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A TOXIC culture of denigration of and discrimination against doctors, nurses and other health professionals exists in the Australian Defence Force (ADF) and it is driving away experienced medical officers after only short periods of service.
This damaging attitude has made recruitment of specialist service officers extremely difficult, despite priority recruiting campaigns aimed specifically at health professionals.
After years of making internal complaints about this attitude and its impact on health support for ADF troops without success I decided to speak out publicly, as I am obliged to do by virtue of my profession, to advocate for my patients’ health and well-being, even at personal cost.
In a letter to the Senate Standing Committee on Foreign Affairs, Defence and Trade, I outlined the genuine, critical problems in the ADF which merit attention.
As a serving medical officer in the Army Reserve, with the rank of captain, I have 10 years’ experience in the ADF, including a 4-month deployment to East Timor at the end of 2006 as an aero-medical evacuation doctor.
I have witnessed contempt displayed towards and poor treatment of specialist service officers by general service officers, which appears to be instilled at the Royal Military College, Duntroon and fostered in other training centres such as the Army Logistic Training Centre.
My experience at these training institutions is that health support specialists are barely tolerated and often denigrated.
This attitude is responsible for driving health support specialists out of the ADF to the point where the Australian Army now has a crisis and simply does not have enough people to provide care for deployed or garrisoned forces.
Most of the doctors in the Regular Army are junior and inexperienced, often just out of internship.
They do not have the experience necessary to support operations.
The proof of the severity of this crisis is that the ADF is no longer able to provide medical support for any of our deployed forces, and struggles to provide medical support to troops in Australia.
This inability to provide health support may also be the reason why Australia was not able to take over as the lead country of the NATO coalition in Orūzgān province in Afghanistan last August, despite the ADF’s dramatic reduction in operational commitments in Iraq.
The health support roles in the ADF cannot be filled by civilian contractors.
The fundamental difference between service and civilian medical personnel is that members of the ADF have been trained and equipped to defend themselves and their patients, and can be sent into a combat environment.
Civilian health contractors are not able to provide this support and are extremely expensive.
I estimate the cost of a civilian contractor at 10 to 20 times more expensive than equivalent uniformed health services.
The real bottom line is that Australian troops are being sent into combat and peace-keeping operations without appropriate health support.
The health officers that have stayed with the ADF are becoming more demoralised and further deskilled.
My concerns have been met with increasing hostility since 2007, and I have been inappropriately referred to a psychologist and charged with insubordination more than a dozen times in the past two years.
As I had exhausted avenues through which I could help the ADF address their worsening crisis in health support, I turned whistleblower.
All health support personnel are supportive of the ADF but we enlist for different experiences, not merely as an extension of a normal day at the surgery.
And we expect to be treated according to our education, ability and rank.
Dr Julian Fidge is a GP in Wangaratta and a medical officer in the Army Reserve.
Posted 17 January 2011
As a serving RAAF medical officer on fulltime uniformed service from 1997-2000 I did not encounter so much of a toxic culture towards me personally but towards health specialists in general. At one stage I was told in reply to a question I put in front of RAAF hospital colleagues to the Chief of Air Force himself that “The service hasn’t got enough money to keep a bunch of doctors happy so there’s no point trying”. This public disrespect made my nursing and medic colleagues ask themselves… if this is what they think of doctors, what must they think of us ? For less than the cost of an obsolete and useless Joint Strike Fighter, the RAAF could have had a military medical capability of which to boast, instead of the current situation in which deployable capability depends on the amateur enthusiasm of reservists and poorly experienced junior doctors.
The high wages paid to civilian doctors helps to maintain the deleterious culture. Those that do not speak out are rewarded with safety of their positions. Some of these doctors may not cope so well in private practice or the hospital settings for a variety of reasons. In Defence,some have found an extremely well paid job where they are left alone as long as they follow orders…. even when it may not be in the patient’s best interests.
In such a culture as Defence, the majority of personnel are too fearful to speak out. Meetings are called to order members to avoid certain people (ie, Dr. Fidge), not speak under certain circumstances and manipulative and deceptive messages that clearly are set up to keep members voiceless and under control.
The errors that Dr Fidge may (or may not) have made, should not be used against him, blown out of proportion or used out of context. Indeed, if Defence did have a culture of courage and honesty, it would be looking into the problem rather than a pro forma denying of complaints.
Unfortunately, Dr Julian Fidge’s observations are real. He is not crazy and his perceptions do not make him the one requiring psychiatric help. On the contrary, it would appear that Defence have either “sold out”, naively backed themselves into a corner or, have fallen into “Emperor’s New Clothes” denial.
A genuine investigation would require forensic investigators. The difficulty in working around the psychopathic or strongly narcissistic personality types that appear to thrive within this culture requires a different approach. Part of the “selling out” of those high in the hierarchy may be due to their lack of experience with these manipulatory personality types.
In reality however, Defence may be more talk than walk in this modern age. There is simply not enough substance (genuine fear from war, etc) to keep the masses honest. One only has to ask how many members are actually deployed into areas of danger (primarily army) and one sees that the majority are sitting in an office being paid to work on their promotion and status.