This week, 9 officers were ordered to be reprimanded regarding Maj. Hassan, the murderous doctor at Ft. Hood. In January 2010, I wrote about
flaws in the Army Medical Residency Training, as well as about the lacksadaisical attitude that led to the keeping of Maj Hassan within the medical corps even though his performance was noted as poor starting his internship year. AMEDD (Army Medicine) repeatedly turned a blind eye to not only performance issues, but also increasingly erratic and beliefs that justified radical Islamic actions. It would seem there were no set standards being enforced by the senior physicians or leadership. The only standard they had was to "turn medical students to doctors" regardless whether or not they were fit.
This constituted a breach of public trust."The entire physician-patient relationship is based on trust. The decision to keep Hassan constituted a breach of public trust. It's imperative in any training program to cut undesirables out early. Anyone unable to make the grade is an uneasy prospect to imagine with patients either in the military or on the civilian side."
In other words, the decision not to cut someone who does not prove themselves worthy of the title "physician" has lasting ramifications for years. What they do each time they refuse to cut someone
is make a conscious decision to unleash a public menace onto unsuspecting and trusting patients not only in the Army, but also in the civilian sector --where the majority of the doctor's career will be played out.
There were plenty of other signs as well. Not only did the Army pay for his medical school, give him double a usual university resident's salary,
they also paid for him to get a Master's in Public Health. A classmate in 2007-08 reported:
Both men were getting a master's in public health at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, but Finnell says Hasan was always focused on another subject.
"He would frequently say that he was Muslim first and an American second. That came out in just about everything he did in the university," said Finnell. "We questioned how somebody could be an officer in the military and swear allegiance to the constitution to defend America against all enemies foreign and domestic and have that type of conflict."
In the case of Hassan, they didn't have to wait for him to enter the civilian world of medicine for disaster to strike. The disastrous results came to fruition during in processing at Ft. Hood in the Fall of 2009. He murdered and wounded professional colleagues all bound to provide medical care in Afghanistan. To date, he has been charged with 13 counts of premeditated murder and 32 counts of attempted murder.
Yesterday, it was announced that 9 officers were being reprimanded for leadership failures. It did not say whether or not the officers were from AMEDD. One can assume, given the long history of overlooking Hassan's faults, this is from where they come.
"The officers — all lieutenant or above — will receive punishments ranging from an oral reprimand to the far more serious written letter of censure that is considered a career-ender." --AP
As far as I'm concerned, they should all be fired. These guys will go out and find jobs in the civilian sector --no one needs to be concerned about their welfare. However, if their attitude remains lackadaisical, then pity the poor patient on the table.
"Whatever" was
the attitude exhibited by these officers. Either they're going to decide to change, or they ought to get out of the game because
the stakes in civilian medicine are high.One thing that isn't being written, although they may get a letter of censure ending their career,
these same doctors can be hired back by AMEDD as contracted physicians. They should
not be given this courtesy. A breach of the public trust has already occurred.
Do not insult the taxpayers by hiring them back. In addition, the
Army Surgeon General Eric Schoonmaker has been ordered "to review policies and procedures for training, counseling and evaluating medical officers." Schoonmaker should remember what I wrote in January 2010:
"Just because the military pays someone's tuition, shouldn't guarantee entry into or completion of internship or residency. To be a soldier/doctor is a very high order. If the medical student gets poor grades, or doesn't pass stringent reviews as an intern or resident, he or she should be cut --just as they would at the best training programs in the U.S. The money provided to them for their medical school tuition and living expenses would then convert to a loan. Just like their civilian counterparts."
In other words, it's more than just training a person to be a doctor. They're being entrusted by the public to adhere to very high standards. Every graduating medical student should also go through
The Match. More details on that in the post as well, and I hope he and his staff reads it. But as important, he needs to decide if we really need to keep pouring resources into training programs. My gut instinct is that we do not --especially if we're allowing them to treat it like a country club as Hassan did. We should let the universities and the other training programs train the doctors. The residents will come to us when and
if they complete their training.
I've seen health care go through many reincarnations in our 23 years in medicine. It's time for the Army to change as well --in
major ways. It is inevitable that military medicine will have to be smaller, work quicker, be more adaptable, and regularly fire the deadwood.