for incompetence and malpractice that is provided by the right to sue,
>>licensing boards, professional organizations, etc., is completely
>>missing from the military.  Recourse for bad medical care?  "Speak to
>>the Patient Affairs Representative."  HAHAHAHAHAHA!  That's about the
>>sum total of what you can do.  
>>
>> Dr. Billig was the three-quarters-blind idiot cardiologist who
>>kept killing patients at Bethesda Naval Hospital a few years back.  I
>>don't remember how long it went on, but I do remember it wasn't
>>stopped until someone outside the USN Medical Corps noticed, and then
>>it became apparent that there was no way his superiors could not have
>>known about his incompetence all those years.  This is the culture I
>>am describing.

>     The state of affairs you refer to above may have existed at the time of
>the Billig incident, but I seriously doubt that it accurately describes the
>current status of quality assurance / accoutability.  The Billig affair was
>the impetus for a major change in procedures and policies to preclude
>repetitions.  All military hospitals open their doors and invite the Joint
>Commission for the Accreditation of Hospitals (JCAH) to inspect them.  Among
>the most important inspection criteria are policies and procedures to ensure
>quality review, accountability, etc.  I can't speak for the other services,
>but in the Navy, the Hospitals score better than their equivalent civilian
>facilities.  In addition, all Navy physicians are required to obtain and
>maintain civilian state licenses, which commonly requires proof of continuing
>medical education in order to qualify for license renewal.  Although that
>requirement obviously cannot ensure competance, it is anther way to ensure
>that quality standards are equivalent to the civilian sector.  I think that
>your characterization of the current state of military hospital competance
>is obsolete.

>Disclaimer:  The above is strictly personal opinion, and should NOT be 
>considered to be an official statement of policy on the part of either the
>US NAVY or the Department of Defense.   Peter
> 
>-- 
>CDR Peter Kent, MC, USN
>Program Manager, Combat Casualty Care
>Naval Medical Research and Development Command
>E-mail: rdc401@nmrdc1.nmrdc.nnmc.navy.mil

From my fortunately limited sampling of the military medical system over the 
past two decades, I've found things seem to have improved.  Early on, I had 
experiences of lost lab specimens, doctors in the GI department who knew 
nothing about gluten sensitivity, and other examples of incompetence.  Over 
the past five years, I've found the knowledge and personal skills of the 
physicians and the conduct of lab procedures to have been on a high level.  
This was at Walter Reed.

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