What is excellence in military medical care?

2015-05-09T09:48:49-04:00

When and where have you personally seen exceptional health care in the military, and what specifically made it stand out to you? It is easy to post gripes and complaints online, but explaining positive observations and experiences is much more helpful in moving our military healthcare network forward toward a new standard of excellence. How would you describe your positive experience in and unfiltered open - text forum like this (as opposed to being restricted to the format of a hospital/clinic survey)?

Response by Capt Private RallyPoint Member made May 9 at 2015 9:53 AM

2015-05-09T09:53:04-04:00

We have received excellent care at Offutt AFB. With medicare we are free to go elsewhere and may since we have moved further away. But. certainly not because the care is lacking.

Response by COL Vincent Stoneking made May 9 at 2015 11:04 AM

2015-05-09T11:04:42-04:00

So, for the first time in my adult life, I am get all of my care through the military system. In my case at Madigan at JBLM. There are things that I find mind-numbingly crazy and some that are rage inducing (Over the last few weeks, I've had to have blood drawn five times - though I review of my records and issues could have made that one trip, instead of five...).

That said, as long as you are OK with the HMO model, the treatment that I have received stands out in several very positive ways:
1. No cost to me. Seriously, no cost, no copay, have a nice day. The outside world doesn't work that way.
2. To give them their due, the people at the lab are quite good at drawing blood, not going hunting with the needle.
3. Fairly reasonable appointment timelines. In line with what I have seen in other HMO structures. (My civilian coverage was PPO, so it's slower than what I am used to, but not what I have seen my peers get.)
4. Excellent walk-in service.
5. Immediate access to specialty services. My PCM said that she wanted me to get a vision test as well as an EKG. I knocked out both before I left the building and in under 30 minutes.
6. Coherent electronic medical records. Civilian medical is all over the map on this.
7. Free and fast prescriptions. Compared to what I got in the civilian world, the MAMC pharmacy is out of this world.

I would say that most of my frustrations come from being more of the HMO model than the PPO model I prefer. But as a HMO, it freaking rocks. The remained of my frustrations were just becoming "part" of the system. According to the Army medical command, I was still a national guard Captain who was last seen in 2005. That took a while to work through.

My wife is on Tricare Standard/Prime. She still sees her same civilian doc. Co-pays are a bit less, prescriptions (if you don't use Express Scripts) are a bit more. Claim payment is FAST!! That isn't necessarily a big deal for us, except we generally don't get even one statement from a provider with an amount owing. It doesn't cover Chiropractic, which is a bit of a bummer. Deductibles and co-pays compare VERY favorably with private insurance (Due to my MOB status, there is no deductible, but the published deductibles still compare very well).

I honestly had a fair bit of angst about whether to keep my civilian insurance while on orders. On the one had, it was going to be in the neighborhood of $1000 out of pocket (not counting deductibles and co-pays) for something I could get for free from the Army. On the other hand, I remembered my experiences with the military medical system both as a military brat, and as a dependent of a retiree (being seen at Old Madigan). Six months in, I think I made the right choice.

I am also considering just putting us both on Tricare Reserve Select when I come off of orders. My civilian coverage is awesome, but I think Tricare has it beat, as long as we are in or near a fairly densely populated area.

Response by SPC Carl K. made May 9 at 2015 11:11 AM

2015-05-09T11:11:58-04:00

This is an easy one. The 121st Army hospital in Seoul, South Korea. In 2001, I almost lost my foot to amputation due to a combination of a bad sprain, over 12 fl. oz. of blood clot and almost died from a still unknown blood poisoning from the injury. I was a resident of the 121 for a month, and endured several surgeries and fought off the blood infection. The care I received was top-notch, and the nurses were all very supportive of me in my dire time of need. The orthopedic surgeon did indeed save my foot, and even though he was the recipient of some foul language on my part when he would stick the wooden swab all the way inside my foot trying to get blood cultures, he fully understood the sheer agony of that and held no ill will because of it. He talked me into taking my four month convalescent leave in-country and I am glad I did. A few months after I was discharged from the hospital, I went back to personally thank everyone for the superior care. I never got the quality of care in any hospital setting, whether it was civilian, military, or VA before or since this.

Response by MSgt Private RallyPoint Member made May 9 at 2015 12:19 PM

2015-05-09T12:19:22-04:00

In 2013 while visiting my son SSG Steven Borders at Ft Belvoir. I had to go to the base hospital for an uncontrollable bleeding nose. Fort Belvoir Community Hospital took very good care of me and was greatly surprised by their service and dedication to their patients.

Response by MAJ Robert (Bob) Petrarca made May 9 at 2015 12:34 PM

2015-05-09T12:34:39-04:00

Definitely not getting a pulmonary embolism while in a military hospital or leaving a military hospital with a colostomy in the wrong place both which happened to me.

Response by Col Private RallyPoint Member made May 10 at 2015 10:41 PM

2015-05-10T22:41:50-04:00

In my opinion, excellence in medical care is when we provide high quality care regardless of the circumstance. My first example may not be what you expected, but as a medic, I am charged to care for my patients regardless of who they are. In Iraq, I cared for an insurgent in our ICU. He had a bad infection from a gun shot wound when he attempted to jump on an Army convoy. While in the ICU, my coworkers, active duty Air Force nurses and medics, would make fun of him and slander him because they knew he couldn't understand them. I felt very strongly against what they were doing and reported them to the chief nurse. The behavior stopped immediately. That was a tough thing to deal with, but we were not there to judge.
My second example comes when I was a patient at 37 and had urgent open heart surgery at SAMMC in San Antonio. I chose an Army surgeon who came highly recommended. I had some life threatening complications after my surgery, and the surgeon sat in my room at night, until my wife arrived at 0100. Oh, and he did that after being in surgery all day long. To me, those are examples of excellence in medical care.