Holaday Clinton R, Holaday Matthew S
Emergency Department, Carle Foundation Hospital, Urbana, USA.
Department of Health Sciences, University of Illinois College of Medicine Rockford, Rockford, USA.
Cureus. 2021 Dec 22;13(12):e20610. doi: 10.7759/cureus.20610. eCollection 2021 Dec.
United States Army healthcare has faced increasing criticism in recent years from its own active duty physicians. Internal surveys of active duty physicians demonstrate a lack of successful intervention in an annual exodus countered only by ongoing recruiting efforts. Anecdotal experience suggests much more widespread discontent due to numerous factors than has been reported publicly. This cross-sectional survey study of 94 active duty physicians paints a vivid picture of an organization in crisis: a majority of physicians planning to separate at the end of their obligation, leadership out of touch with the needs of physicians, and systematic deterioration of clinical skills. Subgroup analysis offers insight into why reforms are unlikely to come from within the medical corps. Prospective recruits are also provided the most comprehensive view yet of life as an active-duty Army physician with a majority reporting unmet expectations, a willingness to accept a financial debt in exchange for early separation, and a low likelihood to recommend participating in the current Army medical recruitment programs. Reorientation of recruiting efforts to focus on attending physicians is discussed to address core deficiencies with multiple downstream effects.
近年来，美国陆军医疗保健受到了来自其现役医生越来越多的批评。对现役医生的内部调查显示，在每年的人员流失方面缺乏成功的干预措施，只能通过持续的招募努力来应对。轶事经验表明，由于众多因素，不满情绪比公开报道的更为普遍。这项对94名现役医生的横断面调查研究描绘了一个处于危机中的组织的生动画面：大多数医生计划在服役期满后离职，领导层与医生的需求脱节，临床技能系统性下降。亚组分析有助于深入了解为何改革不太可能来自医疗军团内部。同时，这项研究也为未来的新兵提供了迄今为止对现役陆军医生生活最全面的看法，大多数人表示期望未得到满足，愿意接受经济债务以换取提前离职，并且不太可能推荐他人参加当前的陆军医疗招募计划。为解决核心缺陷并产生多重下游效应，讨论了将招募工作重新定位为专注于主治医生的问题。
