Perhaps I can explain how a person gets involved with medical services in the first place.
Obviously we have to recruit people, so they go through a recruiting process. Somebody in fact asks them if they've had any problems. They get a medical done to determine whether they're fit--their knees or whatever--to come into the forces. I always ask the doctors, when I'm talking to them there, “What picture did they paint on the Thursday afternoon when they had their medical done? Did they want to paint a positive picture or a negative picture?” If a person goes in there and says they're fine, they can do this, they can do the whole job, they're good to go and everything else, the doctor has nothing more to go on. We don't have a little gizmo--like on the starship Enterprise or whatever--that can tell you whether or not someone's good to go. It's all to do with the experience of the clinician. It's all to do with how you gather the information. The most vital part is doing a good history, with enough time to talk to the patient and establish a doctor-patient relationship.
Now, all the doctors in uniform are understandably company doctors. When people come to see us, they understand that we work for their benefit but we're working on behalf of the Canadian Forces. So we're sort of company doctors. When a person comes to see us and says, “I have this back problem that's bothering me”, there's usually an expectation that they may not have to go to the field to train today or tomorrow. And this is anybody, not just in the military; anybody who goes expects they'll get an antibiotic for something or a consultation or something else.
If you get what you expect, you say “I had great service that exceeded my expectations.” If you don't get what you want, you say “That doctor, I'm not sure he really knows what he's doing.”
I'll give you an example. A doctor sees you and you expect antibiotics. But antibiotics may be the last thing you should get. You don't have a condition that requires an antibiotic. If you go there expecting one and you don't get one, you'll sit there and say, “Geez, he wasn't a very good doctor. He didn't even give me an antibiotic. He took an hour to tell me why I shouldn't have one.”
That doctor probably did the most appropriate thing for you. But doctors, as you know, don't have time to spend an hour explaining why they're not giving you an antibiotic when it's much easier to say, “Here you go, you have your antibiotic.” But in two days, when it's not working, you rush back and say, “That doctor wasn't very good. I need another antibiotic.”
Therein lies the difficulty. You have to understand that care is complex. When people say they didn't like their care provider, it's just like what happens to mothers when things don't work out for kids: they get blamed. The one person with probably the most aspects to try to help them gets blamed. And this is the case with the complexity of care delivery.