US Navy reviews

Civilian physician input does not appear to be taken seriously, whereas active duty physician input seems more valued. Decisions about decisions that impact working conditions are made in a reactive rather than deliberative manner-for example, the Dept of Defense decided that it needed a new EHR without doing an end user needs assessment. Many physicians recommended implementation of an EHR that is used by many hospital systems in the US for many years. The DoD choose a less expensive system instead, and did not purchase certain components of the system-this led to none of the patient diagnoses, allergies, or medications being transferred from the old system to the new one-the end users are expected to enter this data themselves. The neonatal ICU was shut down for safety reasons because the medication and fluid orders were not calculated correctly by the EHR. All high risk pregnancies were diverted away from our medical center for several days. Physician complaints about reduced work efficiency and the potential for inaccuracies in the medical record are met with complex and time consuming “work-arounds” that ultimately lead to reduced patient access to psychiatric evaluation and treatment.

People who are scared of the unknown with separating, or who don't have the functional skills to survive civilian life, end up staying in, ranking up to a higher position, and ultimately becoming in charge of you, regardless of leadership skills. End result is many people in charge of you who make rules and policies to make themselves look good to their superiors, regardless of the suffering of their subordinates. Example: a potential high wind warning occurred, resulting in the upper chain of command wanting to leave that day. Before they left, they realized that they didn't deal with the rest of us; so they pulled an idea out of the hat to make everyone else stay 4 hours late, and have the oncoming crew not relieve until 4 hours late. No wind happened that day, just suffering. So why did they do it? Because it looked like they did something and didn't ignore the people who actually did work around the command. Covered themselves without regard to others.