My Experience in Government Medicine

When I was in orthopaedic training, I joined the Army Reserve. The Army supplemented my limited resident income and I assumed a 6 year reserve obligation to serve in the Reserve. Upon completion of my 5 year residency at Penn State University Hershey Medical Center and a subsequent 6 month fellowship in spine surgery at the University of Rochester, the Army posted me to a local hospital reserve unit intending for me to drill with the unit 1 weekend a month. Knowing that the Army could better utilize my training and skills for which they helped pay, I sent such a letter inquiring where they might better use the services of a board eligible newly trained orthopaedic and spine surgeon. Subsequently, I was assigned to the Dunham Medical Clinic at the Army War College in Carlisle, PA.

Once a month, I would leave my private practice in York and run an orthopaedic clinic at Dunham primarily seeing military retirees. Very quickly, I became aware of significant differences between my 2 practices. At Carlisle, I was taken aback by my patient schedule, being assigned 3 patients an hour for 3 hours, then an hour for comp time, an hour for lunch and then 2 more hours of patient visits in the afternoon. I quickly revised my schedule so I could see 50% more patients and still evaluate and implement an appropriate diagnostic and treatment plan.

Further, in York, I provided care to individuals from the York community; while at Dunham, I was seeing patients from a 150 or more mile radius. When I inquired of my patients why they travelled so far, I learned that otherwise they would likely be traveling just as far to Walter Reed Army Hospital in Washington for orthopaedic consultation where there was a many week wait for a non-urgent consult. My patients in York typically were seen within a week or so.

Finally, ordering advanced diagnostics or planning surgery within the military system proved to be difficult and untimely. In York, if I saw a patient who needed an MRI, that MRI could be obtained within a day or two. If surgery, were recommended that could occur within a week or two. In the military system, obtaining an MRI involved a couple month wait and surgery a several month wait for non-emergent problems.

At the time, I had 2 distinct thoughts about the practice differences. First, I felt that there would never be nationalization of our health system because people would not tolerate such slow delivery of care (now I recognize that nationalization could take place against the will of the majority). Even more, it struck me to be manifestly unfair that military retirees, men and woman who had served their country should have second rate care. In practice, uninsured patients in York enjoy more responsive care than those military retirees.

Again, there is no doubt that our healthcare system, which draws people from all over the world because of its premier status, would benefit from reform to decrease expenses and improve access; however there is no problem so bad that it can’t be made worse by doing the wrong thing. More government involvement in healthcare is the wrong thing.

We must all fight to prevent the wrong kind of healthcare reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and/or other free market based grass roots organizations.