Conflict of Interest

The system is actually fairly decent by design it is the application of the regulations that gets problematic. Right now, with the war going on, the system is way over-taxed and people are cutting corners at the expense of soldiers. (Body Armor saved so many live that the death toll was far lower than initial estimates in Iraq. This lower death rate was coupled with an astoundingly higher wounded rate than anticipated, so now the medical system must pick-up a much larger patient load than they had prepared for.) Different individuals interpret regulations wording different ways. Policies at one hospital do not translate to other hospitals. The rank structure of the army can interfere when one doctor out-ranks another but the lower ranking doctor has better training and experience. When patients are referred to civilian doctors sometimes there are problems because the military just operates so differently than common civilian practice is used to.

The major overlying problem is a conflict of interest between the medical profession working inside the military profession. The doctors are charged with helping patients and are bonded by medical ethical standards. The army is only interested in treating soldiers until they can either return to duty or must be separated from service. What happens is that soldiers are lost in-between the two systems (military and medical) with little guidance and no one to really fight for their rights.
Ordinarily the soldier's chain of command would be the soldier's advocate, but once hurt, a soldier is treated completely differently. An injured soldier is a dormant asset. A fighting unit must choose whether or not to help the soldier heal or to push the soldier away in order to get a replacement (units are only allowed certain numbers of soldiers and must maintain certain strength levels). Fortunately there are Medical Hold Companies where the soldier is not a dormant asset to any specific unit but is in a holding pattern to either heal and return to duty or heal and leave the army. However, now the soldier's chain of command is too closely tied to the doctors. In our case (and the case of the others here) our "case manager" or patient advocate, works directly for the provider/administrator we're having problems with - now we have no voice. So, we go straight to the hospital commander.
Our whole situation is so fucking nuts that we have to explain it over and over again to everyone. When we start telling the story every listener assumes that we have dealt with rationally thinking/acting individuals who may have just made decisions that we disagree with. By the end of our second or third time explaining the circular logic of the hospital staff our audience usually loses any faith in the army medical system. I can't say I blame them.
Not every Medical Hold in the army may have these problems but I assure you the web pages of those hospitals are not going to advertise "abandon all hope ye who enter!"

There is little to no accountability of providers in this hospital. Military doctors must often choose between needs of the patient and needs of the army. As a professional, serving two masters must be incredibly difficult for doctors -- I do not envy their position at all. I have noticed a trend of doctors leaving the army in high numbers and not just to pursue higher paying practices. Budget constraints, which are a major factor in medical care, are not set by medical professionals but by politicians.

- Ragin' Ranger Out