So I know you've made up your mind, but a few things
-I don't know if your husband saw a physician or a PA, NP, IDMT, IDC, random medic, etc. I've seen plenty of servicemembers, even officers, think that physicians in the military are some sort of commissioned medic, or that their junior line medic is the equivalent of a physician.
-Even if they saw a physician, in what setting? Level of training? etc.
-I'm not sure how a diagnosis of gout can come from what I assume to be neck pain? Maybe hand pain? I don't know any physician that would come to that association. But without seeing medical records I can't say.
-How long after the request for imaging did the "disc slip" all the way? A few days? A few months? A year? How many times did he go back and state it wasn't getting better? Or did he just grumble?
-Everyone wants imaging, from the lance corporal that passed out drunk in a weird position and now has back pain, to the 20 year helo pilot that may actually have pathology. The military is essentially an HMO. MRIs are a very limited resource, and most military hospitals are running their MRI almost 24/7 to keep up with demand.
-In the civilian world, you pay a decent chunk of change for an MRI, and there are a lot more private imaging centers that are happy to take your money and crank out as many MRIs as you want - regardless of what the evidence may suggest
-Most evidence suggests conservative management unless hard signs. Usually starting with PT. Because most pain is self limited. If he continued to have worsening symptoms, this would not have been consistent with gout (again this makes little sense), and should have prompted repeat visit and potentially trying a different doc.
-You yourself use the qualifier that "most" civilian doctors would have ordered imaging. Assuming that means you understand that not all would have? Yet unless your husband went to 3 physicians and at least 2 said no to imaging, you're assuming all military physicians (assuming he even saw a physician) and military medicine sucks, and/or most would not have?
There certainly are many problems in military medicine, as there is high rates of turnover among junior medics/corpsmen, nurses, and physicians, and there is always a constant need for training - whereas in most civilian facilities you have these people that are around for decades sometimes. There are also plenty of funding issues. Continuity of care as people are constantly moved around, or deployed. The DHA is trying to separate military medicine into focusing on being ready for war, and trimming down the MTFs while deferring a lot out to the civilian sectors. And there is no incentive to squeeze in patients as DHA doesn't really care if you do more.
