Pros
Good salary, enough time to see patients usually
Cons
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.