SURGEON GENERAL'S 
CONFERENCE - 
MAIN NAVY BUILDING 
WASHINGTON 26, O.C. 
c - •2 NOVEMBER 1949 • CONFERENCE OF THE SURGEON GENERAL 
WITH 
COMMANDERS OF MEDICAL CENTERS AND GENERAL HOSPITALS AND ARMY SURGEONS 
8-12 November 1949 
Colonel Tynes - Conference is now in session. Ladies and Gentlemen, 
The Surgeon General. 
Major General R, W, Bliss, The Surgeon General, Department of the 
Army, opened the conference with an address of welcome. 
Colonel Tynes - Our first speaker will be Lt, Colonel McGibony, Chief of 
the Hospitalization and Operations Branch, whose subject is a "Brief Resume 
of the Current Hospitalization Picture," 
Lt. Colonel McGibony ~ Lt. Colonel McGibony briefly discussed the present 
patient loads in the s'tation and general hospital systems. His discussion 
was illustrated by graphs showing patient loads in each general hospital 
with comparison of beds occupied to authorized beds. Similar charts were 
used to show the occupied bed load to authorized beds in station hospitals 
of each Army area. A final chart"illustrated that of the patient load at 
the present time. General and orthopedic surgery accounted for forty-six 
percent; general medicine for twenty-six percent; tuberculosis for six 
percent; closed ward NP for five percent; open ward NP for six percent; and 
all others eleven percent. Additional charts were used to show the com- 
parison of 1949 and 194-3 patient load and authorized beds in each of the 
general hospitals and each Army area. 
Colonel Tynes - All of you have been hearing vague rumors the last several 
months of radical changes at Valley Forge. He purposely delayed sending you 
any description of this experiment so we could have an opportunity first to 
1 
X see for ourselves how it was going to work and later to present it to you 
in some such discussion as we have here today, I am going to ask Colonel 
Gibbs, Executive Officer of the Medical Plans and Operations Division, to 
give you a brief statement as to what led up to this experiment. After that, 
Colonel Brewer will give you a brief talk on how he worked that experiment 
in his hospital. 
Colonel Gibbs - Gentlemen, the principal story will be told by Colonel Brewer. 
I would like to give you a picture of how we came to have such a plan and 
why we felt it necessary to test it. I think all of you will remember that 
at the beginning of World War II we had a type of hospital administration 
which was out of date. In recognition of these inadequacies the first 
significant steps were taken to realign the administrative setup of our 
hospitals; however, it was not until late in 194-5 that these steps were 
published in a manual, TI.I S-262, to the Medical Department.- By that time 
active combat was over and some of the administrative organization in this 
manual did not fit the new problems we had in our hospitals. In 194B we 
were confronted by curious contrast. The practice of medicine in the Army 
and the training of professional personnel was in every way at least equal 
to that found in civil medicine; however, hospital administration remained 
in the doldrums; in other words, in many respects it harked back to the 
horse-and-buggy days. Yet in modern business the United States had found 
by application of scientific principles of management in their business 
that they could save enormous sums of money and improve the efficiency of 
their organization. Then administration and management in the United States 
had made tremendous strides whereas in the Army it was not kept up to date; 
in other words, administration and management had not kept up with the 
development of our own medical service. In November 194 B, The Surgeon General set up in his office here, a group known as the Management Research 
Group. It was given the task of developing a plan of implementation by 
which our hospital administration could be streamlined and improved. 
Certain facts were recognized, that there was an acute shortage of doctors; 
that the doctors we had, had to be freed from administrative detail so 
that they might concentrate the maximum amount of their time on professional 
practice. ¥e needed to train additional able lay administrators who could 
relieve professional personnel of this administrative load. We needed to 
develop a rating system for administrative officers which would assist in 
selection for chief positions. We needed an administrative system which 
would enable the medical service to operate economically. A procedure and 
reporting system was needed to give us exact data on which to base our 
statement of requirements. It was not until the spring of 1949 that this 
plan was developed. This plan was developed through the help of the best 
ideas and some of the most talented personnel that could be brought in from 
the field. These ideas that were developed did not originate in the 
Surgeon General’s Office. I think whenever you are confronted with them, 
they ’.fill be very familiar to many of you. The plan, as it was developed, 
called for the development of a standard organizational form for all . 
medical facilities, for like medical facilities; standardization of proce- 
dures; development of aids to management, such as manning guides, work 
measurement standards, and cost accounting. Early in the game we felt that 
we had to head up this management research group with a well-trained manage- 
ment engineer,- a man who had> a formal education in management engineering 
and a man who had a practical experience in both business life and in the 
Army. We were fortunate at this stage to secure the services of Colonel 
George Schunior from the Logistics Division, who met all of these qualifi- cations. He now heads up our Management Research Group, Later in this 
program he vd.ll tell you something of the medium through which we hope to 
introduce these new systems into your hospitals. He felt that this plan 
should be tested in one of our General Hospitals before it was issued to 
field commanders. To this end we confronted Colonel Brewer at Valley Forge 
General Hospital with a proposition and he agreed to take over this test. 
He now vd.ll tell you about the plan which we presented, the many changes 
that he has found necessary to make and some of the problems that he has 
had in developing this test. 
Colonel Enewer - I was called down hero about the middle of June this year, 
this problem was presented, and 1 was asked to take it on at Valley Forge. 
Vie agreed* On 10 July we started the test and you '.dll see many of your 
own ideas in this plan. There has been a lot of discussion about it. Vie 
realised from the beginning that we must have individuals who were alert, 
young in mind, and interested in progress. They had to be individuals who 
would not stand up and say, "He can’t do it," but who would say, "How can 
we do it?" -iith the help of Colonel Schunior we started out. 'He looked 
over our old organization plan and charts with its various divisions and 
individuals. Oar main provlem was how to consolidate like functions. Vo 
looked at responsibility and activities. He decided that to begin with 
we would create a Deputy Commanding Officer, a professional man upon whom 
the Commanding Officer could roly to help him and take over his job if 
necessary. Looking into the career guidance plan we felt that we should 
put in an ESC or Administrative officer in this group and give those people 
something to plan for, so we created the job of Executive Officer. From 
some 22 divisions or sections we were able to cut down to 6 divisions. 
That, is a big change. To do this we had to have The Surgeon General’s Office cooperate with us to the fullest extent, and obtain for us the 
permission to deviate from all regulations, directives and what have you* 
As I said, the professional part that the Executive Officer used to 
have, vre placed on our Deputy Commanding Officer. He now heads up our Edu- 
cation Committee and took over a lot of the work that the Commanding Officer 
himself would do* The Executive Officer at the Administrative Officer then 
took over the responsibility or activity of hospital inspector, public 
information, the portion of the Adjutant’s job which had to do with strict 
administration. The Judge Advocate now reports to him, security and 
Inspector General functions are under him. You can see how that relieves 
the Commanding Officer. The Commanding Officer is only called upon then 
for decisions - high level decisions you might say - for the post, and has 
time to actually get out and see “what is going on. 
In order to run this thing we created a management office which is made 
up of 5 people. We have a management officer, manpower officer, fiscal 
officer, a secretary and one other individual. By creating these divisions 
we started with about 8 on the line and then we found out we could come down 
to 6. This chart was essentially correct by 3:00 p.m. on Friday and what 
has happened since then I don't know,' When I get back it may not be the 
same. That’s how fast things move. 
The './elfare Division, we decided should take over all that has to do 
with the welfare of the troops and the patients in the hospital. Your 
chaplain, exchange service. Red Gross, a portion of the convalescent services, 
and special services were all put in the welfare division and headed by one 
officer, we had a little trouble there-- the Chaplain did not like it, the 
\ 
Red Cross bucked a little - but we convinced those people. I say "we," 
Colonel Schunior at this level and I had the Army there. We have those people with us now. They looked it over, they are convinced it can be run, 
he are having no trouble whatsoever, I can assure you, and it is a coordinat- 
ing agency whereby one individual now can take care of your entire welfare 
activities, 
Vfe created a Personnel Division. Look at what we knocked out of the 
•organization chart: We took our Retiring Board, we took the Special Orders 
section of the Adjutant's office and gave then to Personnel (all your orders 
essentially are Personnel functions, movement of personnel or doing something 
with them)* we took a portion of Convalescent Services, part of the Registrar's 
section which had to do with records, and split the Personnel Division into 
3 parts, similarly as shown on here; we took a portion of Troop Command and 
Finance and put them all under Personnel. This resulted in a saving by 
consolidation of these divisions. We have already saved about 32 people, 
including several officers. It is operating more efficiently in many 
respects. It is brand new. This Division is just coming into play at the 
present time. 
Our Accounting and Statistical Division is made up of a portion of the 
old organization that had to do with funds, including appropriated funds, 
record keeping, supply, etc. This division is set up under one officer 
and various other individuals necessary to run it. We took our Fiscal and 
moved it there. We left budgets and budget preparation in Management, 
Here is the Food Service Division which is not hard to understand. 
• We took what was our old food service and mess administrator and made them 
into one food service division. It worked out very easily with no problem 
and again we made a saving. 
’vU/' We took our Supply Division then and said, "What can we do to consoli- 
date supplies?" We took the post engineer, the portion of his job that pertained to supplies and put him into the Supply Division, We took our 
old Supply Division which of course included Medical, Ordnance, Signal, 
and what have you, and moved that over into the Suoply Division, We took 
the supply of our troops and wo put it directly into the Supply Division, 
de have no unit supply anymore, clothing is issued direct from the Quarter- 
master, We took that portion of the Registrar that had to do with the 
supply of the patients in the hospital and we put it into the Supply Divi- 
sion, You can see this portion of the Supply Division that has had to do 
with your statistical and accounting section. The accounting goes over into 
the Accounting and Statistical Division. Then we took the Engineer, we 
left him feeling that he had a very definite staff level function and just 
relieved him of his statistical, accounting and supply, giving him time to 
really get out and get on the job on the post. 
You can see there has been very little on the professional line as 
yet. Our post medical inspector, our outpatient service and ov/r pharmacy 
service were put in the outpatient service. Some of you probably have that 
already. And then we took the tumor board, brought it down and. *iade the 
laboratory service responsible for it. I think that works in several 
hospitals already. 
I am not going to go into detail as Y have some other charts explaining 
these various consolidations that we have effected or combined divisions 
I should say, but would like to show you what we have accomplished as far as- 
Personnel savings go. In 'June when I was celled down here we were run;ling a 
ratio of operating personnel per 100 patients remaining of 160.6. At the 
end of July, we went down to 156.9* As of October, the last of October, we 
were 138.9* I think you can see that is a very definite saving. Our 
efficiency, I feel, has not fallen one bit. I feel in many instances it has 
7 been very definitely improved; we have a happier group of people; we have 
given them something to shoot at; we have given them responsibilities and 
we have taken away a lot of the little detail work that the higher up 
people used to do. Through this thing, unfortunately, because I cannot 
take credit for it, we were able to absorb our Cut with no difficulty. 
I think all you people got cut. ¥e got an 85 space cut, We were about 
ready to declare those people surplus at the time but in addition to that 
85 cut we have been able to get rid of 130 other people. Shortly we will 
declare 11 officers surplus. We have 6 or 7 now that we have already declared 
that we have no use for. And as I said, this is the plan and you are going 
to fuss about it, you are going to fight about it. I fussed. I felt bad 
when I saw the old DOP go out. I just couldn’t imagine the DOP going out. 
Yet we have no DOP anymore. It’s all part of the Personnel Division. Just 
one of the things I had neglected to mention to you, the Welfare Division 
took over all non-approprinted funds that pertain to the hospital and the 
post. Now one that wo have left off of here is the American Rod Cross in 
the Welfare Division but it goes under it at the present time in the, new 
setup. Put you remember your old funds you had, you had your Protestant 
Fund, your Catholic Fund, your Patients and Special Sundry Funds, you may 
have another name for it, Headquarters Fund, Post Trust Fund, Central Post 
Fund, all of your other typo funds, we took all of these funds and we created, 
which has been done in a couple of other the Post Treasurer. It 
moans that we have one fund now under that man. He took the individuals 
that were working in the Hospital Fund; as a result of this consolidation 
of funds with theirs, approximately 4 people have been saved. See the 
Welfare Division? life should have on here really the Red Cross too. It is 
working well too. A couple of you people have seen it. He keeps one ledger with a breakdown of the various ftnds; at the end of the day those things 
are totaled up and placed in the correct fund here and that is all there 
is to it. There is no trouble. We run up against no difficulty. Where we 
had all these large numbers of people, now we have one. We have 3 people 
in addition to him, they are going to take care of all these funds and 
comply v/ith all the regulations. The Chaplain objected to the loss of his 
fund, until we showed him that he would still be represented on the Council. 
how we would like questions, any type of questions that you have. 
We will try to answer them. We still have more ideas to apply. 
General Cole - In your organization do you have control of your Post Engineer 
activities and Quartermaster, etc,? How would you break this down on those 
posts where all those activities are under post command and are only farmed 
out to the hospital itself? We have several situations like that. 
Colonel Brewer - I won't say that it is going to depend on the Army, but when 
this is implemented at your hospital you will have people from the Surgeon 
General's Office who will come out and do their best to get it as near this 
standard chart as possible, but we will have to vary with the Armies., 
Generhl Cole - Practically all your utilities, your Engineer, Quartermaster, 
Finance and Signal, and now the Civilian Personnel are all handled through 
the Army, and that makes up a great part of your activities. Yet, you have 
a Signal Officer, is that right? Does he work out of the Army? 
Colonel Brewer - No, we do not have a Signal Officer. 
General Cole - You have no Signal Officer, Engineer or Quartermaster, the 
Finance Officer is loaned to you from the Army, and all your utilities work 
directly under the Army. The same thing is true at Brooke, and, of course. 
General Streit has the same with the Military District of Washington al- 
though you do have your own Engineer. Colonel Brewer - This is the man with the ideas, General, 
Lt. Colonel Schunior - Now you’ve put me on the spot. General, these pro- 
cedures have been developed for internal use at,the hospital. There are 
innumerable procedures that Colonel Brewer would not have time to mention 
here that the General Staff wants to implement at posts, camps and stations* 
Our supply procedure, for instance, is something that they have been looking 
to- for years. It gives them answers that they have not been able to get 
before so what it looks.like eventually will happen is that posts will adopt 
our supply procedure# However, whether they do or not, it will not affect 
your operation because we will just cut off wherever you picked up, in other 
words, entirely within hospitals. If you don’t have Engineer personnel 
chargeable to you, then you are not directly concerned with that, so neither 
are we. This is the framework of an organisation and cannot work under all 
conditions. It will have to be adjusted to suit the individual hospital. 
It can very well be applied to Army and Na*yy, and Fitzsimons where they 
are independent-type stations and where the commanding officer is also the 
post commander. 
Colonel Liston - My comment, or my query rather, refers to the lowest 
horizontal group of services there and the vertical that extends above them# 
I am a little confused as to where that vertical line should end. It now 
ends below the responsibilities of the Executive Officer whereas it is my 
belief that it should extend through to the base of the green line. Am I 
correct in that? 
Lt. Colonel Schunior - Yes, Colonel, it should go up through in showing your 
professional groups to the Deputy and Commanding Officer. 
General Noyes - Where did you put Cost Accounting? In Management or down in 
Accounting and Statistical? Lt. Colonel Schunior - In Accounting and Statistical. Your Fiscal Offi- 
cers have retained the budget preparation in Management, Your manpower 
i 
determinations and your specifications and workload studies are done in 
Management, 
Colonel Liston - The Fiscal Officer in my headquarters is also the Cost 
Accounting Officer* 
Lt. Colonel Schunior - That is the way it used to be here, but we have taken 
all of his people now and they go into the Accounting and Statistical Divi- 
sion, 
Colonel Liston - Is this where the budget comes from? 
Lt. Colonel Schunior - This will be supervised by another officer. The raw 
statistics are furnished by the Accounting and Statistical Division and the 
analysis and interpretation are made in the Management Office, 
Colonel Liston - Where is your Hospital Fund? 
Lt. Colonel Schunior - It comes under the Welfare Division and under the 
Post Treasurer. I know Army and Navy General Hospital has had a similar 
setup and I think that Percy Jones General Hospital has it. Fitzsimons 
General Hospital has one too, and it has worked very satisfactorily. 
General Streit - Will you explain a little something more about the Manage- 
ment Office in its relation to the organization? 
Colonel Brewer - Well, this Management Office is a group of people who study 
the problems that are presented to the hospital. They study workloads, ward 
personnel, where personnel can be most efficiently used and also the money 
that is necessary to adequately run your hospital and maintain the level that 
has to be set up, that is to say, within The Surgeon General's standards, 
as a group of individuals they do not make policies, they merely recommend 
to the Commanding Officer changes whereby the efficiency of your hospital can be improved and your cost can be kept down to a .minimum. 
General Cole - Yftiat is the difference between the-Management Office as you 
have it and the old Control Office? 
Colonel Brower ~ In some places the control officer did merely manpower 
studies, at other places ho did have both the manpower studies and workload, 
that is, working efficiency setups, except here at Valley Forge. IJhen we 
took it over he was merely an individual who went out and studied the 
personnel situation as it existed there and made recommendations as to what 
to do to utilize personnel. The Management Office is better than that in 
that it has to do also with your budget and personnel utilization. 
General Streit - vftiat has been required,of a medical center? v/hat duplica- 
tion will be necessary in a medical center? Because a lot of these activi- 
ties are in the center level rather than the hospital level. 
Lt. Colonel Schunior - This will have to be modified and changed for a 
center level and I think that probably General Streit is going to have a 
few gray hairs on that. Tie realize that it does not apply to him on a 
* 
center level. 
General Streit - I would like to know a little something more about where 
these savings in personnel have been made. I would like to know just 
what people are being saved in this operation, because as it is we have the 
divisions of operation and administration that we formerly had, only 
juggled together in a little different style. 
Colonel Brewer - By combining these various divisions and sections we have 
been able to keep people comfortably busy for eight hours a day now, 
assuming sometimes some people were busy and sometimes other people were 
not busy. But in the Accounting and Statistical Division, by combining 
the various people in the post engineer’s, those in supply, those in the fiscal and personnel divisions that had to do with statistics, nodical 
records, etc., we have saved three enlisted and 9 civilians. The,organi- 
zation of the Welfare Division has resulted in the saving of three en- 
listed and one civilian. In the IIP Service we have been able to get rid of 
one officer, 25 enlisted and 44 civilians and that included part of our 
cut of 85, so I would like to say again, that instead of 195, we can.only 
take actual credit for about 125 of these people. In our Supply Division 
we arc saving 2 officers, 5 enlisted and 3 civilians so far. There are a. 
couple of minor reductions, one here and one there, but I think that you can 
see that question right there. The cut will be a part of the cut in our 
N? Section where we had to cut down admittance back in the early part of the 
year. 
General Stre.it - I understand you are using IBM machines in this operation. 
Would you give us a little explanation as to how much of this saving is due 
to machines and how much to the organization? 
Colonel Brewer - Well, I would say it is about fifty-fifty. Maybe 60-40. 
You have to give the machines credit, there is no doubt about it. But I 
think that when we first started out we gave more credit to the machines 
than is actually due because this -combining people to take over the 
similar-type jobs has very definitely resulted in savings where the 
machines are not applicable. For instance, in the Post Treasury he does not 
use the machines. But the machines are a very definite element and with 
these machines you can do just unheard of things. 
General Gaines - I believe your cost went pretty high for the last quarter 
of the last fiscal year. Is that in connection with this study or are you 
going to show any money as well as personnel savings here? Colonel Brewer - There -.dll be a money and a personnel saving, I do not 
have the money saving as yet. This section is relatively new right here. 
This has been changed twice in its development, as I told you, in combining 
these various jobs and we cannot say definitely that everything is going to 
work in this division at the present time. 
General .Roberts - I don’t see a Registrar, where is he? 
Colonel Brower - There is no Registrar, Sir. He comes under Unit Personnel. 
Hers is one thing that is progressing'ahead very nicely. The Supply. Divi- 
sion, where we have changed our requisitioning procedure. We are working 
out a punchcard system now whereby we probably will be able to eliminate 
requisitions, in that cards will go to the depots instead ox our people 
having to prepare long requisitions. A card can go right into the depot, 
it can be put on an issue slip and then issued right from the card. Think 
of the time that is spent every year in the preparation of requisitions. 
Your keeping your card on each item up daily, you know what you have, you 
set up your stock levels, 90 day, 120 day, or what have you. ’.Then you 
reach a certain place you can send your cards on to the depot and they in 
* # - 
turn can put them on their IBM machine and the machine will know what is 
necessary to bring them back to your level and then can be put on an issue 
slip which comes back to you. 
Colonel Liston - Is this Armed Forces Radio that you have on the chart of 
the new, organization of the Welfare Division your hospital programing 
system? 
Colonel Brewer - Yes. 
Colonel Liston - There are no other elements in there? 
Colonel Brewer - None that I can think of. Colonel Raff - General Cole, has the setup in your hospital of a Chief of 
Professional Services resulted in any savings in your individual offices? 
General Cole - I don’t think you can cite any particular personnel, but it 
has done this; It keeps all professional activities under one head so that 
the person who is responsible for the professional service and the conduct 
of that service in the hospital is cognisant at all times of what is going 
on, on all the professional services. In other words, he is the coordinator 
of all the professional, services: medical, laboratory. X-ray, surgical, 
orthopedic, and any other services which might be established in the hospital. 
He coordinates those and coordinates meetings so that if one service calls 
for a meeting of a certain type, why, he perhaps is having a meeting of that 
type in another service and he can coordinate this so that they are not 
jumping off at tangents all the time. As far as any actual saving of per- 
sonnel is concerned, I don’t think there is any. 
Colonel Liston - Colonel Brewer, does that responsibility of Chief of Pro- 
fessional Service rest with your Deputy Commander in your setup? 
Colonel Brewer - We cut it out. I will not say it is not practicable, but 
we have not applied ourselves very much to the professional services. 
Whether this man will eventually bu the Chief of Professional Services we 
don’t know. 
Colonel Liston - Do you have a separate Office of Chief of Professional 
Service ? 
Colonel Brewer - We have not bothered with the professional services other 
than to consolidate pharmacy, the Post Medical Inspector and the Tumor 
Board under the various services. 
Colonel Liston - General Cole, is the Deputy Commander a professional 
officer? General Colo - He is. 1 
Colonel Liston - Does he have any other duties to perform other than being 
assistant c ommandant ? 
General Cole - He has the entire professional training program. 
Colonel Welch - Colonel Brewer, vail you clarify the relationship between 
the Fiscal Section of the management Division and the Accounting and 
Statistical Division and the Disbursing activities? 
Colonel Brewer - The Finance Officer is under the Personnel Section. He is 
part of the Personnel Division. Your Fiscal Officer is part of the Manage- 
ment Office, has to do with your budget preparation and the maintaining, 
as Colonel Schunior said, of the information necessary for your cost ac- 
counting reports from the Statistical and Accounting Division, They are 
two separate people. 
Colonel Welch - Does the Fiscal Officer prepare the cost accounting reports? 
Colonel Brewer - All of the necessary data that he wants for any of his 
reports are obtained•from this section through the machine. 
Colonel Vielch - Isn't it anticipated that the cost accounting system of the 
hospital will be merged with that of the engineer service for the post, 
which are quite different? 
Colonel Brewer - It is all merged. 
Colonel Vfelch - But they will still have to keep their various required 
records for engineer activities, for medical supply activites, and the 
various others. May I ask also whether the Post Treasurer is responsible 
to one council? 
Colonel Brewer - Ho, sir. That is a disputed question and nothing has been 
done about it at the present time. Lt. Colonel Schunior - General Streit brought up a point here which I 
think we should emphasize at this time,'and that is - how much are we 
able to do by machine? There are two very important factors in this re- 
■ organization. One is the training of officers and people. The other is 
the proper utilization of these machines, I wish that it could have been 
possible to have given you a demonstration* but I think you are going to 
be extended invitations to Valley Forge so that you can see the rapidity 
with which medical statistics, civilian payrolls, supply accounting, and 
cost accounting are now' compiled, X think you are trying to visualize the 
operation as you have seen it. Also there is some doubt in your minds as 
to why you should have a personnel authorization officer, a fiscal officer, 
and a management officer. In some of your hospitals that will not be 
necessary. One officer can perform the three functions, provided that 
officer is trained in the three functions. If he has had personnel work, 
if he has had fiscal work, if he has had methods work, then you can use 
only one. Here we are having to use three because the previous training 
program of the Medical Service Corps officers was such that we did not 
have the right individual for the job. The machines $3finitely make it 
possible for us to have this kind of an organization. There are many 
things that we have done which do not involve saving of personnel, but it 
involves added service to the hospital. For instance, we do not let ward 
attendants go on any messenger errands of any type. The Supply Division 
instead of maintaining supply records now delivers supplies to the wards. 
The linen people deliver linens. Food carts are delivered. Everything 
that the ward requires is delivered right to the door, so that your ward 
attendants are within the ward at all' times. Those are some of the things 
that mil not reflect themselves in a statement of savings, and in most cases they have been made possible by the machines and by this Accounting 
Division which you see here. This Accounting Division will be concerned 
■vfith anything that has to do with mechanics of accounting - keeping books - 
no policy. They will prepare civilian payrolls. You will be astounded 
when you see what a simple proposition it is for you to get not only 
supplies, but studies on the utilization of supplies - the usage, demand, 
and cost of supplies. As I told you before, there arc many things over 
which we have no control in the Surgeon General's Office, which are directed, 
and we have to do. We would have to go through a very laborious process 
if you had to submit a monthly report on the value of your inventory 
which now will be done mechanically at any time and you can come up with 
both answers. How much in quantity; how much in dollars, llaybe those 
remarks will have explained the function of this division a little better, 
and your question, General Streit. 
Colonel Brower - About the Personnel Division. It has taken over in the 
civilian branches; it remains the civilian branch under the new setup. The 
military branch takes up your finance Division, pay of troops, patients, the 
special orders section that came out of the Adjutant's Office, the A & D 
office, the hedical Records Section, the old military branch, and your patient 
personnel section - all owent in under the military Branch. They are in the 
Finance Branch now, created within the Personnel Division. Your Troop 
Command Branch took over the job of your old Detachment Commander, your CO, 
DOP, and the clothing and baggage section of your DOP, Your Training Branch, 
which has to handle enlisted personnel only. I & E goes over into the 
Training Branch of the Personnel Section. 
General Gaines - How much physical change did you make in the hospital,for 
instance, your patients' clothing, your other supply, Unit Supply, and so on? Colonel Brewer - Unit Supply we don't have any more. Patients and enlisted 
people draw direct from Quartermaster. The* Detachment submits what they 
want to the Quartermaster - they go over there and obtain their supplies 
right there; their uniforms, or whatever they happen to have. Vie had to 
build a new fitting room over the Quartermaster section. Our patients 1 
clothing room stays in the same room as the A & D Office. 
General Gaines - So this is a paper consolidation. 
Colonel Brewer - Some places we are going to be able to adapt this better 
than others. But we have in this Personnel Division, we have civilian 
branch, military branch, the Troop Command, and the Training, all in one 
section - in one building now. Finance is definitely separated. 
General Qffutt - The Troop Command Branch is within the Personnel Division. 
Does that mean you have separated your actual commanding officer of the 
troops from the troops? 
Colonel Brewer - No, sir. He is not separated from the troops at all. 
But it so happens that all of burs are. Our Personnel Division sits right 
next to our Detachment. So he is there, except that he has assumed the 
responsibility of the old DOP command. He has all troops, whether it be 
detachment, patients, or medical detachment. 
General Qffutt - The physical setup is not questioned. The Troop Commander 
could sit in with the Personnel Office, 
Colonel Brewer - Even mine does not sit in my Personnel Office,' sir. Except 
now, all of the work that he used to do that pertains to records, and 
otherwise, is all handled in this division. He is with his troops. He 
comes in constant contact with them out ‘of the hospital, in the hospital 
and can see his people, and;all the’paper work he used to have to do - his 
Morning Reports, and the rest of those things are done here. Colonel Lehman - Colonel, I don’t see any brackets for Military Police and 
Provost Marshal, Explain that, please. 
Colonel Brewer - The security as you noticed up here, which has to do with 
your Military Police section, goes under the administration of the Executive 
Officer, 
Colonel Lehman - Have you abolished the position of Adjutant? 
Colonel Brewer - Yes and no. The Adjutant came down and is to become the 
Assistant Director of Personnel. But we have to maintain that will be his 
primary duty; the secondary duty will be Adjutant. Only for the reason 
that Army Regulations are so cluttered with the fact that the Adjutant this, 
and the Adjutant that, and the Adjutant has to authenticate orders - we 
cannot do away with the Adjutant until we can get that changed, and I doubt 
if we can ever go that far. 
Colone1 Lehman - One more question, I see the Personnel Division is built 
up until it is going to take a good man to handle it. 
Colo no 1 B r oi .rer - Right, You’ve got to have a very alert, active individual 
who really is a fire-ball. He really has to be a fire-ball, 
Lt. Colonel Schunior - Tie left out one point there. Tic have tried to 
organize the services as a team. Each chief of professional services has 
an administrative assistant, who is the Administrative Officer. That 
officer is primarily three things. He is an Assistant Detachment of 
Patients Commander, so that you can take the service closer to the patient. 
He sees ’about passes and minor disciplinary problems and things like that. 
He is an assistant property officer to assist him with property; he has 
charge of all the property on the service. He is an assistant station 
complement commander, so that you haven’t actually removed the station 
complement from the individual soldier; you have taken it a little closer 
20 to him. The nurses and these administrative assistants work out the 
assignment of personnel between the wards. The Management Office makes 
a 117 adjustments between services as are indicated. 
General Cole - What have you done with the Custodial Branch? 
Colonel Brewer - The Custodial Branch comes under the Supply Service. 
Me have under the Supply Division created a service branch, and that branch, 
as Colonel Schunior mentioned a little while ago, your laundry delivery and 
pick-up, your custodial service, and picking up drugs at your pharmacy - 
all those things that are delivered to the ward - ice delivery to the ward, 
all of these come under this one section - the Service Section of the 
Supply Branch. All of your nodical supplies are delivered. On the delivery 
of the laundry alone, we figure wo have saved a minimum of 95 man-hours per 
week. 
General Gaines - Who heads up your food service? Hat type of officer do 
you plan to use there? 
Colonel Brewer - Dietitian. She vdll be in charge of the entire food 
service program. 
Lt. Colonel McGibony - One point there. General Gaines. Hen I came back 
originally, that point was brought up. I was 'wondering what would happen 
to the L1SC officer we had who was filling the jobs. Personnel people state 
that that has been taken out of the career pattern of MSC officers, so they 
% 
will gradually fade out of the picture and Warrant Officers will go in as 
Assistant to the Dietitian. 
Colonel Liston - Under Circular 64, certain responsibilities of the Class II 
installations are the responsibilities of Amy and others are the responsibil- 
ity of Tech service. Does this new setup which mixes those rather freely in 
any way interfere with the wording of Circular 64? I ask this question because in our office we are presently working over that circular. 
Lt. Colonel Schunior - 1 think it does to some extent. There is a new 
circular being written now. 
Colonel Liston —Yes, I have it on my desk at the present time. 
Lt. Colonel Schunior - he ’ll have to back—track wherever that interferes 
until such time as those things can be coordinated on a Logistics division 
level - such as your motor pool, We will not be able to touch that, A 
while ago. Colonel Jolch brought up another ooint on the Engineers cost 
accounting. We are not changing that system of cost accounting at all. 
It stays as is. The thing we are trying to change is the means by which 
we compile the data which the Engineers give. Colonel Brewer has at Valley 
Forge about A or 5 people under the old system who were doing nothing but 
compiling statistics for the Chief of Engineers, how that personnel is 
chargeable to your hospital operation, but what we would like to do is to 
eliminate the cost work to the Engineers for maintaining a separate pay- 
roll from what the fiscal officer maintained. V/hat we are trying to 
maintain is one payroll and from that one make the proper distributions. 
We 'will not conflict with Circular 6A* 'whatever we do, we will have to 
back up until the Logistics Division can have its say either way. However, 
for the period of this test, we do have the authority to deviate from 
these things to see.if they arc practical and will result in something 
better than what we have at the present time. 
Colonel Liston - Has any attempt been made to coordinate the Engineers 
cost accounting system with the hospital cost accounting system? 
Lt. Colonel Schunior - Now,they are so far apart that you cannot get them 
together. We have just put them all in this one statistical accounting 
section. The 2d Army Engineers were up here last week going over this entire problem with us and will be back this next week to show how they-, 
can be 'worked into the overall statistical accounting for the whole hospital. 
As it now stands the Hngin'eers have to work two sets of accounting system. ~ 
■Iq have said time and time again we still have had to keep our records and 
physical data as per regulations but in addition they have had to keep 
another system which we have got to convince the other people is just as 
good and can take over and replace the old type. 
General Streit - There is one difficulty with this system that has not been 
brought out which seems to me a major one in Walter Reed for example, and 
that is lack of space to make the necessary changes. If I wanted to move my. 
Detachment of Patients to the Personnel Office, no one could find a place to 
put it. There isn’t any place to accommodate those two sections and to 
find an office for any of these activities that you want to combine is an 
extremely difficult thing to do. Recently, I had to find some space for the 
Vet Division to get one little office for them. He didn't have one little 
office. The only thing I could do was to eliminate the linen exchange, 
■which I understand the SG was in favor of, so we eliminated that operation 
and made an office out of it. I see great difficulties with a system of 
this sort in hospitals because of physical facilities and space. 
Colonel Brewer - That is true; however, the combining, the taking of portions 
of the various sections out to make another section results in some -space 
in the Personnel Division, or in the other division or DOP or Registrar 
Section, because you are going to lose all that portion of the personnel 
and the Registrar section that deals with statistics. There is going to be 
created a smaller staff, there will be some saving. That was one of our 
problems - you said last night we had a lot of empty buildings. We have 
looked, hunted and torn ourselves apart trying to got these people together to eventually establish one of these divisions. Afterwards you will find 
that it creates space for something else. 
General Streit - To illustrate a point, when you brought the Personnel 
Division together you had a completely empty building. If you didn't have 
one you could have, and you picked a building adjacent to the troop command 
so you could bring these two commands up to your Personnel Division where 
there Y/as sufficient space in that building to move your detachment of 
patients and your sick and wounded. In my wildest imagination, I cannot 
visualize General Cole being able to, at Letterman, or I being able to do 
it at Walter Reed. 
Lt. Colonel Schunior - Here's just an example. We created this statistical 
accounting division. Then we looked over the post Engineer. We took av/ay 
his supply setup of 3 or A people who did his supply work and put them over 
in the supply section Y/here they could be absorbed, with the result of a 
saving of two people. We took those individuals that had to do vath his 
statistical accounting and left them. We moved his small supply section 
s 
that he had, of all his spare parts, nuts, and bolts, electrical appliances 
and put them over in the stock section of the supply. As a result we have 
left in the Engineer Section, the Engineer and his assistant, so that is where 
the statistical and accounting division is-moving in. With the post engineer 
it was rather simple or we never 'would have been able to find an office. 
♦ 
It has been by shifting of people and bringing them into the other places 
that we have been able to obtain most of our vacant, space. 
Colonel Leliman - One of the most difficult minor questions that I have to 
answer is whether I have a bed for someone who is applying for admission. 
Under this new organization, do I have to call up the personnel officer and 
have him contact someone? Colonel Brewer - Nell, we haven't run into that difficulty as yet but the 
chief of Personnel is the man to go to if you want to know anything about 
the status of your patients. lie is responsible for the military branch of 
the Personnel Section. 
Colonel Lehman - I do not believe you have amplified that point. It seems 
to me that that would complicate things. That is a question that does arise 
particularly in a ihoapltal as small as- the Army and Navy is. The urgent 
request may come along: "Do you have a bed? I'm seriously in need of 
hospitalization." 
Lt. Colonel Schunior - You have to answer that reasonably, promptly. Colonel, 
there is an A U D Office as such and we do not attempt to go through all 
the laborious procedures of trying to get the last bit of detailed inform- 
ation out of the patient when he comes in. Instead of having the ward 
morning report, the accounting section now prepares a ward roster every ’ 
night which goes to the ward. If the ward has made a mistake in the person- 
nel that they have there by transfer and have not reported it, then the 
Chief of Service comes in and he gets on that ward for not reporting it. 
he had trouble initially but now those rosters have become almost perfect; 
they don't make mistakes. If they transfer patients from one ward to an- 
other the nurse calls in and that change is made; if she fails to call in, 
she is caught the next morning. So you have control over it, so that you 
do know in the Admission Office where you have beds. CTc tested these pro- 
cedures out on a convoy of 38 patients and we had them out of the Admission 
Office and some of them nevui* did come through, within 26 minutes. Je 
have stressed that a great deal. 
Colonel Tynes - Colonel Schunior is going to talk with us now for a few 
minutes on plans for phasing in our otlwr hospitals. 
i Lt. Cclone1 ochunior - Firsts I would like to emphasize very much from our 
standpoint here in the Surgeon General's Office that /our suggestions are 
welcome. As Colonel Gibbs told you, no one has tried to master-mind this 
thing. You have sent representatives in here and we have gleaned from them 
what ideas we possibly could and then Colonel Brewer has tried them out in 
his hospital, v/e certainly would appreciate it if you have any suggestions 
to offer or want to discuss any immediate problems that are bothering you 
about this organization. I think you could understand it a lot better if 
you could see some of the procedures that have been installed so as to 
make this organization possible. Now unfortunately, on some of these pro- 
cedures we are going to have to go through the red tape of having the 
Logistics Division get all the technical services together, the Army Comp- 
troller and various other people involved, to pass on them before we are 
able to put them in effect in our other hospitals. However, we have kept 
the Logistics Division and the Army Comptroller very close to it. Ne have 
taken their representatives up there and they have assisted -us in finding 
the answers to some of the problems so that'from their reactions to the 
whole thing, I do not think it will take us very long. But we have set up 
' • 
a tentative program for working with you in the reorganization of the 
hospitals, because there arc certain things that we can do without the staff 
coordination that I have just mentioned. There is the matter of procurement 
of these machines which we have already initiatedj the various people who 
manufacture them have told us that they could meet the schedule that we 
gave them. There is the matter of training people to operate these new 
office machines, Vie have started action in that direction. We feel, for 
instance, that we do not have, at the moment, the trained officers to take 
over this Accounting and Statistics Division so we are asking for an extra civilian slot in the appropriate grade to assist with the implementing of 
the procedures of that division. Tentatively we have set up this schedule. 
Me would like to work with Walter Reed and Murphy during the first 
quarter of this coming calendar year; we would like to work with Brooke 
during the second quarter; we would like to work with Letterman, Fitzsimons 
and Madigan during the third quarter, and with the others during the fourth 
quarter, and that is assuming that all these things are approved by you and 
by the various divisions of the Burgeon General's Office. It has been 
presented to them; it has been presented to General Bliss and, I think, to 
everyone else that is involved. If that schedule does not fit in with your 
plans, we would certainly like to get your reactions so we can adjust it 
accordingly. The assistance that we will give will consist of probably just 
a fresh viewpoint on some of these things. General Streit, I want to mention 
one big problem, and that is the matter of space. I am sure that in some 
cases Tire will not be able to do some of these things because of space, but 
I think we should make an effort to find the space and if that is not 
possible we should adjust the plan to fit your requirement. I do not think 
there will be any money available to construct too many buildings around 
our hospitals so that we might as well forget about that. 
General Streit - You mentioned Brooke in the second quarter. Do you mean 
including the Medical Center? 
Lt. Colonel Schunior - Yes, sir. 
General Streit - Do you have plans for the consolidation of centers, acti- 
vities, etc.? 
Lt. Colonel Schunior - Me have a lot of plans. General, but I would rather 
wait until we start working with your own organization. Genera], Noyes - Couldn’t you send us advanced plans down there so we 
can study them? 
Lt. Colonel Schunior - Yes, sir. 
General Loves - I think that would be best. At least you know we would have 
some thoughts by the time you get dovm there. 
Lt. Colonel Schunior - That will be done. "Te 'wanted to work with General 
Streit because it would be convenient. As X mentioned before, and as I 
mentioned to General Bliss, I had not had any contact with medical Service 
Corps officers but it strikes me that they require a great deal of training 
and they certainly require a now type of training to fit this thing. Tie 
have had an.Adjutant -who traveled from hospital to hospital being an* 
at one place he was an aide, somewhere else he was file clerk, 
somewhere else he was a messenger boy, somewhere else lie was a valuable 
staff officer. So you look on the cards and you see someone that ms an 
Adjutant and.you don’t know what kind of an individual you have. Or you 
have some, that have traveled in the Supply circle. They don’t,know anything 
about Personnel*. You have registrars who know all about medical statistics 
but they don’t know anything about Supply, So, we have a considerable 
training program on our hands. That is the more long range. The shorter 
range is that we- need to' train individuals quickly by gathering together 
the best brains in the hospital administration business from our own office 
and from your hospitals to give them a six-week course at Valley 'Forge 
to be your Management Officers. Vfe would like to do that some time during 
the first quarter of next year. Personally, I cannot impress you too much 
with not only the desirability but the necessity of the selection of someone 
who is able to learn and who has the desire to learn. If you pick out some- 
one who is too sot in his ways, along in his forties, it is going to be difficult to give him anything that vd.ll be very valuable in the long run. 
The selection of your lianagement Officer, I think, is very important; if 
he does not do his job, he can ruin the whole program by being the type of 
individual that we knew in the control setup before, where you try to 
master-mind the thing without giving due regard to the people who are 
actually responsible for the operation. ■ Vife will send you more specific 
details as to when the school will start. Vie also hope to bring in your 
executive officers and other key individuals that you may want to send to 
Valley Forge for a shorter period of training, possibly a week. That vail 
be phased in with the plan of working with our hospitals. 
Colonel Gibbs - The first point is that the aim of this new administrative 
setup, this test, is to make it possible to have a better medical service. 
The primary aim is to assist the professional, officer so that be has the 
maximum amount of tine for the care of patients. Point No. 2 is, as Colonel 
Schunior has already covered this in part, we have a terrific training 
program ahead of us. Through this training program we must utilize every 
means possible. In the initial phases and during the time when we were 
determining precisely what we need in personnel, we were dolnr; some training 
down at Valley Forge in preparation for the phase out of this plan. But 
we have already undertaken certain talks with the Training Division and we 
foresee that we cannot make this program a success until certain courses 
are introduced into the Medical Field Service School which will assist 
then in training our administrative officers to accept these new responsibil- 
ities. The aim, of course, is to make every administrative officer who 
is in the hospital service a competent manager. To that end we need every 
training resource at our disposal. 
Colonel Tynes - be will adjourn and reconvene in this room at 1300 this 
afternoon. Colonel Tynes - The conference is now in session. Our first speaker this 
afternoon is Colonel Brace, Chief of Mobilization Planning Branch, Medical 
Plans and Operations Division, who will speak on "Mobilization Planning." 
Colonel Druce - My talk is SECRET, therefore it will not be recorded. 
Colonel Tynes - There is a change in the agenda. Colonel Phillips, Chief, 
Nursing Division, will now speak on "Army Nurse Corps Activities." 
Colonel Phillips - I am pleased to have the opportunity to participate in 
this meeting so as to present to you some of the projects involving the 
Army Nurse Corps, and to discuss briefly some of cur projects and problems 
in which you can be of great assistance to us in making our Corps operate 
more efficiently as a member of the medical team. 
Vie have distributed to you a copy, of the proposed Special Regulation 
on the Army Health Nursing Service which has recently been established at 
one or two of our installations, and which The Surgeon General hopes mil 
•be set up in,other medical installations where the commanding officer of 
the post, camp, or station deems such action advisable. The Nursing Divi- 
sion, with members of the Medical Plans and Operations, Personnel, Preven- 
tive Medicine and Resources Analysis Divisions, have spent a groat deal of 
time in discussing this program, its objectives, the manner in which it 
should be set up, and have finally concurred in the Special Regulation 
which you have before you. It was unfortunate from our standpoint that 
such a regulation was not published prior to the establishment of such 
\ 
programs, but the one or two programs that are under way are pretty much 
in line with the guides proposed in this regulation. 
The. first thing that I want to mention about this program is that 
it is not set up with any idea that nurses can replace medical officers, 
Its organization, however, was suggested in order to assist the medical officer in caring for outpatients at our installations with the hope that 
the nursing service could supplement his work and through the initiation of 
teaching programs, the establishment of a school program, all of course, under 
the immediate direction of a doctor, effect a decrease in the daily workload 
in the outpatient service, and assist in keeping down the rate of hospitaliza- 
tion of dependent personnel. 
In the establishment of any program where nursing personnel is utilised, 
-wo are desirous of keeping our requirements in the selection of personnel 
on a par with similar programs in civilian or other federal agencies. 
The success of this program and its effectiveness to the Medical Department 
will be in a great measure dependent upon the type of nurse selected to 
organize or to participate in the program. It is necessary that the indi- 
vidual selected have preparation and experience in Public Health nursing,. He 
have several nurses, at the present time, who can qualify under the require- 
ments set forth in this proposed Special Regulation, and the Preventive 
Medicine Division of this office is desirous of and ./ill -assist in reviewing 
the professional records of the nurses selected for these programs so-as to 
insure the assignment of the more experienced person to the larger programs, 
Tliis program is not designed to provide nursing care in the home. Of 
course, there are times when the doctor may want certain medications given 
or dressings changed, but the assignment of nurses to do visiting nursing, 
on, the same scale as is provided by Visiting Nurse Societies in civilian 
organizations is not contemplated. Me do not have sufficient nurses for 
such assignment and you know as well as I that were such a program set up 
it could snowball to such a portion that unreasonable demands would be made 
upon the Medical Department for personnel to care for the outpatients in 
their homes. An MOS description for the nurse qualified for assignment to this 
program has been submitted for approval and publication, and will be 
circulated to the field as soon as it is published. In speaking of the 
newly proposed MOS, there are one or two comments I should like to make 
regarding MOS numbers for nurse personnel. We have frequent requests for 
the establishment of additional MOS numbers, and while we recognize the 
value of such classification, we also recognize the dangers which can 
develop. Basically, our personnel have a general nursing preparation. 
We do need, however, to have some nurses receive further preparation in 
certain specialties, and the indication of this special preparation by 
numbers helps us to better assign nurses and meet our requirements in 
staffing. However, it has at times prevented us from assigning personnel 
who may not carry the particular MOS desired but who could function under 
the supervision of a well-prepared supervisor in that field. I am thinking 
particularly of operating room nurses. We also have the problem of certain 
of our nurse officers feeling that the assignment of a specialty number 
should preclude their assignment to other services even though a need exists 
for assistance in areas where the workload has increased and their temporary 
. , i 
a s s i gnne nt is no e ded. 
We have had requests for the establishment of a course which would 
result in the classification of nurses in ophthalmological nursing, plastic 
surgery nursing, etc. Should we concur in such recommendations, we could 
tie our service into such knots that we would not be able to adequately 
cover our nursing needs. 
One of the classification numbers desired by many nurses is that of 
3A30, the Administrative Nurse. There seems to exist an erroneous opinion 
that promotion will be based on the assignment of such a classification and that unless nurses carry such a number they vail not be considered for 
promotions to higher grades. Such is not the case. An administrative 
nurse must not only be well qualified in nursing administration as well as 
in nursing, but must have the qualities necessary for good personnel manage- 
ment and qualities of good leadership. A degree in nursing education alone 
is not sufficient to qualify her. TM 12-4-06, Officer Classification Guide, 
must be carefully followed in order to insure that we get our personnel 
properly classified. If our administrative personnel is not carefully 
chosen, the nursing service in our installations is going to suffer. 
Requests submitted to this office for changes of LIOS on nurse officers 
must be accompanied by an evaluation of performance of duty in the specialty 
classification requested, length of time the nurse has been assigned to 
the specialty duties, as well as a general evaluation of the individual by 
her supervisor and/or chief nurse. 
Some of our nurses who meet the qualifications for the MOS in 
obstetrics and pediatric nursing but are not desirous of changing from 
the classification of "general duty" nurse to the specialty classification 
are not desirous of continuing in that type of nursing throughout their 
military career. It should be explained that an officer can be given a 
secondary LIOS and may be utilized in either, depending on the urgency of 
the need. It is a distinct advantage to us to have nurses with prepara- 
tion and experience in more than one specialty. 
It is, of course, desired that nurses, insofar as possible, be utilized 
in their IDS, but the needs of the service and the desires of the individual 
should be determining factors in such an assignment. This decision should 
i 
be made by the chief nurse and her supervisory staff. May I enlist your cooperation in bringing to the attention of your 
personnel the importance of preparing fair, honest and objective efficiency 
reports on nurses* You all know the importance attached to these reports 
and the part they play in selection for promotions. We have occasional 
requests from commanding.officers to make changes in their administrative 
personnel and still the efficiency reports coming in from their installa- 
tions do not coincide with reports that are brought to us verbally. Our 
promotions to higher grades are limited. We must assign such personnel to 
administrative and supervisory positions. The selection board has nothing 
to go on but what is in the officer's record. The upgrading of an efficiency 
report so as to spare the feelings of the individual being rated or so as 
not to make necessary the discussion with the rated officer the shortcomings 
observed will not help us to maintain the type of Corps we want nor help 
us in the assignment of the type of personnel you want and need in your 
installations. 
Our procurement program is not moving along as fast as we would like 
it nor quite as well as it did a few months ago. While we took on 3&0 
nurses for extended active duty in the period from July to September in 
1948, this year we took on only 138 during those months. We appreciate 
the assistance the Surgeons of the Armies have been giving us in the assign- 
ment of procurement nurses to assist in interpreting our program and needs 
to civilian nursing groups. The number of nurses on such duty, however, is 
limited and the territory we would like to and need to cover is very large. 
The Army chief nurses occasionally feel the necessity of calling on the 
commanding generals of hospitals requesting assignment of personnel as 
speakers who have either previously been assigned as procurement nurses or 
who they know are sufficiently acquainted with the various aspects of both the Reserve and Regular Army program to speak effectively and con- 
vincingly at state nurses’ meetings or before student groups. It would be 
most helpful to all of us concerned if all commanding officers would 
concur in the attendance, if possible, at such meetings of nurses who can 
effectively present our program to the public. We know many of our instal- 
lations could use more nurse personnel, but we cannot get such personnel 
unless we make use of every opportunity to meet with civilian nursing 
groups to explain our program, the means of joiningthe Reserve and the method 
of requesting extended active duty to them. These requests are comparati- 
vely infrequent and the period of time the nurse would be away from your 
installation would be of short duration. We always try to select such 
personnel from installations near the area in which the meetings are to be 
held. 
We in this office take every opportunity presented us to attend such 
meetings and the chief nurses in the Armies usually contact the state 
nursing organization to request an opportunity at their annual convention 
for an Army Nurse Corps representative to speak. 
I recently attended a meeting of both the student nurse group and the 
graduate group in one of our large Liidwe stern States, and while we were 
most cordially received and every opportunity extended us to contact the 
nurse personnel and explain our program, there was very little interest 
evidenced in either the' inactive or extended active duty status of our 
Reserve group. Civilian hospitals are still so in need of nurse personnel, 
and with the expansion of nursing service throughout the country there are 
so many opportunities for nurses in civilian positions that even the enact- 
ment of the Career Compensation Act did not stimulate much interest for 
extended active duty in either the Army or the Navy. While the sala,ries in Federal services are much better than those in 
most areas in civilian life, that is not true of all sections of the 
country, and in addition to'greatly improved salaries in certain areas, 
the more attractive working hours and living conditions, the ability to 
choose their place of employment without frequent transfers or necessity 
for overseas service makes civilian service more attractive than military 
service to many civilian nurses.- 
be all appreciate the efforts made to improve the hours of duty in 
the hospitals, but in a few installations Just recently the cut back in 
personnel resulted immediately in the consideration by commanding officers 
in the hospitals of returning to the 12-hour night duty, and in some placed 
the 12-hour day duty. Just as soon as wo do that we can be assured that 
our procurement will drop even lower and we will gain very little by such 
practices. We should not be laggards in an effort to improve conditions under 
which our personnel must live and work, but rather should set the example so 
that other organizations will look to us when they wish to know how to 
improve their organizations. It may be of interest to you - it was quite a 
shock to me - to find out that in October we took in 16 nurses for extended 
active duty, and separated 32. That in one sentence gives you a pretty 
good picture of our procurement problem. 
Just a year ago we asked I&E to make an attitude survey so as to 
obtain opinions of Army Nurse officers regarding matters affecting them 
and to obtain from them any suggestions and recommendations for changes in 
our policies which might result in making our service more attractive to 
them and aid in procurement. You may recall that a year ago procurement 
I 
in all Corps in the medical Department was a serious problem. We were 
enlisting the support of our state and national nursing organizations and 
36 called representatives from all of the states and national headquarters into 
a conference here in Washington, It was the result of that conference to- 
gether with the efforts that we made to correct some of the situations that 
the nurses in the opinionaires presented to us that our procurement during 
this year took an upward trend. We had hoped to circularize a group of 
nurses in civilian life who had been with us but did not seem to be interest- 
ed in returning. Unfortunately, we were not permitted to include them. 
A study of the opinionaires regarding the relative advantages of nursing 
practice in military service and civilian life were briefly as follows: 
More nurses stated they would choose military service 
over civilian from the standpoint of long-term security, 
pay and the opportunity for specialty training. Lore of 
them said they would choose civilian nursing over military 
from the standpoint of desirable living conditions, working 
hours, and opportunity to use their specialty training 
and skills, 
./hen asked for suggestions which they felt would improve our procurement 
so as to assure the Army of having a sufficient number of well trained nurses, 
the most frequently mentioned suggestions were to improve living conditions, 
to offer more educational opportunities, and to provide shorter working 
hours. V/e have mads progress in each of those areas within the past year 
and should endeavor to continue in that direction rather than revert to 
situations that caused the suggestions to be made in the first place. 
There are to date 3*4-35 nurses on extended active duty, 2,443 of whom 
are Reserve nurses. Tfe are approximately 500 short of our authorized 
strength and attrition continues at a rate of approximately 50 a month. We have noted many instances in which requests for category changes 
are-not submitted in compliance with SR 135-215-5, dated 27 May 1949. All 
nurse officers who are qualified under the provisions of SR 135-215-5, 
and who desire extended active duty beyond,the expiration date of their 
Current category should submit application ‘for such change not later than 
six months prior to the expiration of their current category. Exceptions 
will be, made to this regulation only when nurse officers desire to sign 
Category II or III. 
Me would like your assistance in advising personnel officers to remind 
:those who are within six months of the date of expiration of their category 
that a request for an extension must be initiated if they are desirous of 
remaining on extended active duty. To prevent retention on active.duty of 
ineffective personnel, requests for extension of category should be 
cleared with the chief nurses. 
We were disappointed that the amendment to Public Law 36, which wo had 
hoped would be enacted into' law at the first session of the 01st Congress, 
received action only by the House. It passed the House and was referred 
to the Senate, but Senate action was not possible prior to adjournment. 
We have been assured that it will be given priority for consideration in the 
early session of the next Congress. Although much has been said about 
this legislation, there is still much misunderstanding as to what the amend- 
, merit will do if enacted into law. Briefly, it will allow us for one year 
to give the opportunity for applying for a commission in the Regular Army 
to any nurse who reported for duty with the Army Nurse Corps in World War 
II before she reached the age of thirty-five. Upon the expiration of the 
year the age limit for commission in the Army Nurse Corps will revert to 
twenty-eight as established in Public Law 36. There will then bo no further opportunity Tor the nurse over twenty—eight to be commissioned in the 
Regular Army Nurse Corps. No have had many requests since the close of 
our previous integration to waive our age limit and can only explain to 
such individuals that while we can waive a regulation wo cannot waive a 
law, and no nurse is presently eligible for appointment in the Regular 
Army Nurse Corps, if she has passed her twenty—eighth birthday, 
Ne have a large number of nurses at the present time in our hospitals 
who have had the required six months of service prior to submitting an 
application for Regular Army. There is a regulation providing for the ap- 
pointment at the present time of such nurses in the Regular Army Nurse 
Corps. It is included in the same regulation for the appointment of 
officers in the Regular Corps of the Medical Department, AR 605-20. TTo 
have been encouraging the chief nurses in our hospitals to interview those 
nurses who appear to be the type of individual,we want in the Regular Army. 
From 393 such nurses, we have received approximately 90 applications. 
On October 17th, wo.opened a Practical Nurse School at Walter Reed, 
The schoolroom facilities are provided at the Forest Glen Section and it 
is a physical setup of which the Army can be very proud, Vfe have a very 
enthusiastic and well prepared group of:instructors and the group of NAG 
enlisted personnel -attending this course is a most enthusiastic and well 
selected group. We had hoped t*> have an enrollment of fifty; instead, this 
first group comprises thirty-two, ’whether sufficient publication was given 
the course or whether sufficient time was not allowed for the submission 
and processing of applications, we do not know. It is a forty-eight weeks' 
course with one additional month provided for furlough. This first course 
is a trial course and plans for revision of the course content of the 
..ledleal and Surgical Technicians course is under consideration. Future plans include making completion of one of those courses a prerequisite for 
application for the Practical Nurse course. The selection of WAG enlisted 
personnel was made from applications received from the WAG assigned to 
medical installations. Successful completion of this course will make the 
graduate eligible to apply for registration in states providing such in 
accordance with the standards of the National Association for Practical 
Nurse Education. he would like to see an additional group taken in 
February, but whether that is possible will depend upon the approval from 
OAT, GSUSA, and P&A, GSUSA, availability of housing at Walter Reed, and 
the interest displayed, not only by the 'JAG enlisted group, but1 by other 
Medical Department personnel. 
I want to take this opportunity to express our appreciation for the 
splendid cooperation received from all of you in making possible the 
attendance of nurse personnel at the Workshops conducted each year at 
the University of Pittsburgh. These Workshops which have been given in 
Ward Administration, Improving Patient Care, Nurse-Patient Relationship and 
Staff Education have proved most helpful* We, from this office, as well 
as the chief nurses in our Army areas have noted the effect of attendance 
at these courses, not only in nursing performance in our- hospitals, but 
in enthusiasm of our nursing personnel for association with an organization 
which they feel is interested in helping them to keep alert to and abreast 
of latest developments in their field. I must confess we .were a bit 
hesitant about the response we would get when it became necessary to ask 
how many Army areas and general hospitals could provide the transportation 
and per diem expenses for the last Workshop. Two Army areas sent represent- 
atives and all general hospitals were represented. That is a fine record 
and we are most appreciative of your cooperation. A question came in regarding the possibility of utilizing 'Jest Coast 
universities for such Workshops so as to cut down on travel expenses of 
nurse personnel from those areas. Since the answer to that question will 
appear in papers distributed to you, I will not take time hero to reply 
to it. 
Now one final subject. The success of our, Reserve program as is true 
of Reserve programs for all Corps in the Army, and the extent to which we 
can maintain an interested group of qualified nurses who will be willing to 
keep their reserve status active will be dependent on the effectiveness of 
our training programs. Nith nurses who have had no prior military service 
and who apply for extended active duty, we provide an eight weeks' orient- 
ation course at Medical Field Service School. Such an orientation has 
assisted greatly in making the transition from a civilian to military status 
smoother and more efficient. 
Me were pleased to know the extent to which the Army areas were able to 
provide an opportunity for short tours of duty for Reserve nurses this 
past summer. Me would like, however, to see the plan which has been initiated 
in one Army area extended to the others, i.e., setting up a two weeks' 
orientation program for nurses who have had no previous military service, 
but who are applying for a short tour of duty. If a two weeks tour of duty 
is all the individual is applying for, she will derive more benefit from 
such orientation than she will from two weeks duty in the hospital, and 
next year she vail be of more value in our hospitals. If she is asking 
for more than two weeks, she mil be more valuable to your installation and 
will adjust more readily, if she first had a basic orientation. Mo will be 
glad to supply your Army chief nurses with the orientation program carried 
out by Fourth Army, if the rest of you feel you can provide similar opportu- 
nities next summer. I hope the members at this conference will visit my office or that of 
the Chief of Nursing Personnel* if we can be of any assistance to you, 
liven though you. have no problems or questions regarding your nursing service, 
we would be happy to have any of you stop by. 
Colonel Liston — Will the Surgeon General’s Office supply the nurses in this 
new setup? 
Colonel Phillips - They will be over and above the present hospital personnel. 
You will have to request your personnel, and Resources Analysis Division 
I am sure will authorize it. You don’t want them assigned for duty to the 
hospital. We are also asking for a report to be submitted each month that 
is going to give us the indication of the workload, so that if you should 
come in for more personnel we will see whether or not it is justified. 
Colonel Liston - Because of the shortage of the doctors that we are all -well 
acquainted with, we are using both MSC officers and nurses throughout the 
Fourth Army Area in screening patients, a job which is somewhat similar to 
that done everyday by hired civilian industrial nurses. Some of the doctors 
feel that this duty should be done by nurses and not done by NSC officers. 
Others feel, and I feel personally, that the MSC officer is doing an excel- 
lent job. In other instances, it is being done by Sergeants of the Medical 
Department. I would just like your expression of opinion in regard to 
using nurses for screening sick call. 
Colonel Phillips - I think when I was asked about that program, I concurred 
reluctantly, but because I knew of the shortage, and thought it would be 
for a temporary period only. Whenever wre take a nurse for other projects 
or to relieve the personnel situation in other Corps we are depleting our 
own service and taking nurses away from the care of patients, and I am 
very reluctant to do that. ■ 
42 Colonel Glattly - I wonder if there is any possibility of including 
certain of the scarce category nurses, such as nurse anesthetists under 
the so-called "Black Plan,” or the "Short Tours of Active Duty." I have 
had opportunity in the past few months to get ahold of two or three of 
these nurses, but by reason of the shortage of training funds, was unable 
to utilize their services. 
Colonel Phillips - I believe that too is answered in your book, Colonel 
Glattly. I know when that plan was set up, it was because of the real 
shortage of Medical Corps officers and although the General Staff did not 
want to go along vdth it they did because of that shortage. The shortage 
of nurse personnel was not as great and I believe the Medical Corps person- 
nel felt that they would jeopardize the chances of getting it cleared 
through staff. 
Colonel Glattly - I know I would trade a doctor for a nurse anesthetist any 
time, that’s how scarce they are in Second Array. 
Colonel Phillips - They are scarce all over the Army. Je have a need for 
202 anesthetists and we have 100 of them. We are training them in seven 
i 
hospitals now. 
Colonel Liston - What is the present attitude of the Surgeon General's 
Office in regard to hiring of male nurses? 
Colonel Phillips - You doctors can answer that better than I can, I have 
no objection to male nurses, if they are well qualified. 
Colonel Liston - That is in civilian capacity, is that correct? 
Colonel Phillips - If you contemplate such action, Colonel Short should be 
allowed to clear the personnel. We would like the opportunity to chock on 
the professional qualifications of civilian nurse personnel, just as we do 
military; otherwise, you may be getting some that do not meet our require- 
ments , Colonel Liston - We have quite a number of arsenals, small and large, 
throughout the Fourth Array Area where I think we might be able to employ 
a male nurse very effectively, and where only one nurse is on duty. We 
have had application, but we have not taken anyone on. 
Colonel Tynes - Some months ago. The Surgeon General announced a new policy 
on the appointment of the position of Director of the Army Medical Library, 
Interested officers were advised that they could apply for the position on 
the basis of a lifetime appointment, if they met the proper qualifications. 
The first officer to receive this appointment was Major Frank P. Rogers, MG. 
Major Rogers has just completed IS months special training, including a 
12 months course at Columbia University, and extensive visits to the various 
medical and other leading libraries throughout the country. Several weeks 
ago, Major Rogers was installed as a new permanent Director of the Army- 
Medical Library. Major Rogers will now speak on the subject of ’’Services 
Available from the Army Medical Library." 
Major Rogers - Ladies and Gentlemen - The Army Medical Library is now 112 
years old. It came into being during the presidency of Andrew Jackson. 
During most of its early years, it consisted of nothing except a shelf of 
a few books, but by the close of the Civil War it had a total of 1800 
volumes. At that time, one of the foremost figures in American medicine, 
John Shaw Billings, became its Librarian and he held that.position for 30 
years. When he retired from the Army in 1395 to become the first Director 
of the New York Public Library, the Army Medical Library collection com- 
prised over 300,000 titles as compared to the 1800 at the time when he became 
its Director. The Amy Medical Library had-become the world’s greatest col- 
lection of medical literature. Today, the Library possesses over 1,000,000 
titles, of which at least one half a million arp bound volumes. We still like to call it the greatest collection of medical literature in the world, 
but are not quite so sure that we can call ourselves the largest anymore. 
The latest statistics gathered by the Medical Library Association show two 
libraries that are larger than the Army Medical Library. Both of these are 
in Russia, one at Moscow and the other at Leningrad. 
The Army Medical Library operates under a general directive to 
acquire the medical literature of the world regardless of language, form 
or date of publication. Tie add well over 75,000 pieces to our collection 
each year. We have some 18,000 files of periodical titles of which 6500 
are current and increasing at the rate of 100 per month. By law, vre serve 
the entire medical profession of this country, both military and civilian. 
The library is not only a library in the ordinary sense, it is also 
a publication agency. Various indices have been published by the library 
in its history. First and foremost is the index catalog of the library 
of the Surgeon General’s Office, which was started by Dr, Billings in 1880, 
It is now in its 57th volume and includes over five million references to 
the medical literature of the world. Another publication started at the 
Army Medical Library was the old Index Medicus. This was also begun by 
Billings in 1879 and continued until 1927, when it was combined with a 
publication of The American Medical Association which continues to this 
day as the Quarterly Cumulative Index Medicus. The third major publication 
of the library is a newcomer. It was started under private auspices in 19A1 
and was taken over by the Army Medical Library in 194-5• We know it as the 
current list of medical literature. It is published weekly and is extremely 
important at present in that it is the only current index to the medical 
literature in existence. I would like to speak a little more extensively about two of these 
indices. The Index Catalog is now in its fourth series. This is the tenth 
and latest volume of the fourth series and covers the first half of the letter 
MH", Our records show that all Army general hospitals have this publication 
with the exception of three, namely, Murphy, Oliver and Valley Forge, I 
would ask that the Commanders of those hospitals request this publication 
from us and we will be glad to send you the first ten volumes of the four 
series and each successive volume as it is compiled. You will understand 
that the constantly increasing flood of medical literature has posed a 
problem which is very difficult indeed to solve. We have published five 
million references in the various volumes of this series, we have on hand- 
one million, six hundred thousand references in an unpublished file, which 
is material still to be published, and if we were to proceed to publish 
that material on the same basis that we have published in the past, it would 
take us a minimum of ten years to publish it, if we stopped entirely our 
indexing activity at this- moment. We are in the middle of the letter M'.I" 
now and if I looked through.our files and looked under the letter nTn, I 
.would find under’ the subject of Tuberculosis alone, some 85,000 unpublished 
references. I hats to speculate on what will happen by the time we get 
to the letter "T", and if things keep increasing as they are at present, 
whether we will ‘ever be able to finish publishing what exists on the one 
subject of Tuberculosis. These problems are very large and The Surgeon 
General has appointed a committee of consultants to consider these problems 
and make recommendations as to what we might do to solve them. This com- 
mittee of consultants is also assisted by a research project which is being 
operated by Dr. Larkie, Librarian of the Welch Medical Library, Johns 
Hopkins University, Both the committee and the research project have been in existence for a year and the research project has another year to 
run. . . 
Besides the Index Catalog, we publish the current list of Medical 
literature• It is published weekly under a broad general classification 
with only Journal titles classified. There are monthly subject indices 
included. There were printed in this publication during the past year, 
current references to the Medical literature, and as I said, it is 
the only current index available since Quarterly Cumulative Index Medicus 
has fallen way behind in its production schedule and the index for the 
first has only appeared in the last few days, 
I have placed a few examples of our publications before you. There is 
a copy of the current list, a listing of selected recent book acquisitions 
which we publish from time to time and which may be had for the asking, 
and a list of journals currently received in selected subject fields. I 
\ 
would think that these lists would be very helpful to your librarian and 
to the library committee when they are considering the development of your 
own libraries. • 
Besides these various publications, we have several other services to 
offer. One service is that of inter-library loans. We will loan any book 
which we possess and which is in physical condition to travel anywhere in 
the United States. We loan approximately 25,000 volumes a year on such a 
basis. Any out-of-print or hard-to-come-by item that your medical people 
may wish to see, may be obtained from the Army Medical Library, All we 
ask is that they clear their request through your local library and let your 
local library send it to us or we would indeed be swamped if all requests 
came directly to us. We ask that local libraries screen first to make 
certain that the book wanted is available only at the Army Medical Library. There is a small sheet before you which explains the regulation on inter- 
library loans. The service is rapid, you will get the book by express, 
you can keep.- it for a period of three weeks and may renew it, if you so 
choose. 
Another service ■which should be of'particular importance to you is 
our Photo Duplication Service. You have been furnished with the regulations 
concerning photo duplication service and a copy of the order blanks on which 
we like to have orders come to us. This service is offered at cost to the 
civilian profession and free to all members of the Armed Forces. Your 
officers.may submit such requests direct to the Army Medical Library. Tie 
will copy anything in our entire collection which is copyable by reason 
of its physical condition and which is not prohibited by the copyright law. 
Our.activities in this realm are very large. We have .each year for the 
past few years made well over a million pages of microfilm and photostats 
and sent them all over this country and throughout the world. Tie have 
bibliographical and reference services to offer. Here again wo ask that 
local facilities be exhausted before questions are brought to the Army 
Medical Library. Our staff is limited, but we will do the best we can to 
give you service. I would ask that you specify exactly what it is that you 
wish and to limit the field as much as possible. You can realize with the 
figures I have cited as to our holdings, it is very difficult to fulfill a 
request for all the material we have on the subject of anemia, for example. 
That is. the kind of request wo get and it is simply because the person 
making the request has no idea of the resources which are available to us. 
So I would ask you to limit your requests as much as possible. Do you wish 
to have only the literature that exist in western European languages or do 
you want the literature that exist in all languages? Are you interested 
48 only in the literature that has been written since 1940 or some other date? 
Requests which are specific in that way are much easier to handle and. it 
is also helpful for us to know what tools have been searched for this 
literature prior to the submission of the request to the Army Medical 
Library, so that we do not have to recover ground already gone over, 
■Je have cataloguing services to offer and anyone who has been connected 
'*rith the Library knows that that is quite a" large item although to the 
person outside it seems like there is nothing complicated about it. Give 
a girl, a typewriter and a stack of cards and tell her to make a catalog. 
It is quite a bit more complicated and the Army Medical Library is trying 
to provide a central cataloguing service so that that large job may be done 
only once in a central place and made available to all "our installations. 
Formerly we had a cooperative agreement with the Library of Congress, 
where we submitted our cataloguing copy to them "and they printed the cards, 
which could be ordered for a nominal sum. In the process of reorganization, 
we found that we were no longer able to continue that arrangement and in 
the past two years this supplement of catalog cards has been printed and is 
available to anyone Y/ho wishes to use it. All the research for proper forms 
of names and entry has been done for the material that we have and can be 
obtained through this catalog. This edition was published last year; next 
month the second edition will be published, and I believe that edition would 
be the last because this weejk We are reopening negotiations with the Library 
of Congress so that they will again print the copy which ytg send them and 
once more your librarians will be able to order any catalog card for any 
medical book through the ordinary card service of the Library of Congress. 
That also means that the catalog copy would be printed in the Library of 
Congress Cumulated Catalog so that there will be a complete bibliographical record of all the medical material available throughout the country. 
There are other services. Vfe have been asked if we can provide 
duplicates of out-of-print material for your libraries. The answer is 
"yes" and the details of the answer are found in sheets which have been 
distributed to you. 
I would like to make a comment in this regard, I would advise being 
reasonable in requests. Please do not ask for everything since the year 
one. It would be my recommendation that in building a hospital working 
collection, great care should be exercised. The Army Medical Library has 
' . ♦ 
inter-library loan services and it has photo duplication services. 
There is no need to develop additional Army Medical Libraries throughout 
the country. You must remember that the cost of acquiring material is a 
very small .part of the total cost of operating a library. The Army Medical 
Supply Library spends only about 5% of its budget on acquiring its material. 
There are other costs which are very large - the cost of cataloguing books, 
the cost of binding periodicals, the cost cf providing shelf space, the 
cost of providing personnel to handle those volumes for you. I would urge 
you to concentrate on the acquisition of a small nucleus of the most 
important and most substantive medical Journals, plus a selected group of 
modern medical texts. All should be carefully weeded from time to time 
with the older and less used materials being discarded. They may always be 
had from the Army Medical Library. One of our great functions is to try 
to keep that sort of material in one place so that others throughout the 
country do not have to worry about whether someone is preserving it for 
the time when it becomes necessary. I would say that besides concentrating 
on the small working collection, it would be desirable to have the best 
indexing tools possible in that library. You will want the current list. the index catalog, the Quarterly Cumulative Index Medicus, some of the 
better abstracting journals except the Medica, etc# With such tools you 
have the key to the literature and anything which does not exist in your 
library we will be happy to supply for you. Not the least of the tools in 
a medical library is a trained librarian, someone who can manipulate the 
literature for you. 
I have told you what we can do for you and I would like to close with 
suggesting what you may do for us. Special Regulation 40-405-5, 15 August 
1949, directs that one copy of all publications of medical or scientific 
interest issued by any medical branch, division, or headquarters of the 
i 
Army or Air Force be sent to the Array Medical Library, I am quite certain 
that we have received a very, very small fraction of such publications 
which have come out since that time. The Army Medical Library is the 
National Medical Library; it is the repository for medical literature; the 
archival collection of this country and we should have one copy of all your 
publications. Bear in mind that our definition of the medical field is 
necessarily wide. Vfe include the basic sciences allied to medicine. The 
request would include copies of hospital papers which your institutions may 
publish. That same directive requires that all excess medical periodicals 
be sent to the Army Medical Library, They should be addressed to the 
Director for proper disposition. Occasionally, we can supply items which 
have become lost or mislaid in our collection. Most often the major pro- 
portion of such materials which we receive are reallocated. We have helped 
stock most of the Veterans Administration hospitals. They can go to other 
Army hospitals which may need the very material which is excess to you and 
lacking that we have sent materials throughout the world. We have sent 
literally boxcars full of material to the Library of Chile, which burned down a few months ago. Vie have sent mono material to the devastated 
libraries of Europe. I offer you our services, will give them freely and 
gladly, and I ask for your cooperation in getting your publications in 
to us. 
Colonel Tynes - Major Rogers, will you bring us up-to-date on the plans for 
the new Library? This is 30 years old, but it is also 2A hours old. 
Major Rogers - The plans for the new Library have been under way for thirty 
years, as Colonel Tynes says. That beautiful picture on the wall in 
General Bliss' office is the picture of the new Army Library painted in 
1919. The program has had its ups and downs through the years and now 
appears to be closer to realization than before. Approximately a month ago, 
Mr. Johnson signed a letter and sent it to the Administrator of the General 
Services Administration, Mr, Judd Larson, asking him to budget for, plan, 
and build a new Amy Medical Library. A week or so ago, we received a 
copy of Mr. Larson’s reply in which he said he would be only too happy to 
do that. I had a conversation Friday afternoon (date: A November 19A9) with 
Mr, Reynolds of the Public Buildings Administration, who assures me that . 
they are going right ahead, so I think the prospect of a new library 
building is better than it has ever been. For those of you who have been 
in that old building that we now share with General Dart (Armed Forces 
Institute of Pathology) know that we really need one. It is the oldest 
public building in the city of "Washington and the only one, I am sure, 
which still has outside toilets, , . 
Colonel Tynes - Our next speaker will be Colonel John Caldwell, Chief 
of our Neuropsychiatric Consultants Division. His subject is the ,5Use of 
Doctors on Loan to Medical Schools” and MInduction Procedures and Induction 
Standards Colonel Caldwell - Colonel Types, Ladies and Gentlemen - Availability of 
psychiatric personnel♦ Inasmuch as only four officers trained in psychiatry 
will become available on 1 July 1950, it will be impossible to assign 
additional psychiatrists to Army Areas other than minimum coverage for 
training centers and disciplinary barracks.. In January 1951 11 additional 
officers will be available and on 1 July 1952 approximately 24- more 
officers will become available. Then we will be able to give some real 
help in critical areas. For at least another year we will have to depend 
upon such help as can be obtained from civilian psychiatrists on a part- 
time basis, employing so far as feasible, plans now in operation in the 
Second and Sixth Army Areas, It would be helpful to this office to be 
in close touch with you and to be cognizant of the civilians so employed 
and the locations where they are employed. 
Induction procedures and induction standards. In the Fiscal fear 1949 
the Army and Air Forces lost approximately 58,458 men separated other than 
by termination of tour of duty. These men were separated under the provisions 
of AR 615-361 (14,5Q0); 366 (BOO/); 368 (8,908); 369 (15,967); minority 
(5,143/) or who became general prisoners (5,946). At an estimated minimum 
cost of 6534*94 for each man, to include 4 weeks’ basic training, the cost 
to the Army was 631,271, 522,52, 
The number separated through medical channels (14,500), with an 
average length of hospitalization, of 77 days, a hospitalization cost of 
617.00 per day, and 65*35 per day average pay represented a cost to the 
Army of 624,953,775*00. 
There was an average prisoner, daily population of 4,793, with an 
average cost per prisoner of 61,604.86, totaling 67,691,837*29. The total cost to the Army of &63,917,134*81, and disregarding the 
cost for pension involved for those discharged through medical channels, 
should cause serious thought on our induction and enlistment procedures. 
This chart represents experiences during Torld 'Tar II. There were 
1,3$0,000 neuropsychiatric rejections, constituting 12$ of all examined 
and 3S$ of all rejections for all causes. There were 54-5*000 separated 
from the Service, representing 49$ of all those separated for mental or 
physical defects. This figure included those separated administratively 
(163,000) for unsuitability or unfitness. 
The second chart shows graphically that the losses for rejections 
or by reason of disability discharge by reason of neuropsychiatric defects 
exceeded all other causes to an overwhelming extent. 
Chart No. 3 represents the incidence of neuropsychiatric conditions 
and shows that the rate was greatly elevated during the war years but has 
leveled off at the rate of somewhere around IS per 1000 men per year, 
being roughly comparable to the pre-war incidence. 
Chart No. 4 shows that discharges for nervous and mental diseases 
has likewise leveled off at around 4 per 1000 men per year which is also 
roughly comparable with the pre-war rate. 
Chart No. 5 shows, however, that our administrative dispositions by 
reason of unsuitability or unfitness is 22 per thousand men per year, -which 
is far above the pre-war and even war experience. By reason of broadening 
the base for administrative separations many men are being separated ad- 
ministratively who in former years would1have been separated 
medical channels. 
The experience with general prisoners has also shown a recent increase 
to a rate of 6*9 per thousand men per year, representing an increase over 
the rates for the war and immediate post-war years. As an aside, Chart No, 7 shows clearly that the number of general 
prisoners is increased disproportionately in the group with an AGCT score 
below 90. The increase in general prisoners may be a reflection of lax 
practices in administering intelligence tests on enlistments. 
Chart No. 8 shows 30$ of those separated through medical channels 
for 1940 were for neuropsychiatric reasons. Approximately another 20$ were 
separated for diseases ordinarily regarded as psychosomatic in nature. 
Thus perhaps half of our losses through medical channels are reflections 
to some extent of emotional and personality problems. 
Chart No, 9 shows the relative incidence of neuropsychiatric disorders 
iathin the different Army Areas, There is no marked difference in any of 
the rates. These represent a probable homogeneity of population, of stress 
or supportive factors and overall policies. 
Chart No, 10 shows that among the different Army Areas for the Fiscal 
Year 1949 there was a 0*33$ rejection rate for neuropsychiatric reasons in 
contrast to the 12$ during 'NorId War II. There was an average failure on 
the R tests of 9*87$, with a greater variation among the Array Areas than 
was present for incidence of neuropsychiatric rejections. The rejection 
rates for both neuropsychiatric conditions and for intelligence qualifica- 
tion were considerably below expectations. There was also considerable 
variation between different stations in the Array Areas themselves. For 
instance, there were 160 rejections for neuropsychiatric reasons at Atlanta 
out of a total of 16,764 examined. There were 7 rejections at Birmingham 
out of a total of 21,839 men examined. 
Chart No, 11 for the month of September 1949 shows no appreciable change 
in the extremely low rejection rate for neuropsychiatric conditions and not 
too much change in the rejections by reason of the R Test. Chart No. 12, taken from the experience of the Third Army Area, shows 
41,}802 men examined, with 5,604 rejected on the R tests. Now the R Tests 
‘are so constructed that it is expected that 25$ of men would fail the test 
within the age group eligible for enlistment in the Army* Ther.efore:, in 
the Third Army Area 10,448 men should have been rejected. This means 
within the Third Army Area there were 4,844 men in September 1948 who were 
accepted but should have been rejected. 
• .It seems fairly obvious that our enlistment procedures have been lax 
and that many of the medical and-administrative problems encountered today 
are from men who should never have been inducted or,enlisted. This matter 
has.come to the attention of the General Staff, and it is expected that 
some change will be forthcoming in the standard operating procedure for 
enlistment and/or induction. 
Current planning on enlistment procedures. Lt. Colonel R. E, Conine, 
Procurement Branch, elanpower Control Group, P&A.Division, states that PdA 
has drafted a lengthy detailed- letter which they are submitting to the 
Chief of Staff, requesting that he send the letter to each Army Area commander. 
The letter points out the inadequateness of recruiting procedures during 
the past few months and indicates the cost to the Army of such practices, 
I 
It urges each Army commander to take what steps he feels necessary to 
assure a higher quality of recruiting proced'.yes in his Army Area, 
Colonel Conine states that the P£.A Division feels that a certain 
number of the unsuited recruits brought into t) e Army are passed by 
examining physicians who do not perform their job properly. They feel 
that the Army surgeons'should give this matter closer attention and 
should work closer with the military Personnel Procurement Officer in each 
Army headquarters. Colonel Conine states that the P&A Division at this time is attempting 
to set up some kind of a reporting system which will let each recruiting 
station know v;hen one of their recruits is separated from the 'Service within 
the first I4 weeks of service. They feel that such a reporting system will 
disclose the recruiting officials who persistently recruit unfit personnel. 
He emphasized that they hope this report will also disclose the examining 
physicians who approve physically unfit recruits. The purpose of the report- 
ing system is to eliminate from the recruiting procedure those individuals 
who are not doing a good job, as well as encourage all recruiting personnel 
to apply more carefully existing standards. To this end, they are contem- 
plating setting up net quotas instead of gross quotas which now exist. 
Under the proposed plan, each recruiting officer would lose points for 
each unfit individual he recruits. They have not worked out the details 
of this system as yet but they feel that something in this line will be 
initiated soon. 
Colonel Conine stated that the Navy has requested all .of their medical 
installations to help Army recruiting stations in the examination of 
recruits. He stated that a number of recruiting stations have reported 
that they have been using adjacent Navy medical units and have found that 
service to be very helpful. He states that P&A feels that a medical 
officer of one of the Armed Services is much moi e capable of examining a 
recruit than is the average civilian physician. 
Colonel If. G. Caldwell, Chief, Organization and Training Branch, 
MPPSD, AGD, also feels that the examining physician should be more closely 
supervised and that the Army Surgeon should make greater effort in educating 
the examining physician in respect to Army examining standards. He defi- 
nitely feels that a closer relationship should exist between the Army physician and the Army MPPO and that the Army Surgeon should have a more 
accurate knowledge of the situation by a closer liaison with the Training 
Division in their respective Army Areas. Colonel W, G. Caldwell also 
poses the following questions; 
a. Would prompt report of fraudulent enlistments from the 
the Training Division to the Recruiting Station (through channels) 
tend to raise the standard of administration of the physical 
examination? 
b. Is the present physical examination form and its 
administration adequate to disclose either physical or psychiatric 
defects? If not, what improvement is recommended? 
c. Do enlistment quotas tend to result in lenience on 
the part of the medical examiner in what appear to be minor 
physical defects? 
d. Is closer supervision of Recruiting Station medical 
facilities and personnel practicable? 
e. Would a closer liaison between the Surgeon of the Train- 
ing Division, Army Surgeons, and the Surgeon in the Recruiting 
field particularly in the matter of acceptable standards, 
be advantageous? 
Recommendation: The recommendations of the Neuropsychiatry Consultants 
Division, with reference to enlistment and induction, include the following; 
. . I".' ’ 
a( Information from schools. It is recommended that 
pertinent data on the individual who enters the service from 
school or who has been out of school for not more than five 
years be obtained from appropriate school written records, 
(Information suggested; Age left school; last grade completed successfully; grades failed; reason for leaving school; average 
academic standing in class; school years covered by the report; 
remarks to include significant fluctuations in grades and deport- 
ment and pertinent information from other schools, if available.) 
b. Information from Police and Court Records. It is recom- 
mended that the individual's fingerprints be cleared through the 
,V, 
Federal Bureau of Investigation before induction and that details 
of charges, convictions and sentences be obtained by direct cor- 
respondence to the police agency or court in which a record 
appears to exist as indicated by the Federal Bureau of Investiga- 
tion report, (information suggested: Type of conviction; nature 
of charge; nature of and disposition of sentence; and remarks 
from record which will help to evaluate the individual's adjust- 
ment to military service.) 
c. Information from Mental Hospitals and Institutions. 
It is recommended that the individual's name be cleared through 
the central files of mental patients in the states that have a 
central filing system. In states where central files do not 
exist, it is recommended that the individual's name be cleared 
with each mental hospital in the state in which the individual 
has resided for a period of five years or more. (Information 
suggested if he had been a patient in any mental hospital: 
Date of his admission; date of his discharge; diagnosis; and 
condition at discharge.) 
d. Information from Employers. It is recommended that 
information not be obtained from employers. Because it is be- 
lieved that the number of pertinent evaluations by employers will be so small, a general coverage in this area for all 
individuals is not warranted, 
e. Information from Social Agencies, It is recommended 
that information not be obtained from social agencies. It is 
believed that only a few of the individuals in the induction 
age group wH.1 be known to social agencies and that an overall 
coverage is not warranted, 
f. Attitude of Induction Personnel, It is inferred that 
if the persons making contact with the candidate for military 
service are sincerely directed toward adhering to existing 
procurement procedures and standards, it is believed that the 
individual candidate will (l) understand the purpose for which 
pertinent information is sought, (2) be motivated to present 
the factors honestly, and (3) be able to give considerable 
information of real value. 
g. Clearance for Previous Military Service, It is recom- 
mended- that effective and accurate clearance for previous mili- 
tary service be instituted so that the record of prior service 
would be available before induction, this can best be obtained 
through clearance of fingerprints at the Federal Bureau of 
Investigation. 
h. Evaluation of Motivation. It is recommended that 
induction personnel should carefully evaluate the motivation 
for joining or staying out of the Armed Service before accepting 
the individual. 
i. Assistance in Processing. It is recommended that personal 
assistance in completing the forms and understanding instructions should be given to the inductee on the assumption that confusion 
and inaccuracies may be eliminated by such help. It is also 
recommended that the language of the forms and instructions 
should be lowered to the comprehension level of the average 
candidate. 
j. Continuous Checkup Procedure, It is also recommended 
that the induction process should include a continuous checkup 
procedure so that the personnel at the induction level would 
become fully aware of each of their "failures.n A record of 
these failures should be maintained to eliminate from the 
procuring program those procuring agents who persistently induct 
such failures. 
Colonel Tynes - Colonel William S, Stone, Chairman of the Medical Department 
Research and Development Board, vail now speak on Medical Department Re- 
search and Development during the past year. 
Colonel Stone - Army medical research and development is confined to 
militant medicine, except for minor work being carried out in various Army 
hospitals, in conjunction with clinical care of patients. The definition 
of military medicine used is the knowledge, skills, supplies and equipment 
required for the maintenance of health, the treatment and rehabilitation 
of the sick and injured occurring in war which are not developed, or in- 
adequately developed, by non-military agencies. For the most part, mili- 
tary medicine consists of four main fields: 
a. Preventive medicine on a world-wide basis under conditions 
where civil public health services are non-existent or operating in a 
totally inadequate manner. b« The treatment and rehabilitation of large numbers of traumatized 
individuals suffering from wounds, chemical, radiation and other injuries. 
c. Reactions due to stress. 
d. The classification of manpower on the basis of physical and mental 
health standards needed for the efficient use of personnel under conditions 
of war, 
In recapitulation, the main fields of research and development of 
military medicine are: 
a. Physical and mental standards for the most efficient use of man- 
power. 
b. Preventive neuropsychiatry and psychology. 
c. Radiobiology as it affects medical practice, including preventive 
medicine. 
d. Arctic medicine. 
e. Traumatic surgery and resuscitation required for war casualties. 
f. Disease prevention, control and treatment. 
g. Metabolic diseases. 
For Fiscal Year 1949* was appropriated by Congress for re- 
search and development of the Medical Department of the Army, This money 
supports: 225 projects in 10 Army installations, 3 other governmental 
agencies,, and 42 colleges or universities or hospitals; moneywiso, approx- 
imately 50$ of the research is done in Army installations, and 50$ by 
contract with other agencies. 
I will not attempt to review all of the projects, but will briefly give 
a few details on progress made in some of the outstanding projects: 
Army Medical Department Research & Graduate School. Washington. D. C. 
a. Chloromycetin treatment of typhoid fever was developed. b. I'/hat appears to be an effective rodent repellent has been found 
and is undergoing test, 
c. Purified virus vaccines with greatly reduced foreign protein 
content have been developed. 
Medical Nutrition Laboratory. Chicago. Illinois 
a. Further evidence on the role of cobalt salts in anemia has been 
brought forth. 
b. That globin can be a source of protein in regeneration of red 
blood cells has been demonstrated, using N15 isotopes. 
Medical Department Field Research Laboratory, Fort Knox, Kentucky 
a. Additional physiological studies on man's ability to work and 
\ 
live under conditions of extreme cold have been made. 
b. A new method has been developed for studying cell injury due 
to ionizing radiation. 
Surgical Research Unit. Brooke Army Medical Center, Fort Sam Houston, Texas 
a. Prevention and control of surgical infections have been further 
studied, using combined antibiotic therapy. 
b, Plasma substitutes, Dextran and gelatin have been studied. 
Engineering Development Division, ASMPA, Fort Totten, New York 
a. Improved field X-ray equipment and new field chests have been 
developed. 
CONTRACTORS 
Dr. J. Garrott Allen, University of Chicago demonstrated the role of heparin 
in hemorrhages following radiation injury, and the value of promin, 
certain dyes and bone marrov/ shielding in the treatment of radiation 
injury. Dr. Hugh Smith, et alt Campbell Clinic, Memphis, Tennessee - the use. of 
intramedullary nails in the treatment of fractures, their value and 
limitations. 
Dr. William S. Tillett, New York University - Bacterial enzymes in. the 
handling of purulent and fibrinous exudates as an aid in the treat- 
ment of infections. 
Dr. Harvey Allen. Cooke County Hospitals, University of Chicago - the 
treatment of thermal burns - a new first-aid dressing has been de- 
veloped. 
Dr. Edward L* Howes. Columbia University — the mechanism of wound healing. 
The inhibitory action of ACTH and similar substances on wound heal- 
ing has been demonstrated. 
Dr. Paul D. White, Harvard University - 20 year follow-up on cases of psy- 
choneuroses of World War J and evaluation of psychotherapy as a 
therapeutic agent. Psychotherapy produced no better results than 
friendly counsel and reassurance. 
Dr. J. W, Conn, University of Michigan - the- chloride content of sweat 
has been demonstrated to be an index of stress experienced by the 
individual. 
Dr. John H. Dingle - Dr. Charles H* Rammelkamp, western Reserve University 
Studies on streptococcal disease at Port Francis E. warren - the value 
of penicillin prophylaxis for the prevention of rheumatic ..fever in 
exudative streptococcal disease of the nose and thrpat has been 
demonstrated to markedly reduce the incidence of rheumatic fever fol- 
lowing known streptococcal infections,. 
Dr, Aram Glorig, Audiology & Speech Correction Center, Forest Glen - a standard hearing test for auditory screening during mobilization 
is being perfected.,,. . 
From this brief review of some of our research and development 
projects, I am sure it is apparent that much information is becoming 
available that is of great importance in medical training for national 
defense. 
It is planned to inaugurate courses in military medicine in the near 
future to teach the lessons learned through professional experience in 
World War II, and to supplement that information by the products of re- 
search in military medicine as fundamental steps in military medical 
preparedness. It is hoped that this material can be made available to all 
medical components of the Army, civilian medicine and those interested in 
civilian defense. 
Colonel Tynes: Our next speaker is General Hays, Chief, Supply Division. 
He will discuss problems of supply. 
General Hays; I want to say "hello” to everybody. I havenft had a chance 
to see most of you as I have not been here most of the day. 
On the subject of supply one of the urgent problems at this time is 
the development of a comprehensive policy with respect to the retention of 
an adequate level of "standby” medical equipment at station level. 
The basic authority for the retention of "standby” or "housekeeping” 
equipment at stations is contained in Section II, Far Department Circular 
No. U, dated 4 January 194-7. In general, this authority authorizes the 
retention of sufficient quantities of non-expendable, non-deteriorating 
medical equipment to support normal operating requirements for the planned 
total strength for the active forces listed in Progress Report, Section 3-D, Program of Installations, Volume II, dated 30 June 1947. Active 
forces as defined in the Program of Installations includes trainees 
under the Universal Military Training Program. The quantity of medical 
equipment to be retained is to be computed on the basis of three percent 
(.03) of planned strength. 
Based on the above authority, Commanding Generals of Zone of Interior 
Armies and the Commanding General, Military District of Washington have 
established maximum levels of equipment to be retained at each Zone of 
Interior installation under their control. Similar action has beentaken 
by this office in the case of general hospitals. The difference between 
the maximum equipment level and the current authorized bed capacity 
represents the actual amount of equipment authorized for retention in 
standby status. 
The above mentioned policy is inadequate in .several respects, insofar 
as medical requirements are concerned; 
The procurement of Additional equipment is not authorized until 
such items in a standby status have been utilized. Under this provision, 
items in standby would, of necessity, have to be withdrawn to meet current 
requirements thus obviating the retention of a firm level of equipment. 
The' justification for standby is based chiefly on requirements 
for the support of TJMT. The repudiation of UMT as an approved national 
defense policy would result in the withdrawal of the majority of medical 
equipment now in standby and reduce levels for all practical purposes to 
the current authorized bed capacity. 
If, as these hospitals are reduced in authorized bed capacity, 
and we are forced to dispose of equipment 'already on hand down to the bare 
66 operating level, it'.will be impossible to re-expand them to their 
maximum constructed capacity oath any degree of rapidity* There will 
probably be a decreasing number of authorised hospital beds as a result 
of decreasing morbidity rates and a decreasing Armj strength. In other 
words, we will have no cushion to take care of neets for increased beds 
in any hospital. Such.a local need might result from increased sickness 
rate, an epidemic, local disaster, or possibly sven.local enemy action. 
The policy is expensive. As hospitals are reduced in size, 
we will be forced to go to the expense of packing and shipping equipment 
and inspecting and warehousing it in depots. Should the need develop 
for temporary or permanent expansion in any hospital, we will then have 
to go to the expense of shipping the materiel from the depot back to the 
hospital. 
To alleviate this situation, the Surgeon General requested authority 
of the Department of the Army to retain standby medical equipment in Zone 
of Interior general hospitals to the extent of constructed capacity. It 
was recommended, also, that standby equipment in general hospitals be 
considered a firm reserve, not subject to. withdrawal, to meet current 
requirements. These recommendations were approved and announced to the 
field under date of 23 August 194-9 (letter, Office of the Surgeon General, 
MEDDE, 23'August 1949, Subject: "Standby Medical Equipment (Expansion 
Reserse)” addressed to Sommanders, of general hospitals through Zone of 
Interior Armies). 
At the time the revision of standby policies was requested for 
general hospitals, the Department of the Army was advised a study would 
be made of Zone of Interior station hospital requirements and submitted at a later date* This study has been completed and forwarded to the 
Department of the Army recommending a*n increase of approximately /+0% in 
equipment levels for station hospitals. It was recommended, also, that 
standby equipment in station hospitals be considered a firm reserve under 
the same conditions authorized for general hospitals. 
In the event that the revised policy is approved for station hos- 
pitals, this office will advise each Army of the total level authorized 
for their area. We will also furnish a suggested breakdown of equipment 
authorization for each installation, based upon the latest information 
available in this office concerning station hospital requirements. 
This office has published to the field a specific list of items 
authorized for standby. This list includes approximately 250 items of 
medical equipment, many of which require installation, such as operating 
lights, dental units and x-ray machines. 
Last spring we developed a certain procedure for mothballing equip- 
ment at hospitals. We conducted these tests at Camp when that 
hospital was closed. We have taken movies of it and we are preparing a 
manual. They should be available within the next few months, and we will 
be in a position then to give all hospital commanders assistance in moth- 
balling their equipment. They can bring the movie into your hospital and 
give you the manual and we can send a detachment from a depot that has 
been,carrying on this mothballing procedure to assist you in mothballing 
your equipment. It has been rny experience that even in hospitals where 
we do rot have much standby, or do not plan to have much, that this moth- 
balling operation can well pay its way on many items of equipment that 
you have in stock. As soon as the film and manual are'.ready, we will let 
you know. Section II of Far Department Circular No. 4 of 1947 is being 
replaced by a new publication now in process. The new publication will 
restrict considerably the amount of equipment now authorized for standby. 
The Surgeon General's Office has concurred in the general policy of 
reduction since most technical services do not have an urgent need for 
the retention of equipment at station level. There is, however, a 
specific provision in the publication authorizing the retention of 
Medical Department equipment on the basis of 125 percent (.125) of 
authorized capacity or constructed capacity, whichever is lower. There 
is a provision, also, that exceptions to the overall policies will be 
made -when indicated. Since the Surgeon General already has asked for 
specific amounts of equipment to be retained at general and station hospi- 
tals in the Zone of Interior, the new publication will not effect levels 
of medical equipment authorized to be retained at stations, 
y 
Another important phase of medical supply operations is the equip- 
ment survey of medical installations. This survey is a function of the 
"Medical Equipment Survey Committee" that has been operating as a field 
agency of the Supply Division for the past two (2) years. 
This Committee was organized for the purpose of visiting hospitals 
and dispensaries and compiling accurate and up-to-date information on 
requirements of medical equipment. It supplements our normal requirements 
system and has rendered valuable assistance in improving standards of 
equipment im medical installations. 
The Committee has visited all hospitals and dispensaries in the 
Zone of Interior and recently completed a survey in an oversea command. 
Members of the Committee are familiar with recognized standards of equip- 
ment in both civilian and military hospitals. jn conducting field surveys, visits are made to the various clinics 
and departments of a hospital and equipment requirements are. discussed 
with operating personnel. Upon completion of the survey, a report of 
equipment requirements is submitted to the hospital commander for comment 
and transmittal to the Surgeon General’s Office, through command, channels. 
The report includes both standard and nonstandard requirements. 
Upon receipt in this office supply action is initiated to the extent 
of available stocks and funds. Since the Committee was organized we have, 
as a result of field surveys, distributed standard stocks valued at 
approximately tv/o million dollars and nonstandard funds amounting to 
approximately 1,3 million dollars. 
A considerable backlog of both standard and nonstandard requirements 
has accumulated due to budgetary limitations. These requirements are 
reviewed in this office at periodic intervals and supply action is 
initiated automatically as stocks and funds become available. Due to 
rapidly changing conditions in medical installations, it is our policy to 
communicate with stations before initiating supply action, when there has 
been any appreciable lapse of time since completion of the survey. The 
cooperation of hospitals, in this respect, will be of material assistance 
to this office in effecting an equitable distribution and obviating the 
accumulation of excess stocks.. 
One of the projects under the Medical Equipment Survey.Program is 
the replacement of white enamel, and out-moded items with corrosion re- 
sisting metal and other preferred types of equipment. This includes such 
items as medicine cabinets, bedside tables, dressing cabinets and 
instrument trays. It will be necessary to continue this program over a 
70 period of years since funds do not permit immediate replacement of all 
items. There is, also, the problem of excess equipment that would, be 
generated at stations by mass replacement of serviceable items. As a 
matter of general policy, we propose to replace these items as they become 
unserviceable. Some stations have not understood this policy and have 
been of the opinion that we were in a position to replace all white 
enamel equipment within a short period of time. When we query stations 
as to their immediate requirement for a preferred item of equipment, we 
want them to consider their needs for replacement of unserviceable items, 
plus any requirements they may have for additional equipment. We do not 
expect as a result of this program that a station will accumulate an 
excess of serviceable equipment which will have to be returned to a depot. 
Another problem we have found is the matter of funds for installa- 
tion of new equipment. The Medical Department is responsible for the 
installation of tcchincal medical equipment to the extent of placing, 
connecting, adjusting, calibrating and testing the item. Cost of 
installation which involves changing of utilities (plumbing, heating, 
electricity, gas, water, air conditioning, etc.), or modification or 
renovating structures or bringing in power lines are chargeable to Repairs 
and Utilities Fund. This policy has been announced to stations through 
medical distribution depots. Wherever possible we include cost of 
installation, properly chargeable to Medical Department funds, in the 
contract. In case an item is issued from stock and no provision is made 
for installation by the manufacturer, request for Medical Department funds 
required for installation should be directed to the medical distribution 
depot. The medical depots will either effect installation by a Medical 
71 Equipment Maintenance Officer or authorize the station to procure the 
service locally from funds furnished by the depot. Estimates of 
repairs and utilities funds required should be submitted to the Repairs 
and Utilities: Officer designated to service the station. Considerable 
delays have, occurred in the installation of Medical Department equipment 
due to a lack of repairs and utilities funds. In a number of instances 
this was due to a lack of advance planning since Repairs and Utilities 
officers had not been informed, in advance, that certain funds would be 
required for installing medical equipment. We do not feel that requisi- 
tions for medical equipment should be delayed pending assurance of the 
Repairs and Utilities Officer that funds are available for installation, 
provided there is a definite need for the equipment. However, close 
A 
coordination should be maintained with the local Repairs and Utilities 
Officer,, and he should be advised when a requisition is submitted for 
equipment that will- necessitate the expenditure of repairs anc utilities 
fund for installation. 
During visits to hospitals we have noted that medical equipment 
furnished under the survey 'program, as well as items received through 
normal requisitioning channels, are not being utilized to the fullest 
advantage-. For example, we have found, in storage, new items of corrosion 
resisting metal equipment, as well as other preferred items of equipment 
while equipment .in varying stages of serviceability was in use through- 
out the hospital. 
We have found, also that some medical supply officers are not 
familiar with the survey program and the fact that a survey has been 
made at the hospital. Medical equipment survey reports are kept current in this office. The data contained in the reports are used as a basis 
in computing requirements, scheduling procurement and in making distri- 
bution to individual stations. The particular itmes of equipment 
included in the program have been published to the field. It is recom- 
mended that hospitals make periodic surveys of requirements of these 
items and keep this office informed through medical distribution depots, 
of additions:or deletions that should be made to the original survey 
report, 
The Medical Equipment Survey Committee will continue to make visits 
to stations for the purpose .of reviewing previously established require- 
ments and keeping the survey program up-to-date. Te make a policy of 
advising stations approximately one (1) month in advance of a proposed 
visit. It rail assist the Committee materially if a thorough study of 
requirements is made by local personnel prior to their arrival. 
Only one other thing I would like to say and that is the thing that 
I always say in talking on supply. That is that the weakest link in our 
supply chain is now and always has been between the professional man in 
the hospital and the supply man. It is half the fault of the professional 
man and half the fault of the supply man. All individual cases differ, 
sure, but totally speaking, both of them are at fault. The professional 
man does not do his part, and the supply man dees not do his part. Now, 
it is the job of the supply man to get out, visit the professional men 
in their'place of business, in their clinics, in their wards, find out 
what they need, and get it for them. Likewise, it is the job of the 
professional man to find out what the supply man has and take proper 
steps to get it. I do not think that can be emphasized too strongly - that is always cur weakest link and every time we find supply trouble in 
a hospital, that is always present, I think you as hospital commanders 
and as army surgeons can do quite a bit to improve that situation. You 
can encourage, and if necessary, insist that your supply officer get 
around to visit the professional activities in the hospital and get 
acquainted with the younger doctors, the older doctors, the dentists,,, . 
and the nurses and find out what they need. Give him five minutes at 
your staff meetings and conferences. If he has the attitude that his 
professional people cannot come down in his supply room or warehouse and, 
see what there is, get him straight on that. Those people ought to be 
able to come down there and look around just as much as they can go into 
a surgical supply house and look around and see what there is. I think 
that the hospital.commanders can do quite a bit. 
General Offutt* What do you mean by constructed capacity? Is that 
1 . . ; '■/ , , ' 
emergency capacity of 72 feet or is it constructed capacity of 100 feet? 
General Hays; I cannot answer that off hand,* but the letter that went 
to each hospital gave the constructed capacity as recorded on records in 
this office. 
General Offutt.; It does- not say on what it was based. 
General Hays.;. I cannot answer that. Colonel Riordan can you answer 
that? 
Colonel Riordan-; No sir, I am not sure. 
General Hayg: Will you check that? ■ You can check that right now and we 
can have that answer for you this afternoon before the meeting adjourns. 
Colonel Tynes * Colonel Goriup is our next speaker. He will speak on 
’’Basic Requirements for Medical Service Corps Officers.” Colonel Goriup; Ladies and Gentlemen. The. Medical Service Corps is 
slightly over two years old. I thought that perhaps you might be 
interested in a few statistics with reference to the Regular Army 
Medical Service Corps, These figures care approximate. 
Our original authorization was 1,022, which has since been reduced 
to 832 as a. result of the establishment of the Medical Department for the 
United States Air Force. Considering the numbers of Regular Army Medical 
Service Corps officers transferred to the Air Force plus the gains and 
losses, we have approximately 590 on the roster today, of which 505 
normally fall under the Pharmacy, Supply and Administration Section; 
11 in the Engineering Section; 73 in the Medical Allied Sciences Sections; 
and 1 in the Optometry Section. The 590 breakdown approximately in the 
following categories: 30 are preintegrated officers of which 11 came in 
by way of the professional examination for the old Pharmacy Corps. 
Approximately 75 were career enlisted men who came into the Army in 1939 
and prior thereto. Approximately 4-00 were selectees who received their 
commissions through Medical Administrative Corps Officer Candidate Schools, 
and approximately 90 held Reserve commissions prior to World War II or 
received a direct appointment during the War, A few were integrated into 
the Medical Service Corps from other branches of the Army. 
A recent study of records indicated that 4-2.0 percent hold bacca- 
laureate degrees of one form or anot.her, that 13 percent have graduate 
degrees up to and including the doctorate. Medical Service Corps officers 
with graduate degrees are not all in the Allied Sciences Section, 
Approximately 30 are enrolled in graduate schools at this time, including 
4 pharmacists, who are assistant professors of military science and tactics at pharmacy ROTC units. 
I should like to mention a few words for those Regular Army 
Medical Service Corps officers who have less than a baccalaureate degree. 
In my opinion, I think it can be safely said that the Army is the greatest 
university in the world and that these individuals have race-’ ved certain 
training that makes them equally qualified with their brother officers 
with academic degrees by their training, indoctrination, and experience 
gained while on duty. I believe it Is safe to invoke the "grandfather 
clause" in their case, 
vre have approximately 2,000 Medical Service Corps Reserve officers 
on extended active duty. Time has not permitted a statistical analysis 
of their educational qualifications. Approximately 8,5 percent have had 
six years experience as officers on extended active duty, and it is felt 
that approximately the same number would reenlist in thd Service upon 
attrition. 
The subject of my address is "Rasic Requirements for Medical Service 
Corps Officers." To my mind the basic qualifications of our officers are 
that they be intelligent, personable, and adaptable, or, more facetiously, 
he should be a mortal giant, a veritable Solomon, and a miniature Dale 
Carnegie. 
To determine the basic qualifications for a Service Corps officer, 
we must base it upon certain assumptions such as; It is altogether 
possible that in the event of hostilities, the United States and her 
allies could well be outnumbered in manpower by our only potential enemy 
and her satellites. It has been mentioned on many occasions by people 
in all walks of life that the necessary mobilization could well be a total mobilization. It would also appear that the Array could hardly avoid 
participating in civilian defense in time of a mobilization. It is 
safe to assume that the current trend of our civilian population in 
placing more and more demands on our medical doctors will continue and 
that the supply will not be able to keep up with the demand in peace- 
time let alone in time of an emergency. This trend, I am sure, will 
further aggravate the supply of medical doctors and create a shortage 
for the Armed Services in time of mobilization. If this is true, then 
it becomes increasingly important that qualified assistants be made 
available to the Medical Corps to assist them in their mission both in 
peace and in war, • 
It can now be assumed that the efforts of the Medical Department of 
the past few years will result in the Medical Departments obtaining a 
sufficient number of medical officers for' their requirements for the 
Regular Army, At such time as that requirement is met, we can ill afford 
to relax the continued development of the Medical Service Corps officer 
lest we be caught short of trained, qualified officers of this sort in 
time of mobilization. I feel that it is incumbent upon all of us that the 
training of Regular Army and the Reserve Service Corps officer on extended 
active duty should go hand in hand with the training and development of 
their counterpart in civil life. 
It is traditional for a man to get a year older each year, which 
may not be true of a woman, and as such, we have and will continue to 
got attrition in our Reserve Corps, To that end, we must constantly 
look to new procurement. We expect to get this new procurement in the 
Reserve corps through the medium of Circular #210, ROTC of our own pharmacy units, as well as from other ROTC units, and in the near 
future, from CCS. It is hoped that our total future procurement for 
the Regular Army will accrue to us by the direct appointment of Dis^- 
tinguished Military Graduates of our own as well as other ROTC units 
■■ ■ ■ ' » " ■ • ■■■ . 
and as a result of successful completion of qualifying tours of our 
Reserve officers. 
At this point, I feel that you can be of great assistance to us in 
the Surgeon General's Office by screening out at your level those 
viduals who apply for a qualifying tour with less than ‘an academic degree 
and who are over 30 years of age. This is not a Surgeon General's policy, 
but rather the policy of the Department of the Army. The Medical Service 
Corps is authorized to appoint officers up to the age of 30 years, whereas 
the other corps of the Army cut off at 28 years. Public Law #381 provides 
for the Secretary of the Army to waive age requirements. However, the 
Secretary of the Army's Office has stated and reiterated on many occasions 
that they do not intend to waive the age requirements. We do have 
authority, however, to credit an officer with all service performed subr- 
sequent to 31 December 19A7. In other words, a Service Corps officer 
who on 31 December 19A9 is 32 years of age and who has been on continued 
active service since 31 December 19A7 would be eligible for a qualifying 
tour, since his two years' service could be subtracted from his current 
age, which would bring him within the authorized age of 30. 
Just a word about career development. It is our Job to furnish 
you with Medical Service Corps officers to satisfy your requisitions. We 
do our very best to assign capable officers to your command upon your 
request. We are fully aware that it is your responsibility for their subsequent assignment and utilization, ?.Te have only recently been able 
to analyze the background and other qualifications of our Regular Array 
Service Corps officers and voucher them in a systematic mannerDuring 
this study we observed several c.onditions that I believe you will be 
able to assist us in correcting. 
We have observed that in some instances Medical Service Corps 
officers have been in the same type assignment for a number of years. We 
believe that in order to insure versatility in our Medical Service Corps 
officers that be rotated. We are very■reluctant to contact you with 
official letters in this regard. In the final analysis, we of the 
Medical Service Corps lock to our senior medical officer for guidance and 
advice, Wa have also observed that in some instances there is a dispro- 
portionate number of Reserve officers in key positions. This also tends 
to prevent our Regular Array officer from obtaining the type of training 
necessary in his development. A recent study of the composition of field 
units indicated two conditions; One, that an inordinate number of combat 
arms officers were assigned to medical field units and that of 253 Service 
Corps officers assigned to .field units, only 20 were Regular Array. Wo 
are attempting to correct this situation at this time by making available 
a larger number of Regular Array Medical Service Corps officers for this 
type of duty. 
I believe you will all agree that the mere assignment -f an officer 
from the field to the Surgeon General’s Office dees not make him any 
brighter, but the very nature of this assignment places him in the 
/ 
position of making certain decisions and recommendations to the Surgeon 
General. Many of these decisions are based reports and records, such as efficiency reports and the general 201 file. In many instances, 
we find it extremely difficult to make erudite decisions on'our. Medical 
Service Corps officers due to the inadequacies of the records. In 
order to develop the Medical Service Corps to its highest pitch .of 
efficiency, it is most important that we who work with records be insured 
that we have explicit data on each and every one of our officers. I do 
not wish to imply that I am advocating a witch hunt, but we would, 
certainly appreciate your being factual in your statements on any Medical 
Service Corps officer should he not be up to standard in performance, A 
Reserve officer of this type can be declared surplus, A Regular Army 
officer will eventually be attrited. 
If there are any cripples, we must ruthlessly ncut them out of the 
herd” to the end that we will have a pure strain. 
We are not interested in thoroughbreds for they quickly become con- 
taminated by inbreeding. 
We are proud of the group we now have and will be prouder still of 
the new man we are now and hope to 'continue to attract in Joining up 
with us. 
Colonel Tynes; Before calling on our final speaker for the afternoon, 
I have one request - I would like an opportunity to see Colonel Keeler 
and Colonel Welch sometime tomorrow or Thursday, at their convenience. I 
will be in my office all day Thursday and five to ten minutes with you 
tomorrow, possibly on the way up to the meeting might be sufficient to 
’ ' * ' ’ i 
take care of what I have to give you. 
Our last speaker this afternoon is Colonel Wilson, .who will talk on 
the subject "Current Situation of Civil Health Affairs in the Army." 
Colonel Wilson: Gentlemen, you have no problem of potential greatness equal to this one today. As time would prevent a complete discussion of 
this subject, I have prepared for you two sets of papers, one, an out- 
line of notes on the subject assigned, another which includes some 
answers to the question submitted by Colonel Gorby with reference to 
the Array surgeon's responsibility in making plans for meeting biological 
warfare. As you can well see, that second set of notes will have direct 
application to this subject. The outlined notes which will be provided 
you and have not yet been, speak specifically of the responsibilities, 
as they may be seen now, which are faced by the Array surgeons. It also 
lists exact references in which you can find definitions or clarifications 
of terms which have been made by the Department of the Army and therefore 
should be uniformly used by all of us until someone gives us different 
definitions. Within the listing'of definitions in that particular 
reference,, one finds, also, clear statements of what is meant by mili- 
tary aid to civil authority, what is; meant by civil defense, what is 
meant by responsibility for internal security and such terms which have 
been a little bit nebulous or vague in•our minds for the past two years. 
The second group of references has to do with exact policies as they have 
been determined and- published by the Department of the Army. The third 
set of references in that list-bf notes has to do with certain other 
things such as methods of planning, components of a plan, suggested 
activities in which the Array surgeon, cr his station surgeons under his 
direction or supervisi n,. or advice can proceed to aid local authorities 
in their planning; that is local civil authorities in their planning. 
No?/ you will see the significance of that a little bit later ?/hen we 
refer to a Special Regulation of the Department of the Army. In your outlined notes- there' will also? bo a-:-statement- of your, justification for ; 
interesting yourself, in this; subject. Up to. now there has- been .some . 
excuse for any one of us questioning v/hether we actually have any.res- 
ponsibility, ' and if we thought'we did have, vdiat justification we might 
advance' to our command, What•Justification can we advance to any 
civilian when he wants to know why we poke into such affairs as this? 
You will have specific Statements in the notes. -Finally, there will be 
a rather detailed statement of the exact, current situation with refer- 
ence to civil defense particularly, but much less on.any other civil 
affair. That is primarily because of the fact that here- in the United 
States we actually have no civil affairs responsibility of any great 
importance, except perhaps civil defense.. I should like to stress to ; 
certain specific references and if you donft mind I shall just hold 
them up for you to see. If you do not have them in your library apd if, 
you should have any trouble obtaining a copy of any one of these, we 
would certainly undertake to help obtain copies. The first one I should- 
like’ to mention is the Hopley Report, -i.e., Civil Defense for National 
Security. Now'certainly I would recommend that no one further along 
the line than the Army surgeon undertake to read this report too care- 
fully, ft is a top level planning document, so except for the Army 
surgeon who might want to study it for federal organization, for poten- 
tial military organization, or for integrating suggested local and state 
civil defense civilian organizations within his thoughts, I would 
recommend that no one do more than just look at it. A second document 
of real significance, Y/hich ought to be thoroughly understood by every- 
body to the farthest level is Special Regulation 5B0-10-1, Civil Defense, 
82 These all are listed for you in the outline'of notes. This is a clear 
statement of civil defense and it places specific responsibilities upon 
the Army area commanders. The third reference which you'may not have, 
and I would suggest that you be sure'you have, is this "Guide to Termin- 
ology and Policies with Reference to Military Aid to CiYil Authorities," 
dated 30 September 19-49. That was sent out to all Army commanders. 
Knowing how things happen I wouldn’t be surprised if it didn’t filter 
down to each Chief of Technical Service in the Army headquarters. It is 
essential for all of us to use a uniform terminology henceforth, A fourth 
reference of particular value to you in reassuring you that you are on 
safe grounds from a security viewpoint, and in giving you something that 
you can clearly refer to civilian planners or any civilian interested in 
this subject, is the Secretary of Defense statement on biological warfare 
potentialities. Each visiting officer has been provided with a cop;/. 
That is unclassified as you will see, and it is a step in the right 
direction. Another reference which is purely of a press nature is the 
outline that was handed to you, "Articles Published in the Philadelphia' 
Inquirer" by John McCullough. Those are as clear a statement as I have 
seen of'many of the aspects of atomic warfare. You and I have seen reams 
. . . » . ..... . * • , . t 
and reams c5f literature and we see pamphlets arid we gat confused before we 
can get started. Now these four consecutive daily issues of the 'Phila- 
delphia Inquirer" include a very clear and usable statement that you can 
apply and can refer to civilians readily. The Office of Civil Defense 
Planning before its abolition in the Department of Defense, was authorized 
to reproduce this in full for use by military personnel in their regular 
duties so no copyright was infringed in this, and you therefore can use 
83 it freely as long as you cite the source. There are two other references 
which may be of some help that you can cite to civilians. One was an 
article and I apologize to you for mentioning this,-but in the January 
1942 issue of the Army Medical Bulletin was published a through and 
complete outline, a check list actually, that could be employed by 
civilians in drawing up Civil Defense plans. That’s. listed in your out- 
line too - it was Medical and Sanitary Care for the Civilian Population 
Necessitated by Hostile Aircraft, A second one which you may not have and 
- is very difficult to. obtain, practically impossible through official 
channels, is a directive that went out in 1943 on Military Hospitalization 
and Evacuation Operations* Now I want to urge that there be no confusion 
about the applicability of that total document. It no longer has any 
official standing as a directive but in that, for your, use in planning or 
discussing civil defense, there1s still a very sound basis for integrating 
military and civilian planning® In that directive, I think that General 
Offutt vd.ll remember, we had from the Surgeon General’s Office a deter- 
mination of mobile units which could be quickly thrown together as an 
expedient for an Army station, either a general hospital or any one of 
our large stations, in the event as a last resort, civilians or civil 
authority were compelled to call upon the Army for aid in a situation of 
civil defense. The reverse is covered somewhat satisfactorily there too, 
Fhat the military could expect from civil Authority on such questions. 
Fhen you have had an opportunity to glance through some of these 
notes, I think that you will find that five conclusions which I shall 
present to you here are thoroughly justified: 
First, that the only real civil affairs problem that might exist for you today in the United States is civil defense. 
Second, that there is no agency of government charged by law with 
civil defense responsibility except indirectly, and that applies mostly 
to the Army. 
Third, if'a major disaster or enemy attack should occur within the 
next few years, the Army and other Armed Services could not avoid par— 
ticipation in the necessary activities to re-establish the civilians in 
their communities. • . 
Fourth, only by considered effort now, and this is by you, with 
appropriate military understanding and organization for civil affairs, 
can we insure civilian preparation and readiness for handling their own 
civil defense at a later date, perhaps five years from new, if civil 
defense actively got going at this time. . ■ 
Fifth, that this special regulation that I have cited to you placed 
such definite responsibility for readiness upon the Army commander that it 
cannot be avoided. 
Now, as a matter of interest here at the end of the day, in order not 
to tax you, you might-like to know that there are many agencies, many 
individuals, many people interested in this subject. For example, 
repeatedly, medical societies over the country are asking for speakers 
from the Office of the Surgeon General. No doubt you are having them out 
in your own areas the same or a similar way, I know that several 
divisions of this office have provided speakers on particular- subjects in 
which medical societies have been interested. In many instances, they ask 
for discussions for which they are not prepared because they haven’t even 
gotten these basic problems solved, but in every instance, it seems to me, all of us should make every effort to provide a speaker who can discuss 
' ■ •; ■ : ■ •; : ,-v ■ 1 ; „ ; - , 
the subjects they want and can tie these military policies, to the extent 
that you can reveal, to them, should tie our own limitations, our primary 
military responsibilities, should tie in the necessity for these civilian 
communities or societies or groups to immediately "get going’* on their 
owTn organization, their own planning. There are four of the ten active 
schools of Public Health in this country who now rare putting into their 
schedules exact and definitely delineated courses in this field. They 
may not be any more-than an assigned problem in Public Health adminis- 
tration, which involves at Johns Hopkins, for example, approximately 
three full afternoon sessions. Thatfs nine hours. At the California 
School of Public Health, which was cited by Colonel Gorby to bring up 
this question of biological warfare, there are forty five hours being 
given to a special group interested in special weapons and administrative 
planning and organization for such problems. At another school there is a 
one hour lecture. That’s just an example of those four schools that we 
have had a direct part in sponsoring and in suggesting content for the 
course. There are medical schools which are including exact lectures on 
this subject, that we have had a little part in. You’d like to knew 
* ‘.f . 
perhaps, that there is a possibility that the Association of American 
Medical Colleges will implement in the orientation of medical students a 
specific course in integration of military and civil medical affairs, 
that being visualized’ as valuable because such a small proportion of the 
medical'students actively engage in the RCTC program; so that the 71 
medical schools in this country, if the plan should develop under Colonel. 
Wergeland in our Education and Training Division of this office, would be implemented as a part of their regular orientation. I think we can all 
appreciate the value of such a thing as that to the undergraduate medical 
students. . 
Several of cur reserve units have requested speakers in this field. 
They arc probably the most active of the' so-called civilian groups, those 
who can most thoroughly understand and aid us in cur efforts to persuade 
civilians to do their own planning and get set to do their own job. 
Under current directives, you could have the job to do if civil 
defense becomes necessary. In that event, you will have to do it all 
\ . - ■ 
if local plans and systems are not set up by the time they are considered 
necessary, I won’t stress that I Therefore, it seems to me that all of 
the supervised station surgeons should go out and preach the gospel at 
the tops of their voices to offer every.aid, and every advice, and every 
reasonable participation with the civilians and civilian groups in setting 
lip their own organizations. You are net only authorized to do that but 
this special regulation directs that it be dene, I should like to repeat, 
you are authorized and directed to furnish advice.and support in the 
civilians’ 'efforts, but you are not, under any circumstances, authorized 
to provide training (yourself) to the civilian groups. 
Let me urge that you should call for help fr-mn here if anything is 
needed. Many times we may not be able to give it, but if there is any 
possibility that we can help we have direct contact with all.of the 
agencies here in Washington, We are working closely w-ith them in the 
— I 
friendliest sort of voluntary way. There is no agencj7-, as I stressed, 
that has the authority to tell any of us from the federal level what we 
are doing in civil defense. Perhaps that makes it even stronger because we try to keep each other informed and it is entirely possible when you 
do have a question 'or you want some support, we can cite to you the 
exact agency which could provide it, immediately, or we could get it for 
you and forward it, Vre are definitely in from the Surgeon General?s 
Office on the establishment of policy by the Department of the Army. We 
, actively participated in this special regulation on civil defense. We 
actively participated and really stimulated the publication of that 
mimeographed directive on the guide to terminology. So, anything, not 
only in the way of‘questions, but suggestions or advice, you feel is 
worth transmitting in here may very well be applied to the advantage of 
all the other Army areas. Weld be glad to have you, while you are here 
if you care to come to my office, I would like to show you some of the 
things that vre have presented to civilians at their request in the form 
•pf addresses or suggested approaches to this problem.' We have some 
.charts down there that may particularly interest you - a step by step 
process that local civilian groups could undertake today. Glass slides 
.of this are not satisfactory, and all of you could not have seen the 
large colored charts had I brought them here. So, if you are interested, 
I would consider it a privilege to quickly show you these and as soon as 
they are published,•if you want'them, we can get any number of copies 
for .you. 
Let me stress finally, the real problem is for you on the military 
side to aggressively integrate military and civilian planning in the 
/ 
organization for civil defense by civilians. They are going to.look to 
you;they have no other source to really get educated, experienced and 
properly trained advisors. Thank you very much. References: 
I. 1. Civil Health Affairs might involve the Army in plans cr opera- 
tions for* 
a. Civilian populations for which the /'imy is or might be 
responsible; 
(1) In liberated territories, 
(2) In occupied territories. 
(3) In theaters of operations. 
(a) In the United States. . 
(b) Outside the United States. 
•(A) In the United States without war. 
(a) Disasters. 
(b) Civil defense. 
b. Civilian populations for wrhich, the Army has no current 
responsibility: 
(1) Normal civilian population, 
2. The Army area surgeons have little-if any direct responsibility 
for planning or implementing civil health affairs operations for? 
a. Liberated territories. 
b. Occupied territories.. . . 
c. Theaters of operations. 
(1) Outside the United States. 
d. Normal civilian population. 
'■ , f- ■' J 
3. The Army area surgeons could have certain responsibilities for 
civil health affairs, as follows: 
a. Theaters of Operations created in the United States. 
b. Disasters. c. Civil defense. 
d. Civilian population under certain circumstances of martial 
law (Federal). 
e. Mass evacuations or relocations, if directed. 
II, 1. Reference applicable to the circumstances listed in I-2» 
a. Definitions' and terms: * 
Directive AQAO-S 400,38 (28 Sept 49) CSGPO'-M) dated 30 
September 1949, subject;- "Guide to terminology and 
Policies with refe-rence to Military Aid to Civil Authorities." 
b. Of policy nature; 
(1) Joint Army Air Force Bulletin No, 13, Functions of the 
9 \ 
Armed -Forces and the Joint Chiefs of Staff, 13 May 1948. 
(2) FM 27~$, United States Army and Navy Manual of Civil 
Affairs Military Government, October 1947. 
(3) FM 27-10, Rules of Land Warfare, as amended, October 
1949.- •• •’ ■* - . •. •: 
(4) T/o & E 41-500, 3 June 1948, Military Government Service 
Organization. 
2. References applicable to the- circumstances listed in 1-3; 
•a. Definitions and terras - same as above, 
b. Of policy nature; 
(1) Theaters of Operations :in United States - same as other 
theaters. 
(2) Disaster relief. - AR 500-60, 1 December 1939, Employ- 
ment of Troops•and Supplies - Tar Department Activi- 
ties in Connection with Disaster Relief. (3) Civil defense, 
SR 580-10-1, 30 .August 19-49, Civil Defense, 
(4) AR 500-50, 17 August 194-8, Employment of Troops - Aid 
of" Civil Authorities. * 
(5) T/0 & E, 41-500, 3 June 1948- - Military Government 
Service Organization. ■■ 
III," 1; ..References of possible aid in planning; 
-a. TALI son, Filliam L: Medical and Sanitary Car..; of the 
Civilian, population Necessitated by Attacks from Hostile Aircraft, The 
Army Medical Bulletin-, No, 60, January 1942, p. 63* This article has a 
bibliography of 120 references; all of the principles enunciated are 
still fundamentally sound, ' ■ 
b. Milson, William L; Medical Plans for Civil Defense and 
Disaster, to be published by Fulton C unty Medical Society, A copy, if 
published, might be obtained from Dr. E. M. Dunstan, 215 Doctors Build- 
ing, Atlanta 3, Georgia, This later article, applicable to current 
possibilities, details many aspects of local planning, and has a more 
"current reference list of 84 articles. 
c. Mar Department, Headquarters, Services of Supply; Military 
Hospitalization and Evacuation Operations (SPOPH 3-72.15) 15 September 
1942, which required a simple, reasonable intagrated military-civilian 
system of mutual medical support. It is still basically sound. 
d. Tilson, M. L.: Civil Defense planning, Bulletin of U. S. 
Army Medical Department, IX;11, 880, November 1949* 
2, Discussion; 
a. The justification for our interest in civil defense planning can be stated as follows* 
(1) Complete responsibility rests upon the Commander in 
the theater of operations abroad and at home for 
foreseeing, planning, and implementing adequate civil 
defense, as well as passive air defense, and for the 
immediately subsequent civil affairs administration, 
(2) while less clearly defined in the United States, where 
clear operational responsibility for civil defense may 
not be established for the Army, certain responsibili- 
ties are 'prescribed and limited by laws for relief 
furnished by the Army in disasters, for military aid 
to civil authority, and for the establishment of 
martial law under certain prescribed conditions. 
(3) The third responsibility, which the Army may always 
have because of the nature of war and the technical 
training, experience, and understanding of such- 
matters by military personnel, would be to sponsor and 
support the main objective of civil defense in the 
future; thus, complete civilian responsibility and 
readiness for proper conduct of all necessary civilian 
reactions and response to immediate enemy attack is 
assured. Only by that means may the Armed Services 
concentrate upon their primary missions of conducting 
war against an enemy without diversions of their 
energies or resources. (4) On three occasions the Army operational staff of the 
British actually planned with civil defense authori- 
ties on a large scale and produced operational plans 
on a military coordinated basis for active defense, 
passive air defense, and civil defense. The first 
was in 1941 to resist possible invasion of the United 
Kingdom; the second was during late 1943 when 
threatened unpiloted bombardment of London and United 
Kingdom was immediately in prospect, and the third 
was during preparations for the invasion of Europe 
• when specific planning for civil defense, passive air 
defense, and other necessary measures for covering 
assembly, communications and transport areas required 
i . 
consideration. 
b. In the United States the situation has been as follows; 
(1) The Office of Civilian Defense was dissolved by 
Executive Order 9562, dated 4 June 1945, with effect 
30 June 1945. It had existed since 20 May 1941 when 
established vd.th.in the Office for Emergency Manage- 
ment by Executive Order 8757, which, as amended, 
had, the purpose to assure effective coordination of 
Federal relations with state and local governments, to 
provide for necessary cooperation with those govern- 
ments with reference to measures for adequate pro- 
tection of civilians in war emergencies. 
■ (2) The subject was, so far as I can determine, dormant until the Far Department Civil Defense Board was. 
established pursuant to r. D. Memo 4-00-5-5 dated 
25 November 1946, as amended. The War Department 
Board, after some delay, conducted an extended study 
resulting in the "Report'of Far Department Civil 
Defense Board" released February 1948, The report 
was a line of departure for the next important active 
step in civil defense planning, 
/ 
(3) By letter dated 27 March 1948, the Secretary of Defense 
established an "Office of Civil Defense Planning," 
which met and worked from April 1948 until release in 
October 1948, of the so-called Hopley Report, "Civil 
Defense for National Security," 
(4) The President eliminated existing uncertainties as to 
the status of the Hopley Report by his letter 3 March 
1949 to the Acting Chairman, National Security 
Resources Board, in which he called upon the Board to 
develop leadership in a program of civil defense plan- 
ning under civilian control. Following consideration 
?dthin the National Security Resources Board there 
developed a report which resulted in the followings 
(a) Leadership in developing the program of wartime 
disaster relief has been delegated by the National 
Security Resources Board to the Federal ""'orks 
Agency, which, by Public Law 152, 81st Congress, 
is redesignated General Services Administration, Participating in planning would be the Atomic 
Energy Commission,, National Military Establish- 
■ ment, Federal Security Agency, and the Depart- 
ments of Agriculture, Interior, Treasury, and 
Justice, The National Security Resources Board 
will still coordinate the planning within the 
Federal Government and serve as focal point of 
contact in civil defense planning between the 
Federal Government and the states, municipalities, 
and the federal and trade organizations, if the 
present understanding prevails, 
% 
(b) The Department of Defense has been assigned 
planning for voluntary civilian participation in 
defense activities against armed forces, embracing 
air raid warning, civil air patrol, aircraft de- 
tection and identification, auxiliary defenses, 
camouflage,.protective construction, and other 
physical measures of defense. 
(c) Internal security measures, including sabotage and 
espionage related to the civil defense program will 
be coordinated by the National Security Council. 
(5) While the program of the General Services Administration 
is currently expected to include planning for the follow- 
ing, slight progress has occurred: 
(a) Medical supplies and services, including hospitali- 
zation, sanitation, and blood banks. (b) Decontamination and measures to minimize the 
, 'effects of chemical,, radiologic, and biologic or 
other unconventional attack. 
(c) Fire protection and fire fighting. 
(d) Emergency measures for the regulation of trans- 
portation and communication facilities and 
services and the restoration of order, including 
conditions under.which martial law would be 
declared and methods for invoking it. 
(e) Rescue and evacuation, including feeding, clothing, 
. • and sheltering. 
(f) Repair and restoration of water, gas, electric, and 
sewage systems, including antipollution measures. 
• (g) Demolition. 
(h) Formation and use, only in the event of war, of 
warden or auxiliary sjrvices, and mobile battalions, 
whose members will be prepared to implement appro- 
priate phases of plans developed for wartime 
.disaster relief. 
(6) As all of this was,developing, the Office of Civil 
Defense Planning within the National Military Establish- 
ment was abolished. At the same time, there was set up 
the position of ’’Assistant for Civil Defense Liaison” 
in the Office of the Secretary of Defense, His duties, 
detailed in JAAF Bulletin 27, 19 September 1949, have 
been briefed as follows; M(a) Provide for the full coordination within the 
National Military Establishment of planning and 
preparation for (1) apy military aspects of 
civil defense; (2) any other civil defense 
matters which may from time to time be assigned 
by appropriate authority as a responsibility 
of the National Military Establishment, and (3) 
any voluntary civilian participation in related 
military defense activities, 
"(b) Assure that there is effective liaison and 
cooperation between the National Military Estab- 
lishment and other governmental and private 
agencies with respect to such matters to the end 
that planning and preparation for civil defense 
are closely related to planning and preparations 
for military defense, 
"(c) Provide the several departments and staff agencies 
with a central source of technical information, 
v t 
advice, and assistance on civil defense matters 
« 
in general,*» 
(7) In May 194-8, the Surgeon General of the United States 
Public Health Service established within his office 
the Health Emergency Planning Unit for the purpose of 
developing public health service plans for disasters 
and other major emergencies. The missions of that 
office within the Public Health Service are markedly similar to the research missions of the Special 
Assistant to the Surgeon/General (Army) for Civil 
Health Affairs. 
IV. 1. Army area commanders can easily have wide responsibilities at 
present regardless of our disclaiming them. Hence, SR 580-10-1 should 
be thoroughly understood, the medical portions fully developed under 
the commander’s policies, 
\ 
2. Many matters cannot be presented here because of limitations of 
time and space. Any questions or advice desired will be gladly furnished 
by the compiler of these notes. Sources for references can also be 
provided. 
Colonel Tynes; I have the answer to the question raised a while ago as 
to the constructed capacity of general hospitals relative to the standby 
for supplies. Ifm not too sure you will be satisfied with it, but the 
capacity of your hospital is the capacity developed by the last trip- of 
the ’’flying circus” to your hospital, I think, actually, if you will 
recall, at that particular time, Mr, Cogan and several of us went around, , 
there was no real percentage' that actually counted. Now, if you are not 
satisfied with that capacity as such, relative to your headquarters, there 
• .* / 
may be some other files that w‘e may be able to dig into for another 
capacity. If there are no other questions, we’ll adjourn for the after- 
noon and reconvene in this room tomorrow morning at nine o’clock. 
•>;- */- -V- .v- 
Colonel Tynes* I have one rather important announcement that is a 
change from the one on the original sheet. As you know our meeting this 
afternoon is a joint meeting with the Army, Navy and Air Force under the auspices of the Navy and will be held at their auditorium at Bethesds, 
rre will have two large busses ready to leave here promptly at 1:15 PM. 
They will leave from the police box between this building and the old 
Munitions Building, that is the building next to this building on 
Constitution Avenue. They leave promptly at 1315 hours. 
Our first speaker today is Colonel Paul Robinson, Chief, Personnel 
Division, who is going to discuss various personnel problems. 
Colonel Robinson• HOSPITAL COMMANDERS AND A RAY SURGEONS: The personnel 
Division has decided that it would utilize its time today in the presen- 
tation of a number of current subjects. In order that you may know the 
"subject's which we have decided to discuss, a list of them are shown on 
■ the blackboard: 
1. Army-Air Medical Department transfers. 
2. Current and projected status of the Medical Corps. 
3. promotion criteria. 
• 4-. Current reduction in strength., 
'5. Intern and Residency Programs. 
60 Utilization of enlisted personnel. 
7. -Legislative topics. 
It is proposed that after presentation of. each one of these subjects, a 
few minutes will be allotted for questions and discussions. I have 
asked a number of the officers of the Personnel Division to be present 
today to' answer completely and accurately any of the questions which may 
arise. . p 
Army-Air Medical Department transfers? 1 be have a series of charts 
which will assist in emphasizing the important features of this problem. The first chart illustrates, for each Corps of/the Medical Department, 
the number of those, by Regular and other components-, who did and did 
not request transfer to the-Air Force before the 26th of July of this 
year. You will note that in the Medical Corps 3151 did not request 
transfer, whereas 1264- did so request. There were 4415, which is 
approximately 97% of those on active duty, who submitted a,request one 
way or the other. You will note also that 1206 of those not requesting 
transfer were also in the Regular Army, The remaining were Reserve 
officers on active duty or AUS or National Guard officers. With regard 
to the Dental Corps,- 517 out of 1024 requested transfer to the Air Force, 
In the Veterinary Corps, 113 out of 349 requested transfer. In the 
Medical Service Corps 1256 out of 3081 requested transfer. In the Nurse 
Corps 2006 out of 4425 requested transfer and'in the Womens Medical 
Specialist Corps 127 out of 396 requested transfer to the Air Force. I 
think it is evident that the Air Force is particularly popular with the 
.Dental Corps, the Army Nurse Corps and the womens Medical Specialist 
Corps. In all but the Medical Corps, there were sufficient who desired 
to transfer to fill the agreed upon allotment of the ne?\r Air Force 
medical service. 
Chart No. 2 shows a breakdown of those who were approved for 
transfer to the Air Force by the overall board composed of Army and Air 
Force Medical Department officers. In the Medical Corps, 1153, of which 
405 were Regular Army, were approved. In the Dental Corps 423, of which 
175 were Regular Army, In the Veterinary Corps 78, of which 42 were 
Regular Army. In the Medical Service Corps 729, of which 158 v:ere 
Regular Army. In the Army Nurse Corps 1199, of which 307 were Regular Army, In the '"'omens Medical Specialist Corps 90, of which 31 were 
Regular Army, 
Chart No, 3 shows a breakdown of those approved for transfer 
to the Air Force by grade in which serving. I think it is evident that 
there was no serious malproportion by grade transferring to the Air Force, 
The most serious might be said to be that of the Army Nurse Corps, where 
only 12 Majors and 1 Lt. Colonel elected to transfer. The general trend, 
of course, was for a large majority to be in the younger age and rank 
group. 
Chart No A shows the Regular Corps as distributed by permanent 
grade who requested transfer. Here again the proportion can in general 
be said to be equitable. Probably the most severe disproportion is in 
the Army Nurse Corps, Y/here only 3 permanent Majors elected to transfer. 
Chart No, 5 indicates those v/hc were finally approved and 
appointed in the Air Force, you will note that difference was not 
remarkable. Of the 435 in the Medical Corps who desired transfer, 405 
were approved. Of the 199 in the Dental Corps who Y/anted to transfer, 
175 were approved. Of the 49 in the Veterinary Corps who desired to 
transfer, 42 v/ere approved. In the Medical Service Corps, 158 of the 
210 desiring to transfer Yrere approved. Of the 417 Army Nurse Corps 
desiring to transfer, 307 were approved. Of the 41 Womens Medical 
Specialist Corps desiring to transfer, 31 were approved. 
Chart No. 6 illustrates what happened to those in the Medical 
Department Reserve Y;ho were not on active duty. We made every effort 
to get information to the individual Reserve officer; however, it seems 
doubtful that the information could have permeated to all of them. Nevertheless, 1039 Reserve Medical Corps officers not on active duty 
transferred to the Air Force; 567 Dental Corps officers; 58 Veterinary 
Corps officers; 1008 Medical Service Corps officers; 312 Army Nurse 
Corps officers and 18 Womens Medical Specialist Corps officers. All 
requests for Reserve officers not on active duty were approved by both 
boards. 
The points which might be said to be illustrated in this series of 
charts are* 
• ' 7 ' - • • • ' , • 
a. The number of officers transferring to the Air Force was 
remarkably equitable, both in the Regular and non-Regular components, 
b. If the Regular authorization in the Air Force and the Army 
remains substantially as it now exists, there will result no great per- 
manent grade promotion advantage in either Department, 
c. Because of the fact that the number of officers who would 
transfer to the Air Force are serving in the lower grades, it can be anti- 
cipated that some advantage will accrue to those who transfer to the Air 
Force in temporary promotions. However, even this advantage is not as 
great as might well have been expected. 
d. We did not feel it was feasible to attempt to break down the 
transfer by Military Occupational Specialty numbers. Had we done so, 
such a breakdown would have revealed that the Air Force did not receive 
its proportional share of the B and C grade specialists. A number of 
residents, however, desire transfer to the Air Force and it should 
therefore not be too long until this situation can right itself. 
You are all aware that a Congressional Act which was passed only a 
few days after the transfer had been consummated extended Army and Air Force transfers for an additional year. We are at present receiving a 
few requests each wray every week. From the 26th of July until the 
present, from those on active duty, we have received 10 applications 
from Army Medical officers to transfer to the Air Force; 2 from the 
Dental Corps; 1 from the Veterinary Corps; 8 from the Medical Service 
Corps and 12 from the Army Nurse Corps. 8 of the 10 Medical Corps 
officers have been approved for transfer, 1 of the 2 Dental Corps, 
none of the Veterinary Corps, 8 of the 8 Medical Service Corps officers 
and 5 of the 12 nurses. We have no definite criteria. Each case is 
considered on its own merits, and approved or' disapproved as the case 
seems to warrant. In reverse, the Air Force has approved, to our 
knowledge, 3 Medical Corps officers for transfer to the Array,. 2 of 
which Y/ere Regular and one Reserve, We know there are other cases 
pending in the Department of the Air Force, This subject is now open 
for questions and discussion. 
Colonel Robinson*. General Cole, you have a question? 
General Cole: Colonel Robinson, I have several residents who transferred 
to the Air Force and they are disappointed to find their stations un- 
favorable to them and they are contemplating steps to transfer back. 
Are they looked on favorably or not? 
Colonel Robinson: Yes sir, each case will be considered individually. 
General Cole; When they put in a written application to the AG? 
Colonel Robinson: Yes sir, that is correct. 
Current and projected status of the Medical Corps; 
I believe every time you have been in the office during the past 
two years, the Personnel Division has attempted to portray the actual situation with regard to Medical Corps officers at that time, and has 
each time attempted to project it into the future. Previously, we have 
outlined the measures that have been taken to interest doctors in serv- 
ing with the Medical Department and have reported on our progress. The 
next chart, No, 7, might therefore be said to be the next in such a 
series. You will note that we have divided our requirements into two 
phases; operating and training. Our operating requirement at present is 
2500; our training requirement 1175, We have available against the 
operating requirement 666 who are employed on a civilian status* We 
actually have an operating shortage of 88. The training requirements, 
as you can see, are fully met by 431 military residents, 323 civilian 
residents, 172 military interns and 200 civilian interns. Also, ypu will 
note that there are 49 officers in other training . These Regular Army 
officers who are taking training in addition to being professors of 
military science and tactics, plus a few who are being trained in such 
specialties as neurosurgery and preventive medicine, where.we do not feel 
that we have the volume requirement to establish training programs, I 
will not go into detail to point out the numbers in each of those cate- 
gories that can be expected in March of 1950. However, it can be 
followed easily by the chart. You will note that until the first of 
July 1950, because of the release of Reserve and AITS officers, the 
shortage will continue to increase. After July 1950, however, the 
situation will definitely teverse itself. Officers will be finishing 
the training programs in substantial numbers and will revert to the 
operating side of the chart. In 1952 there should be no shortage of 
operating personnel, provided it will be possible to hire approximately 350 civilian doctors, I would like to add here that this chart can be 
considered a conservative one;,probably extremely conservative, because 
in making projections we always attempt to make them on reliable data 
only. We intend, during this entire period, to continue our procurement 
program, which should probably increase the number of both Regular and 
Reserve officers in Fiscal Years 1951 and 1952, I think it might even be 
safe to say that the availables in this period might easily be ICO to 200 
more than is depicted. 
This is the first time, I believe,•that I have been able to portray 
to you that a substantial increase in the number of officers available to 
us is definitely a fact in the not too distant future, I think you are 
all aware of the efforts that have been made to accomplish this; but some 
of the points might be just mentioned to refresh your memory; 
a. In 194-7, additional pay of $100 per month was gained from 
the Congress, This was extended in the Officers* Compensation Act which 
■ / 
was passed last summer. 
b. The various professional training programs wore integrated 
with the procurement program early in 1948, and this chart certainly 
speaks for the success of that program, . p • 
c. The Moral Suasion Program netted the Army only about 158 
doctors, Theyare on duty at the present time for two years, 
d. You are all very well acquainted with the various published 
programs that have been effected during the past two years. All 'of you 
have been instrumental in circulating many of the pamphlets and movies - 
and in preparation of much of the material which has appeared in magazines, 
newspapers, and scientific journals. 
105 g. You are also aware of the part the Society of U. S. 
Medical Consultants of World War II has played in disseminating informa- 
tion, as well as in assisting in the operation of all these programs. 
f. Priority on quarters, special consideration on promotions 
and concurrent travel have all been established as policies by the 
Department of the Army General Staff. 
g. The Personnel Division has exerted every effort to personal- 
ize its work to guarantee that the transfers not only were within the 
individual officer’s career pattern, but that it met with his present 
situation insofar as his present livelihood and family are concerned. 
I shall have more to at a later time on two other subjects; (1) 
short tours of active duty for Reserve officers and (2), civilian doctor 
utilization. 
Before leaving the subject of requirements and availabilities, it is 
appropriate that you should know the distribution as it will be on the 
31st of December 1949, as nearly as we can now project it. Chart No. 8, 
therefore, projects the assignment by commands to the 31st of December 
1949 for operating personnel only. You will note that the 1st, 2nd and 
6th Armies appear to be somewhat better staffed than any of the other 
command areas. This is because they have been able to employ a number 
of civilian doctors. The number of military in these areas, however, is 
considered about as low as could be possible in order to cover the 
primary mission of the Army Medical Department, The 3rd Army fares 
better,with regard to military doctors because of the number who are 
assigned to Reserve Units in that area, even though the large majority 
of them, are also on duty in the station hospitals. The civilian doctors in the European Command are displaced persons or German doctors. There 
have been no serious repercussions from their employment, although every- 
one recommends that they be replaced by American military doctors as 
rapidly as possible. Civilian doctors in the Far East are American 
doctors who have been employed for Military Government work. In general, 
it can be said that this distribution is reasonably equitable. The 
apparent maldistribution in some instances results from many factors, 
among which are insufficient remaining tour of duty to warrant a move, 
personal commitments and Military Occupational Specialty shortages. 
The overall situation as far as Medical Corps officers is concerned is 
now open for questions and discussion. 
Colonel Robinson* Colonel Gorby, you have a question? 
Colonel Gorby? Relative to the transfer of the CRC group I feel that 
the real reason that they did not apply in the same proportion as the 
Regulars is the fact that the training program in the ORG program of 
the Air Force is not £ood in the field and a lot of them knew that, I 
feel that they have not built up their program and that was the main 
reason. 
Colonel Robinson; Yes sir, they had that reason. 
Promotion, criteria; 
A discussion of promotions is always most difficult. In order 
to simplify it we have again a series of charts with which we will 
attempt to portray the situation. There has been much discussion as to 
whether or not the Army and Air Force criteria on the recent promotions 
were in any way equitable. These charts may appear to you to be somewhat 
complicated because it is necessary in showing criteria to show years of 
service for each grade, as well as the effective date of years of service. The blue bars and lines indicate Army criteria and the red bars and 
lines indicate Air Force criteria* You will note that in the Medical 
..Corps- the criteria from 1st Lt. to Captain are identical. From Captain 
to Major the number of years of service is identical but there are 25 
days difference in the date of the completion of the service. From 
Major to Lt, Colonel the years of service is identical but here again 
there"is U months’ difference in the time of completion of that service. 
The reasons why it was necessary for the Air Force to vary from the Army 
criteria are two; (1) It was administratively more convenient for the 
Air Force to use these dates and (2) It was necessary to extend the dotes 
slightly further than the Army in order to obtain sufficient oligibles. 
Corresponding data is shown for the Dental Corps, the Veterinary Corps, 
the Medical Service Corps, the Army Nurse Corps and the Womens Medical 
Specialist Corps. You will note that the most variable discrepancies 
appear in the Veterinary Corps, the Dental Corps and tho Army Nurse 
Corps. The Army has no 1st Lieutenants in the Dental Corps eligible to 
be promoted to Captains. The number of Captains to be prpmoted to 
Major in the Air Force was not sufficient without greatly extending the 
time. However, that extension of time in the Air Force is also slightly 
augmented by a lesser number of years 'of -service. The Veterinary Corps 
is having to depend upon the workings of - the law for promotion into 
% * J. 
the grade of Lt. Colonel. In both the Nurse Corps and Womens Medical 
Specialist Corps Army criteria is just about 11 months behind the Air 
Force in the promotion from Captain to Major, 
... AH of the discussion up to nbw has been concerned with Regular 
Army promotion as it has pertained to the boards which are currently operating or have just completed their activities. Announcements of the 
actions of these boards should be made within the next few weeks. As 
far as the Medical Corps of the Army is concerned, delay in announcement . 
of promotions from this board is necessitated by the fact that there are 
still 5 professional examination reports not in, even though we have 
gone to the commands concerned for the fourth time, in some cases, since 
September. If any of these instances should happen to be in your 
command, I hope action will be expedited. 
We thought it would be interesting to again show, in this some- 
what complicated chart, the status of the Regular Army Medical Depart- 
ment by Corps. Our authorization for the Regular Army Medical Corps is 
now 2271. At present we Hhve an authorization for 182 Colonels. As of 
the end of this year there will be A6 vacancies and we'expect in the 
next promotion board, which will probably be soon after the first of 
the year, to fill all of those vacancies and select a group to fill the 
vacancies that will occur during the remainder of 1950. If so, 
approximately 55 officers will be selected. You will note that the 
authorized number of Medical Corps Colonels will be completely filled, 
You are all aware that there is an 8$ limitation on the number who can 
be Colonels in the Medical Corps, as well as the rest of the Army, and 
that there is no statutory provision for compulsory promotion into the 
grade of Colonel as exists for all other grades. There are 318 spaces 
in the grade of Lt. Colonel, The promotion board which has just 
finished its deliberations will have selected approximately 85 and 
there will remain 68 vacancies in the grade of It, Colonel. This is 
occasioned by the fact that there are insufficient Majors in the determining Zone of Consideration to fill all vacancies in the grade of 
Lt. Colonel. After this promotion there still should remain approxi- 
mately 68 vacancies in the permanent grade of It. Colonel. The same 
general situation exists insofar as Majors are concerned. Due to the 
overall shortage of Medical Corps officers there are insufficient 
officers with length of service qualifications to-fill approximately 
157 of the Major spaces and 166 of the Captain spaces. 
You will note that in the Dental Corps the Colonel spaces are now 
practically taken up. and the number who can be promoted each year de- 
pends upon the attrition from now on. The situation is exaggerated 
in the Veterinary Corps, in that there are actually an excess of 15 
Colonels, which results from, the workings of tfte law before the present 
Officer Personnel Act was passed. Only one of the Colonels in the 
Veterinary Corps transferred to the Air Force, which also makes the 
situation seem worse. There is a statutory limitation in the Medical 
Service Corps on the number of Colonels, which is 2%, Actually, by 
utilization of the same criteria as is used for Medical Corps and 
, Dental Corps, there are insufficient eligiblos.to fill even this 
for the next J or U years. There has been considerable discussion as 
to whether or not that limitation of 2% should be raised to 8% in 
order that it may correspond to the rest of the Army. Legislation 
has been prepared, but at this writing it has not left the Surgeon 
General’s Office, The red figures in the Dental Corps, Veterinary 
Corps and Medical Service Corps indicate present overages in these 
permanent grades. ■ A number of you have probably been wondering about 
1 • v . 
the large requirement shown for the Nurse Corps and 7Tomens Medical Specialist Corps. This results directly from the legislation estab- 
lishing these Corps, which set a number on the strength cf the. Army as 
it then existed. This law was prepared in 1947 and, while the number 
is specifically stated in the law., the requirements do not now equal 
this number. As a matter of fact, the requirements for nurses and 
members of the Womens Medical Specialist Corps are calculated by G-3 
of the Army and do not represent as high figures as are here stated. 
Nevertheless, this is the legal and correct presentation. As calcu-> 
lated, the legally authorized number of captains and Lieutenants in 
the Nurse Corps is 5736, and the Womens Medical Specialist Corps is 
889, The actual requirements of Regular nurses is somewhere in the 
neighborhood of 2000, and for the Womens Medical Specialist Corps is 
approximately 350, 
The next chart shows the overall status of the Medical Department 
by Corps by grade. Taking the Medical Corps again as illustrative of 
the chart, you will note that of the 325 authorized spaces in the 
grade of Colonel, 3, not now serving in the grade, would be promoted 
to the permanent grade of Colonel and there would remain 35 vacancies 
which might be considered for temporary promotion next year. Of the 
502 spaces for Lt, Colonels, 7 remain who have been on the eligible 
list since the last temporary promotion, and vacancies would exist 
for approximately 125. There are 82 of the 360 Major spaces vacant. 
There are 550 Captains overstrangth, due to the wrorkings of the 
special promotion privileges for Medical and Dental' Corps officers. 
It might be said that this chart, throughout, shows a net picture 
because consideration has been given to the shifts that may result within all grades in the event certain promotions are made, A similar 
picture exists in all the male: Corps. The criteria for temporary 
promotion for the Nurse Corps and Womens Medical Specialist Corps 
have been forwarded'to Personnel and Administration Division, General 
Staff, to effect the promotions as shown on the chart in the grades of 
Captain and Major, It is thought that our recommendations will be 
approved. The subject of promotions is now open for questions and dis- 
cussion. 
Colonel Robinsont Mr. Cogan. 
Mr. Cogan; while on this subject I would like to point out something 
that came out and was decided upon yesterday, which,would be of interest 
particularly to the Army surgeons. You are all acquainted with.what 
we used to call ceilings or staff might call manning levels which-con- 
trols the number of assigned military. In the past these were issued as 
part of the manpower voucher. You mil notice that the last manpower 
voucher did. not have a breakout of Medical Department- personnel ceilings 
i , *. 
by Army area. The reason they were not on there was because of the 
confusion at staff level. Some of you will recall-that when they in 
staff went out of the picture, ceilings stopped for a little while. The 
reason at that time was because O&T and P&A could not decide whose' 
responsibility it was. An identical thing-happened now with a change 
of a few officers and they got'in the same place. Anyway, that question 
has been resolved and those ceilings will be issued. However, they wall 
not be issued on a War Manpower voucher, Ihey will be issued on a 
separate sheet-in the Troop Program so that the Troop Program will shew 
( 
requirements with the Troop Basis and wall shew a separate sheet of pi anning level up to which you can requisition. So from now on that 
will be the procedure and you can always look for it. 
Colonel Robinson! Any comments or questions? 
Colonel Billick: What is that O&T in the first part? 
Colonel Robinson; Organization and Training Division, General Staff, 
Colonel Liston* Are these requirements balanced against the shrinking 
.military population that we are anticipating in the United States up to 
this point? 
Colonel Robinson; These requirements take into consideration every pro- 
jected change in troop status throughout the world, is that right Mr, 
Cogan? 
Mr. Cogant Yes, and we might add there is a possible release right now. 
Current reduction in strength; , 
* 
I am sure you are all interested in the reduction in force of the 
Army which is currently-going on. As you know, the Army-wide objective 
is 3300 officers. Medical Corps, Dental Corps and Veterinary Corps 
officers were excluded, as were both the female Corps of the Medical 
Department. In Phase I of the program, 1069 officers ?.rere selected, and 
of the 1952 Medical Service Corps Reserve officers on duty, only 20 ?/ere 
selected by the major commands. You will note that the Army ratio was 
1-A8, whereas the Medical Service Corps ratio was 1-100, 
Phase II of this program is now being determined. The Surgeon 
command was given no specific quota, but was told that it -was 
expected that certain recommendations be made to the overall board 
which is making the determination of those who will be eliminated, Ye 
asked each of our commanders to submit names in order of their value to the military service* 7:e appointed a board in the Surgeon,General’s 
Office consisting of a representative of each of the Chirps and asked 
them to review the record of every Individual regardless of Corps, who 
had two"or more efficiency reports which scored less than 70. Remarks . 
from the various Class II commanders were also taken into consideration 
by this board and the Surgeon General, as a result of the action of this 
board went on record as heccmmending 81 for separation. Whether or not 
this 81 will be finally selected is not presently known, because they*- V 
in turn, will be compared with submissions from all other commands on a 
value to the service basis. It is conceivable that a number of the -81 
individuals nominated will not be separated. It might be emphasized 
that our board’s action was not limited to the Class II installations, 
but was a' world-¥vide survey. 
You will be interested to know, that of the nominations made by 
the Surgeon General’s board, 16 were from Class II installations and 
65 from all other major commands. The ratio of selection was, neverthe- • 
less, quite close because of the much greater number of Medical Service 
Corps officers who are assigned to major commands other than the Class 
II installations had 1-31. 
Of the 81 individuals selected, 6 had already been nominated by 
the major commands under phase I. Of the remaining 7$, 9 were recom- 
mended by major commands in submission-of their Class II quotas. We 
feel the nominations made by the Surgeon General are in every way as fair 
as is possible’. Utilization was made of as much as 10 years’ official in- 
formation on many of the individuals, as well as the current performance. 
We have presented only the Medical Service Corps charts, because the few other nominations which were made were incidental. This topic is now 
open for questions and discussion. 
Colonel Robinson: Are there any questions that have been bothering you 
on this subject: 
General Cole; Can these men be notified between now and the first of 
the year? 
Colonel Robinson; Isn’t it immediately after the first of the year, 
Major Richards? 
v . ■ 
Major Richards; Prior to 1 January. 
Colonel Robinson; Any other questions? As far as other Corps of the 
Medical Department are concerned, I did not include any information 
because any recommendations that have been made by the Surgeon General 
on any of the other Corps are fairly incidental and not sufficient to 
chart. I have very few remarks on the interne and residency program. 
Intern and Residency Programs: 
I think the general hospital commanders are probably already aware 
of the current residency selections since representatives assisted this 
' • \ ' . 
office in making the. determinations. A few general statements, however, 
might be mace. A priority selection method as follows was utilized* 
(1) Those in the Regular Army who have not yet had an opportunity to par- 
ticipate in the Residency Program. (2) Military interns, (3) Civilian 
interns, (A) Direct from procurement. Since, at the time- of selection, 
all applications from the Regular Army group were not available, approxi- 
mately 25$ of the spaces have been reserved for applications which will 
straggle in between-now and the first of April, Seventy military resi- 
dents have been selected contingent, of course, upon their applying for and being accepted in the Regular Army. 
In the selection-of interns this year, emphasis has been placed on 
whatever information is available that may indicate that the applicant 
is sincerely interested in an Army career. We had 1014 applications for 
228 positions. No service obligation is established for military 
interns. The reason for this, is that we desire to maintain this as a 
permanent procurement procedure and we do not feel that it is necessary 
to have such a requirement. From the 25 interns we had in 1947, 18 are 
still in the service *— and from the 113 We had beginning in 1948, 78 are 
still in the service,- This represents approximately what we would desire 
. to retain and wre hope each year will cause a proportionate number of 
individuals to remain in the service. We realize this can be done only 
■with the assistance of the hospitals to which interns are assigned. 
Colonel Robinson; Colonel Fielding just suggested that he would like to 
say a few words in behalf of the interns that -ware selected this year. 
Colonel Fielding, 
Colonel Fielding; Not so much as -to' how they'were selected but to the 
type of individual that was selected. As you know, the year before we 
went considerably on past standings. This year it plays a part but not 
quite so impprt-ant a part. It was mere if the man was interested in a 
military career. You find among*the interns that come to your general 
hospitals, everything from ex Lt. Colonels of General Staff Corps, to 
It. Colonels of MSC, on down to enlisted men who were in Medical Depart- 
ment activities in the line and military intelligence, etc. Practically 
7% are veterans.which will mean' that there is a large number who will 
probably enter and stay in the service. They know what the service is like, so I think you will find a reasonable military minded group of 
interns* We have efficiency reports from some of them and looked at 
them. They contain answers to questions, also their battle decorations, 
silver stars and on down. I think you will find them a very interest- 
ing group to work with. 
Colonel Robinson: Any questions or comments? 
General Gaines : If I understand you correctly, there are ICO or more 
interns now in hospitals who have not been selected for residency train- 
ing. As far as I know, we do not have that list. 
Colonel Robinson; It is in the mail. Any other questions? 
Colonel Fielding: General Gaines brought up that question of lists. 
There is in the mail to reach the general hospitals, a letter stating 
which of your interns were selected for which specialty in which hos- 
pital. Also, a notice to the effect that any other applicant's name 
that did not appear on that list was not selected at this time and 
advising that they may submit additional applications, if they desire, 
for the April selection. Other information is also contained in that 
letter. 
Enlisted personnel; 
There are many features of the enlisted personnel management 
program that could be discussed. We have selected what we consider 
the three most important to discuss today. These are considered the 
most important for two reasons. First, they constitute the framework 
of the enlisted personnel management system and, second, information 
continues to reach this office indicating that the real enlisted 
problems result from the improper application of these three features. 
The three features I refer to are; a. Careful synchronization of enlisted strength reports with 
particular reference to Tables of Organization and Tables of Distribu- 
tion. 
b. Classification and assignment of enlisted personnel. 
c. Utilization of enlisted personnel. 
I shall discuss these three features separately. 
First, Synchronization of enlisted strength reports» 
Tables of Organization and Tables of Distribution consti- 
tute the personnel authorization representing the personnel require- 
ments for the particular command. Such tables are prepared' jointly by 
the interested agencies; those agencies being the using commander and the 
major force commander. Those tables if carefully prepared and kept 
current, by MOS and grade, should constitute a framework or requirement 
wherein the enlisted personnel system can operate. Those tables .are 
consolidated at Department of the Army level and when compared with 
actual strength, by MOS and grade, represent the basis for procurement, 
the basis for the assignment of priorities to requisitions, and the 
basis for training needs. Tables of Distribution that do not reflect 
the true requirements upset the entire system. 
Second, Classification and assignment; 
Classification of personnel cannot be accomplished by one 
individual. The principles of Department of the Army Circular 202, 19-48, 
as amended, are believed to be sound. That circular states that classi- 
fication will be accomplished by a Glassification Board consisting of at 
least three officers — a classification or personnel officer, a train- , 
ing officer, and a representative of command. A technical specialist should be included where technical MOS are concerned. 
This board should be able to consider all factors having 
any bearing on the MOS to be assigned, and in the best interests of the 
individual and the service, should be able to "label” a soldier with 
the proper MOS. That is classification and proper operation will elimi- 
nate all other methods that we hoar so much about which give only 
temporary relief. Too much emphasis cannot be placed on the operation 
of the Classification Board, That is a command responsibility. 
Assignment of enlisted personnel follows classification. 
Assignment of enlisted personnel at Department of the Army level is an 
administrative procedure. Enlisted qualification cards are not main- 
tained at this level. Names of individuals do net ordinarily enter into 
the assignment procedure at this level. The Department of the Army 
knows what personnel are available. Likewise, the existing vacancies 
are known. Availables are matched against vacancies, necessary priori- 
ties applied, and orders are issued, completing the assignment activity, 
"Force issues" are necessary at times to absorb "over" availables. The 
whole system is based upon proper "labeling" of availables reported 
and a correct picture of personnel requirements. 
Assignments at unit level means placing the right man on 
the right job. When that is not possible, the man should be reported 
as available for reassignment adjustment. 
Third, Utilization of personnel; 
Utilization is another phase of personnel management 
shared by every echelon of command with the using agency carrying final 
responsibility for proper utilization. Proper utilization implies that avenues for advancement 
will be opened, school opportunities will be offered, and that the un- 
fit and unqualified will be eliminated after reasonable attempts to 
qualify the individual concerned by elimination and not by transfer. 
The waste of technicians and specialists, of which the 
Army is critically short, is in a great part a utilization problem. 
Many such men are improperly assigned at lower levels. Reports contin- 
ually reach this office of individuals who were school trained for 
several months at a great expense to the government and then assigned 
to duties that bear no relation to the training received. This practice 
. f' 
results in a manifest waste of school training, forces further school 
training to fill the vacancies, and, expends funds so urgently needed. 
Experience indicates that there will always be a shortage of school 
trained specialists and mhl-utilization tends to aggravate the condition. 
For example: surgical technicians assigned-.as typists; mess stewards 
assigned as first sergeants; laboratory technicians assigned as clerks; 
orthopedic technicians assigned as training noncommissioned officers. 
Enlisted men who have not attended schools and who possess 
interests and ability to absorb school training in critical MOS should be 
sent to schools and assigned upon graduation to fill the vacancies. By 
such action the shortages of technical specialists can be met. 
In working with the enlisted personnel management system, it is 
necessary to receive the enlisted personnel that enter the Army through 
the recruiting service. Provided that the personnel does not bring into 
the Army skills and experiences that can readily be converted to Army use, 
it is necessary to start training, either formal schooling or on-the-job or both. Training and classification are then continuous throughout the 
enlisted man’s military career and experience tells us that in the Array 
there will probably never exist a situation where the individual soldier 
is a finished product. Provided he is, it is necessary to train someone 
to take his place. 
We believe the majority of enlisted personnel are being properly 
handled from a personnel management standpoint, While a great deal is 
being said on a general basis that is adverse, the number of specific 
instances ’’pointed up” do not bear out the general complaints. 
We will cooperate in all programs to effect the proper classifi- 
cation and utilization of personnel. The Department of the Army and The 
Adjutant General’s Office have published innumerable directives outlining 
the enlisted personnel management system. The continued efforts of all 
echelons of command operating as a team should be able to close up that 
area of poor enlisted personnel management. The result will bo a 
planned and organized personnel system for the enlisted peacetime program 
that will be capable of expansion in the event of mobilization, 
' 
Colonel Robinsont There have been some questions sent in on enlisted 
personnel that have been answered in your booklet. Unless there is some 
questions on that, I hope they will not be brought up again. Major 
Martin, do you want to add anything to what I have said? 
Major Martint No sir. 
Legislative topics; 
Everyone is always interested to know of pending or proposed legis- 
lation which will affect the personnel of the Medical Department. Seven 
proposals have been made in recent months, none of which have, at. this writing, actually been incorporated in ,dra|t0legislation. I will 
mention these proposals and, discuss them very briefly, 
(1) Elimination of professional examinations for promotion; — 
With the advent of selection as a method of promotion, the continuation 
of professional examinations had become farcical. Actually, some of the 
selection have been made without the professional examination by the 
various boards, because it was not possible to get world-wide information 
available to the board in the time intervening between the determination 
of the Zone of Consideration and the meeting date of the board. Promo- 
tions, as I mentioned before, have actually been held up because of the 
necessity of waiting for the professional examinations. There have been 
instances where professional examinations have not been adequately given— 
and certainly no, one is making the preparation for them that was common 
practice in previous years. One instance of an officer having to fly 
3000 miles from .Puerto. Rico to Panama in order to appear before officers 
senior to him, is a concrete ,• example of the fallacy of attempting to 
continue this examination*. . j ■ 
(2) . Increase, in general officer gra.de authorization;—-At the 
time of passage of the Officer-Personnel A$t: of 1947, the Army as a 
whole was granted.,75 of 1% of the authorized strength of the Army in 
the grade of general officers. The Medical Corps was granted .5 of 1% 
in the grade of general ufficer. It is understood that in the first 
drafts of the legislation, ,75 of 1% was also included for the Medical 
Corps, but was changed to .5 of 1% during, discussions with Navy repre- 
sentatives, At- the present time, tTavy representatives are highly in 
favor of increasing general officers for the Medical Corps to .75 of 1%, (3) Increased service credit on appointment:—As you new know, 
the Personnel Act grants to the Medical Corps 4 years' service credit on 
appointment; the Dental Corps 3 years'; and the Veterinary Corps 2 years' 
service credit on appointment. Because of the fact that medical students 
in the future are to be almost 100% college graduates, and whereas the 
same fact is generally true of dentists and veterinarians, it is con- 
sidered that the service credit should be raised to 5 years, 4 years and 
3 years for the Medical, Dental, and Veterinary Corps, respectively. A 
counter proposal has been made by Personnel and Administration Division, 
GSUSA, of giving service credit in accordance with the number of years 
actually spent in education over and above a college degree, We consider 
that such a scheme has many loopholes and would prefer that credit be 
given on the basis of degrees rather than years of schooling. The 
final solution of this problem as you can see,, has not been determined. 
(4) Elimination of the grade of Second lieutenant in the 
Veterinary Corps:—If service credit as I have just discussed were 
approved, a natural corollary Would be the elimination of the grade of 
Second Lieutenant in the Veterinary Carps, We believe this is fully 
justified and have proposed this as a separate item from the increased 
service credit, 
(5) Promotion to Colonel after twenty-five years of service»■— 
If you will recall, in our promotion charts which I presented earlier, 
the time is not far distant when there will be many eligibles from the 
standpoint of service who cannot, because of space limitations, be 
promoted to the grade of Colonel, Statistically, it has been estimated 
that 64 out of each 100 officers in the Medical Corps can expect to become Colonels under'the workings of the, present Officer Personnel Act. 
There is no mandatory provision in;.the. act for promotion to the grade of 
Colonel, as exists for all the other grades. It has been proposed that 
a revision of the law be made to provide promotion to Colonel after 25 
years of service creditable for promotion purposes. You all know that the 
service credit which has been allowed the Medical, Dental and Veterinary 
Corps is creditable for promotion purposes. This would guarantee the promo- 
tion to Colonel of all competent Medical Corps officers after they had 21 
years of actual service; Dental Corps officers after 22 years of actual 
service and all Veterinary Corps officers after they had 23 years of actual 
service. It does not preclude the promotion to Colonel of officers of a 
lesser number of years of service, providing a vacancy exists and they are 
selected. 
(6) Training in civilian institutions;—-There exists on the 
statutes a provision that not more than 8% of the Army can be in training 
in civilian institutions at any one time. Under the '.jar powers of the 
President, however, which are still in effect, there is no limitation in 
the number of officers who can be in training in civilian institutions. 
As you know, we have a considerable number of officers in training in 
civilian institutions, particularly in our civilian intern and residency 
procurement programs. As a matter of safety, therefore, more than a year 
ago wc proposed -draft legislation to provide for the Medical Department 
unlimited numbers who could be in civilian institutions in a training status 
for a period of 6 years to cover the programs I have just mentioned. We 
were told only last wool: that it-has been determined by the Secretary of 
Defense and the Bureau of the Budget that there is no contemplation that the war powers of the President vail be terminated in the foreseeable 
future, insofar as this provision is concerned. This legislation, then, 
""ill be held in a-"standby statusp", ready to introduce in the event there 
is a contemplated change in the war powers of the President. 
(7) Reserve retirement benefits — ANC and Vt.SC;—As all of you 
know, the Army Nurse Corps had a relative status until the passage of their 
act in 1917. The Homens medical Specialist Corps did not exist until that 
time, many had been career individuals on a civilian basis. This 
proposal would give retirement benefits to those individuals who served on 
a relative basis in the Nurse Corps and on a civilian basis in the 'Nomens 
Medical Specialist Corps. I should make clear that this proposal pertains 
only to the Reserve and not tl'fb Regular components of those two Corps. 
There are two bits of legislation still remaining before the 
Congress which we hope will receive consideration in the session starting 
in January, 
(l) Appointment of women doctors and other specialists;—This 
bill proposes that women doctors, dentists, veterinarians and other special- 
ists may be appointed in both the Regular and Reserve Corps of the Medical 
■y 
Departments of both the Army and the Air Force, It has passed the House of 
Representatives, but was held up in Senate Committee because the Navy did 
not desire to participate in this legislation. In the Navy law establishing 
the YTA7ES, appointment of women doctors can be made in the Navy, Wliile 
women doctors so appointed may work with the Medical Department of the Navy 
and be eligible for benefits such as the additional $100 per month, they do 
not have the promotion privileges of male doctors in the Navy — and there 
are other features which arc- objectionable to the Department of the Army 
and Air Force, At this time, the Department of the Navy is actually taking some female interns and have commissioned at least /+ women doctors in the 
Regular Navy, There is no statutory authority for the Army or Air For®e 
except in the '.TAG or USAF, where they would not be eligible for the addi- 
tional plOO per month or promotions and other privileges accorded male 
doctors. There is no objection on the part of anyone to the principle of 
this bill and as soon as the difficulties I have just mentioned have been 
ironed out there is every expectation that it will become law, 
(2) Procurement of the ANC and .7]SC;—The essentials of this bill 
raise the age limit so that many fine nurses who are still serving with the 
Medical Department and did so serve during the war might become eligible for 
Regular appointment. It would extend integration for appointment into the 
Regular Army in the AKC and .TEC for one year, and grant credit for retire- 
ment purposes to certain members of the ViTIvSC for civilian service in the 
Medical Department of the Army. This bill has, been cleared by the Bureau of 
the Budget i-and has been passed by the House of Representatives. It was 
passed late in the session, and consideration could not bo given it by,the 
\ 
Senate. There is every expectation that it-will become law in the second 
session, which meets in January, 
Colonel Robinson - Mould anybody like to comment on that or would anybody 
like to suggest any other thing that we can think' of, we need thoughts on 
this bill. 
Colonel Bauchspl.es - How is this five years in permanent grade of Colonel 
going to affect the Medical Department? 
Colonel Robinson - The provision of the law is that you 'will be in the grade 
of Colonel 5 years or 30 years service, whichever is the later. As it now 
stands, after 1953 you can extend on to 30 years service because it wall 
be less. Do you want to answer that question more fully. Major Benade? Major Benade - Yes, sir. I/hat Colonel Robinson has said covers the point 
but I might amplify it a little by pointing out that Colonels who serve in 
grade, either 5 years from the date they are appointed in that grade or 30 
years of service, whichever is the later, and in addition to that there are 
provisions for the retention of 10$ of those Colonels who would otherwise 
be eliminated from active service under the provisions I have just mentioned, 
hot more than 10$ of the number authorized in that grade may be retained 
\ 
on the active list after the date specified for their retirement. At the 
age of 60 they must be retired as a statutory requirement and there is no 
getting around that. One other feature is to hold a certain number of 
Colonels on active duty even after 30 years of service if they appear on 
the recommended list for promotion to Brigadier General. With the operation 
of the retention of 10$, plus the retention on active duty of those on the 
recommended list for promotion to Brigadier General, it gives you enough 
to take care of any officer who might happen to be in that situation. 
General Discussion: 
Colonel Robinson'- As time will allow, I want to mention two or three other 
■■ 
matters of which you may or may not be aware. 
Utilization of Reserve Officers under the short term plan:—tie were 
able, some time ago, to obtain authority to utilize Reserve officers on 
a 1 day to 29 days plan, payment to bo made from pay of the Army, It was 
necessary at that time to put the program out to all commands, telling 
them that it could be utilized under their overall ceilings, for each 
grade. This caused no little concern in the commandsj some interpreting 
it rigidly, some afraid to use it because of this provision, and others 
not considering this provision in any way deterrent to them, life expected thu program to be helpful in accomplishing physical examinations* in 
projects of short duration and in the transport service. It has been 
extremely helpful in all these categories. Actually, last month the 
equivalent of some 20 medical officers were gained by the utilization of 
this plan, he have worked out a definite allocation of grades by command 
under this scheme and this has been submitted to Personnel and Administra- 
tion Division, Department of the Army General Staff, IT© expect that it 
will come to you within a short time. This should eliminate the questions 
which have arisen in the utilization of Reserve medical officers on short 
tours of active duty. 
Utilization of civilian doctors:—A year ago, when the employment of 
civilian doctors was authorized, we felt that it would be necessary to 
maintain a very close control of the program. For that reason we set up a 
system whereby each of you would have to call to our office by telephone, 
or otherwise communicate with us when you had a doctor who was employable. 
This program has become somewhat stabilized and we now are able to de- 
centralize the 600 positions intelligently to the commands. Representation 
to this effect has been made to the General Staff — and it is expected 
that it will be promulgated within a*short time. 
General Noyes - Must they remain at that level or go up lj$ of our current 
authorization? 
Major Ilonnen - The Army Comptroller wants to stay down to that l'|$. 
Actually there is an anticipated reduction up to 1 November and I think 
that 1is what it will take. That is the reason for this policy. Many 
of the commands are down to 95% and some lower. Some of them qre hard hit. 
Colonel Robinson - Mr. LaCross, did you want to add anything further on 
this subject? I'lr, LaGross - No, sir, nothing to add. 
Conelugions: 
Colonel Robinson - he hope the Personnel Division.has portrayed to you today 
that almost every conceivable means has been utilized in providing profes- 
sional personnel for medical service, V/e feel that each of these means 
has contributed to the successful operation of the Medical Department during 
the past, several months and will continue to give the necessary support 
until greater stabilization can be accomplished. Under the present concept 
of rendition of medical care in the Amy, some 30 to 35% of the doctors of 
medicine are to be specialists. The remainder need not have specialty 
training under the present concept. I Would like to submit to you that the 
American philosophy of medical education has changed to the extent that a 
great proportion of all medical graduates demand postgraduate training in 
the form of residency programs. It has been our experience that more than 
90% of all the young doctors v/e have dealt with make such a demand. 
Furthermore, the teaching in our medical schools apparently has ingrained 
in these doctors the fact that they are inadequately trained to practice 
medicine until they have had postgraduate training. It appears, therefore, 
that the future holds for us a group of trained officers, a second group 
in training and a third group that we might classify as awaiting training. 
As time progresses — in fact, beginning at present, the number in training 
■will be reduced. Nevertheless, there has been no plan evolved whereby 65 
to 10% of our officers in the permanent structure can be held without 
residency training being made available to them. There are then, two courses 
open to us: 
(l) To devise some plan which will make military medicine and 
medical practice in the Army so attractive that young officers will be 
willing to forego specialty training. (2) To change our concept of medical practice in the Army to 
utilize a much greater percentage of professionally trained officers. 
At the present time work is being done along both these lines. 
Consideration is being given to establishment of courses in military 
medicine which might eventually result in a specialty board in that field. 
This would incorporate all of the advances that are being made in our 
various Reserve programs as it affects military and field medicine. This 
program would not be limited entirely to nonspecialists, since it also 
visualizes further specializing many of the specialists in military problems. 
The difficulty to this program is that it is unpopular with younger officers. 
Since military medicine is our sole reason for existence, a program for 
its development is imperative. Such a program must be made popular and it 
must also be good. The development of such a program, therefore, must be 
our prime objective in the months and years ahead. 
With regard to the second proposal* that of changing our concept 
of rendition of medical care to utilize more specialists, preliminary work 
has been started along this line. Possibly our sick call and station and 
general hospital system as it now exists is outmcKied. Probably a better 
concept would be a development of a group practice system such as is in 
effect in many communities and in many large modic.nl centers* 
Colonel Robinson - Is there any comment as to the possible utilization 
of this machine (ADmatic Projector), or the possibility of producing better 
slides and things of that sort, does anybody want to make a comment? 
Colonel Corby - It locks to me as if it might have some application at 
these various medical meetings where you would utilize it to advantage. 
There is an advertising medium for you as well as for instructional 
purposes• Colonel Robinson - That is really what we had in mind for the use of it. 
Colonel Gorby - It could be used for instructional purposes for enlisted 
and officer personnel, with proper slides set up for circulation. 
Colonel Potter - I was only able to secure six of these machines out of 
procurement funds. The Army Area Surgeons can have them for whatever use 
they care to make of the machine• You know you are all called on to put 
some sort of exhibit up at the time of various professional meetings 
within your areas and it is hard for you to get something made every time 
for each release. Therefore, having a machine like this does give you 
something that you can put almost anywhere that you are called on to display, 
he thought it might be quite useful to you. You cannot get more of them 
out of these funds so that they would be available for training. We just 
wonder if they are adequate to help you out. 
Colonel Dauchspies - I have a question, it is a double question. There are 
a number of medical students who are graduating in December, particularly 
the ones at Duke. A number of these students hold commissions in the various 
branches and are asked to come on active duty for 90 days or more until 
their internship begins some tine next year, about the first of July. Our 
training funds are not available to put these men on active duty. 'That 
provisions do we have to bring these men in? Along with that same question, 
would we bring them in on the grades that they hold in the Air Force or 
Engineers, Chemical Warfare, etc., or would ‘they be eligible for a com- 
mission in the medical Reserves? 
Colonel Robinson - We have made special provisions for that, which Colonel 
Potter will tell you about. 
Colonel Potter - The idea of opening Beaumont and Liurphy to internships 
was set up so that the graduates of the schools, and there are several of them now who graduate individuals in the various quarters of the year, can 
turn to internship beginning upon their completion of the school. As to 
your other question ox bringing them on duty if they are going into intern- 
ships in July and graduating in December. Those who are HOTC will accept 
their commissions as 1st Lieutenant, Medical Corps, upon completion of 
their four years of medical school and they will no longer hold any other 
commission. The other commissions will havo been terminated when they 
accept that commission in the Medical Corps as 1st Lieutenant. It is not 
desirable to bring to active duty as a medical officer an individual who 
has not yet had his internship. I know we tried it in some cases last year 
but we are not planning to do it this year* The Duke people, a number of 
them have been offered internship beginning 1 January and 1 April, 
Colo riel B au c h s y > i e s - hell, I don’t know if that answers my question. 
Colonel Potter - You are quite right, those who hold other reserve commis- 
sions, why not just bring thorn to duty? 
Colonel Robinson - Training funds are the only method by which you can bring 
them"to duty in their line commissions, 
Colonol 3auchspies - You cannot bring them to duty in their lino down there. 
They will, maybe, in the summertime but they will not this time of the year. 
Tfe are losing a lot that way, 
Colonel Robinson - Is there another question? 
Colonel Liston - I thought that my question was rather insignificant after 
picking up the microphone. It was Just to say that from my experience as 
a PMS&T, the ADmatic would be of greater value to the PMS&T’.s than anyone 
else for temporary display, I would personally like to take a machine 
like that and send it to the various PMS&T’s and with the approval of the Dean of the Medical School put it in a prominent place, say for a month, 
then move it on to another unit. 
Colonel Robinson - Major Nelson, do you have any comment on that? 
Nelson - I think the general .service.machines mould fit into 
Colonel Liston's idea, I am sure that most of the Medical Schools 
mould welcome the opportunity to have one on display. The group in the 
Medical Schools are our primary targets. I might add that in many cases 
v/here you have local problems and local ideas and facilities, there is 
nothing to prevent making photographs and slides locally that fit your 
own needs and ideas because we are not going to be able to furnish too 
much in the way of supplies and materials from this office. 
Colonel Robinson - Since that seems to be about all the comments, I will 
close this session. The utilization of methods which have been in vogue 
in the postwar years have held the Medical Department intact and has the 
potentiality of building us back into a strong and competent organization. 
It is necessary, however, that further study and further progress be made 
in order that our personnel may work on the plane to which they are 
entitled by virtue of the advancement of the profession and military ideas. 
Before closing, I do want to say that I appreciate very much all of the 
things that all of you have done to assist the Personnel Division during 
the past few years. I expect that you will continue to do the sane in the 
coming years. 
Colonel T.ynes - Your next speaker is Major Sheehan, who will speak to us 
on "Medical Legal Problems." 
Major Sheehan - Fellow Officers - In the remarks that follow, there will be 
put before you some of the medico—legal problems presented to the Office 
of The Surgeon General. These problems deal with the rights and duties of individuals and the Government of the United States. 
"Ghat About Censoring the Mail of Psychiatric Patients? There are no 
Federal laws which authorize such examination, Dow hear this - it's good - 
and I quote from Gerty’s MPsychiatry anti the Civilian,” "The right of 
liberty is only one of the fundamental rights and, under the conditions of 
mental illness, should not always take precedence over the preservation of 
life or the opportunity to recover that measure of happiness for which 
mental health is necessary." 
It is the opinion of this office that the commander of an Army 
hospital legally may require examination of the communications of 
psychiatric patients. Such power to be exercised, incident to medical 
treatment, within the bounds of sound discretion and in the best interests 
of the individual concerned and the Department of Defense, The protection 
of the patient, the hospital and, in some instances, society demands.these 
letters be examined, 
VJhat About the Consent of Minors in the Military Service to Surgical 
Procedures? Enlistment in the military Service by an infant is a contract 
between the soldier and the Government, which involves a change in status 
which cannot be thrown off at will. By enlistment the minor ceases to be a 
part of his father’s family and puts himself under the control of the 
Government, A minor who enlists, with or without the consent of his parents, 
is emancipated so long as such services exist because such enlistment gives 
rise to a new relationship inconsistent with subjection to the care and 
control of parents. 
It is the opinion of this office that by virtue of such emancipation 
and the general powers exercised by military authorities over persons 
subject to military law, and when incident to medical treatment, surgical procedures, as deemed necessary, may be accomplished on minors in the 
military service without the consent of the parents and the infant’s 
consent would be sufficient. 
‘.fuat About Self-dedication and Its Possible Relation to Line of Duty? 
An important feature of the Federal Food, Drug and Cosmetic Act sometimes 
misunderstood is that it recognizes the public right to self-medication 
but aims at making self-medication safer and more effective by requiring 
the labeling of drugs to bear information essential to the consumer. 
The medical profession recognizes that there is self-medication and that 
a good deal of self-medication is "warranted. There has never been any 
essential protests over the sale to the public of aspirins, laxatives 
and certain cough mixtures, 
Uhat About Foreign Nationals Practicing in Army Hospitals? A foreign 
military physician attached to an Army Hospital may be sued in the United 
States Courts for torts committed while attached to such hospitals in 
the same manner and under the same conditions as a medical officer of the 
Army may be sued. VJhether claims arising from torts committed by foreign 
medical officers in the United States military hospitals would be considered 
as falling within the provisions -of the-' Federal Tort Claims Act, i.e., the 
United States being held liable, must be regarded as an unsettled question. 
Observer training of foreign 'nationals is to be cor.fined to observation 
and only such actual participation as nay be considered to not in any way 
adversely affect the health and welfare of patients. The extent of parti-. , 
cipation will be determined by the commander of the installation conducting; 
such activity and the immediate supervisor of an observer student is con- 
sidered to be responsible for the activities of such foreign student. 
135 YJhat About Malpractice? Malpractice is a personal, wrong and the 
liability for acts of such cannot be waived or assumed by another. The 
individual medical officers are subject to suit for malpractice or 
negligence and in the event of judgment there is no means of reimbursement 
from the Government. In case of suit against an individual, the Department 
of Justice will furnish an attorney to assist in the defense thereof. 
However, under the Federal Tort Claims Act of 1946, the Government has 
authorized individuals to present for consideration or adjudication claims 
for damages, personal injuries or death arising out of certain acts of 
commission or omission of officers, agents or employees of the Government 
acting within the scope of their authority. The "fad" seems to be to sue 
the United States. Here is a resume' of the latest cases in point appear- 
ing on the records: 
Wllscan vs. United States. 76 Fed Sup 581 (Hawaii). In this case, 
action was brought under the Federal Tort Claims Act for death of plaintiff's 
(Naval Marrant Officer) four year old child allegedly caused by error of 
Naval Pharmacist in filling a prescription. The United-States was held 
liable. 
’ Jefferson vs. United States, 77 Fed Sup 706. In action under the 
Federal Tort Claims Act for damages resulting from alleged negligence of 
Army officer as a surgeon who performed operation on plaintiff, it was 
held plaintiff could not maintain action against the United States. It is 
to be noted that the-instant case differs from the Milscan case which 
involved the death of a dependent, whereas Jefferson was an enlisted man 
on active duty and the operation in question was incident to his service. In the Jefferson case the judge, among other things, ruled that an 
implied exception to the Federal Tort Claims Act existed in this case, 
not from the wording of the act but from other existing Federal legislation 
on soldier’s benefits pertaining to pay, allowances, hospitalization, 
retirements, etc., and that in view of the elaborate provisions for the 
Armed Forces, including the Veterans Administration, it is probable that the 
claim as illustrated was not contemplated by Congress. I understand an 
appeal to a higher court has been taken. 
.Brbolpvvk. United States. 69 S Ct 918. This is the first case to reach 
the' United States Supreme Court involving a claim by a soldier for injuries 
or death not incident to service under the Federal Tort Claims Act. The 
soldier on leave was killed when the car in which he was riding was struck 
by a United States Array truck. Recovery was allowed. Justice Murphy 
(deceased) delivered the majority opinion. In so doing. Justice Murphy 
stated that, were the accident incident to Brooks' service, a wholly dif- 
ferent case would be presented and mentioned that provisions in other 
statutes for disability payments to servicemen, and gratuity payments to 
their survivors indicate no purpose to forbid tort actions under the Tort 
Claims Act but it would seem incongruous at first glance, if the United 
States should have to pay in tort for hospital expenses it had already 
paid, for example. This interesting case gives some indication of the 
thinking of the United States Supreme Court on the problem. 
The Office of the Judge Advocate General, Department of the Army, 
at the present time, in the administrative consideration of claims of 
the United States military personnel, has consistently disapproved claims 
for personal injuries incident to service. 
137 Colone1 Tynes - Recent passage of the new retirement law, the Career 
Compensation Act, has brought up a good many problems 'which are of extreme 
y v 
interest to all of us personally and also to you who are commanders of 
hospitals. Title IV of this act had to do with physical retirement of 
individuals from the service. The responsibility for the implementation 
of Title IV for the services was assigned to the Department of the Army, 
and further passed along to the Medical Department of the Army. We have 
two speakers today who will try to bring you up to date on the interpreta- 
tion of Title IV' as we see it and as it will be implemented in the hospital 
system. First Captain Imbelli and then Captain Watson. 
Captain Imbelli - Title IV of the Career Compensation Act of 19A9 makes 
certain changes in the mechanism for the separation of individuals from the 
service because of physical or mental disability. It establishes uniform 
procedures for officers and enlisted men, and establishes generally the 
principle of fixing retired pay in accordance with the degree of disability. 
Therefore, certificates of discharge for disability are eliminated and a 
fixed retirement pay of 75 percent of base pay for officers and enlisted 
men with more than 20 years of service are discontinued. 
Under the provisions of this new legislation, individuals who are 
found incapacitated for duty, whether officers or enlisted personnel, are 
retired or separated from the service. 
An individual not physically fit for active duty who ; 
a. Has a disability which was not due to his own misconduct, 
b. Has a disability which is 30 percent or more, 
c. Has a disability which is the proximate result of performance of 
active duty (any disability incurred in line of duty in time of 
138 war or emergency is deemed proximate to the performance of 
active duty), or 
d. Has completed at least 8 years of active service, 
e. Has a disability which may be permanent, 
will be placed on the Temporary Retired List unless it is determined con- 
clusively that the disability is permanent, in which case he will be per- 
manently retired. However, even though an individual may have less than 
30 percent disability but has 20 or more years of active service he will 
be retired under the provisions of this act. 
An individual not physically fit for active duty who: 
a. Has a disability which is less than 30 percent and has less 
than 20 years of service, or 
b. Regarless of the degree of disability, has less than 8 years of 
service and the disability was not the proximate cause of per- 
formance of active duty, 
will be separated from the s ervice. 
If retired an individual may elect to receive retirement pay computed 
by multiplying the degree of disability by the basic pay of the highest 
rank held or multiplying the number of years of service by 2y percent of 
his basic pay. 
If separated from the service, an individual receives disability 
severance pay computed by multiplying two months* basic pay of the highest 
rank held by the number of years of active service not to exceed a total 
sum equivalent to two years1 basic pay. 
An individual placed on the Temporary Retired List will be reexamined 
every 18 months for a period of five years, and as a result of such re- 
examination, may be either 
139 a. Permanently retired, 
b. Restored to active duty, 
c. Have his disability pay increased or decreased, depending upon 
his physical condition at time of re-examination; but in no event will he 
receive less than 50 percent of his basic pay while on such Temporary 
Retired List. 
Captain Hutson - In considering retirement procedures, oversea hospitals 
may be eliminated inasmuch as they participate in the retirement of indi- 
viduals only in the following respects: 
a. To return to the United States individuals who are likely to 
require separation from the service by reason of physical disability. 
b. To take care of retirement procedures (except review and repeal) 
of those individuals domiciled in an oversea area such as Porto Rico, 
Hawaii and the Philippines. 
From the foregoing it is seen that the retirement procedures apply 
mostly to ZI hospitals. 
Workload. It is anticipated that approximately 1300 Army and Air 
Force officers or enlisted men will be processed for retirement per month. 
This vdll result in a considerable increased load upon the hospital system; 
in order to minimize this load and in order to enable the utilization of 
accommodations ordinarily not used for patients it has been provided that 
individuals who do not require active hospital inpatient care may be 
treated so far as quarters are concerned essentially as duty personnel* 
There are two new terms that must be remembered, 
a. A medical board has essentially the same functions as a disposi- 
tion board used to have. 
140 b. A physical evaluation board has essentially the same functions, 
plus certain additional functions as a retiring board used to have* 
For the purpose of clarification we will classify ZI hospitals not 
into general and station hospitals but as: 
a. Hospitals having an evaluation board, 
o* Hospitals not having an evaluation board. 
All hospitals down to and including 25 bed station hospitals are 
authorized to have medical boards. 
Only certain general hospitals are presently authorized to have 
physical evaluation boards. 
There are then two procedures for handling physical disabilities; 
one is the procedure where the individual is admitted to a hospital which 
does not have an evaluation board, the other is the procedure that pertains 
to the individual who is admitted to a hospital that has an evaluation 
board. 
Hospitals not having physical evaluation board authority. As soon 
as practicable after admission to a hospital it should be determined whether 
an individual will require physical evaluation board action. If physical 
evaluation board action is indicated and: 
a. He has a disability which clearly and without a reasonable doubt 
existed prior to entry into the service, 
b. He has loss than 20 years of active federal service and a disabil- 
ity which is clearly and without a reasonable doubt less than 30 percent 
in accordance with Veterans Administration standards, 
c. His base pay is such that under existing Veterans Administration 
laws and regulations he -would receive higher compensation thereunder. 
141 Such individual will have his rights explained to him by the command- 
's. . • 
ing officer or his representative and will be requested to consider fore- 
going personal appearance before an evaluation board. The commanding 
officer or his representative will execute a certificate to the effect 
that the individual’s rights have been explained to him and that he has 
or has not agreed to forego his appearance before a physical evaluation 
board# 
If he does not agree to forego an appearance before a physical evalua- 
tion board he will be transferred immediately or as soon as transportable 
to a hospital having physical evaluation board authority* If he does agree 
to forego a personal appearance before a physical evaluation board he is 
then retained in the admitting hospital until he has reached maximum 
hospital benefits and is then brought before the medical board of the 
admitting- hospital (unless these patients have conditions which require 
their transfer to general hospitals under existing instructions). 
The local medical board may reach one of the following findings: 
a. Return to duty, 
b. Temporary defect with return to duty at a specified later date, 
c. Condition not stabilized and examination and reevaluation deferred 
to a future date. 
d. In certain unusual cases refer the case to the Surgeon General’s 
Office for review and recommendation# 
e. If it is determined that the individual’s case should be referred 
to a physical evaluation board, the necessary papers giving the required 
facts in the case are prepared and forwarded directly to the appropriate 
physical evaluation board. 
142 '.inen the papers reach the appropriate physical evaluation board 
it considers the case on the basis of the papers and will ordinarily 
reach specific findings. These findings will ordinarily either be a 
recommendation that the patient return to duty, be retired or separated 
« 
from the service with or without severance pay. The board may, however, . 
call for the personal appearance of the patient in which case the patient 
'-ill be transferred to that hospital and personally appear before said 
board. 
Hospitals having physical evaluation board. The same procedure occurs 
in a hospital having physical evaluation board proceedings except that 
there is no transfer of the patient from one hospital to another whether 
or not he foregoes personal appearance before an evaluation board. The 
only instant when transfer to another hospital would be indicated would 
be in case an evaluation board was located at a station hospital and the 
patient needed treatment for which personnel and facilities were not 
available at that station hospital. In this instance the patient would be 
transferred to a general hospital having an evaluation board at ’which the 
necessary personnel and facilities for the required treatment existed. 
This transfer of course would be effected as soon as practicable after the 
patient’s original admission to the hospital. 
General Colo - Have these instructions gone out to the hospitals? 
Captain Vatson - The advance copies of the Special Regulation which carried 
these instructions have gone out and the printed copies are now in process 
of either the last stages of printing or they may have at this date been 
sent out to the field. General Cole - Can we proceed with the copies of the tentative regulations 
■which we now have? 
Captain Vfatson - I think that is v/hat Colonel Tynes has just told me, that 
you may . 
General Cole - One more question. Many officers who are now retired and 
many reserve officers who are now retired as I understand under this lav;, 
will have to be re-evaluated. 'Till that be done by these evaluating boards 
in general hospitals? 
I ' 
Captain Watson - I think not. General. That question is nov/ in process of 
discussion in P&A and they are also, in that connection, in the process of 
publishing a pamphlet of instructions to those people. However, the think- 
ing on it is that those cases will be reviewed from their records alone 
upon application by the individual concerned. 
Colonel Villars - Who appoints those evaluation boards? 
Captain '/atson - That is handled the same as the authority for appointing 
the old retirement boards. . The Army Commanders appoint the board as 
directed by the Secretary. In other words, he may from time to time require 
that the Army Commander appoint various boards. This regulation that we 
spoke of does specifically name the boards that will be formulated currently 
and in the future it is contemplated that there may be some additional 
boards appointed. That announcement will be made from the Department of 
the Army to the Army Commanders concerned. 
I * 
Colonel Liston - I dici nqt get a distinction, if it was made, between the 
case that has disability incident to service and the case of disability 
which existed prior to service, VJhat do you do with the latter man? 
Captain Watson - That is the man who has come into the service to find that 
he has a disability that existed prior to service. Colonel Kilgore - if I may, I would like to explain that question* It is 
rather a wild one and in connection with this training we had last week, 
that question was brought up and discussed at quite some length by both 
members of the Surgeon General’s Office and PGA. 
Colonel Tynes - I believe that you can ask questions all day on this 
subject* Captain Watson, Captain Imbelli, and Colonel Fitzpatrick were 
the three principal speakers at the orientation meeting with •the..'Army, 
representatives last week and the week before. I have been to several of 
them and actually, questions were asked as long as we could stand on our 
feet. Now each of you had a representative from your own hospital or 
your own Army Headquarters who attended this course and I believe they are 
pretty well oriented by this time, I think they can answer the questions 
that you specifically have. If not, then I believe it would be better to 
put them in writing, send them back to this office, or leave them with us 
before you leave and we will get the answers back to you in writing. 
I say this because I had to interrupt two other conferences in the past, 
otherwise we would never have finished with any of our work. I do not 
mean that we are not willing to answer questions, if you do have questions 
on this subject, but we do have a meeting with the Navy, "Je still have 
one other speaker today and unless I am interrupted now we will complete 
our schedule. I am going to let Captain Watson make one other statement. 
Captain ..hitson - Just to relieve your concern on these questions, in co- 
ordination with PGA, 3GO is taking all of the questions that were brought 
up at this conference last week and they are preparing a pamphlet which 
will be sent to all the commands concerned. 
Colonel Tynes - General Armstrong will close our conference. General Armstrong - May I express for The Surgeon General the appreciation 
of General Bliss personally and his entire staff for your coming into this 
meeting and the interest I know you have shown in the various discussions 
which have taken place. 
JOINT ARi.il-NAVY-AIR FORCE CONFERENCE 
Auditorium, Naval Medical Center 
Bethesda, Liaryland 
/Wednesday. 9 November 1949 
1315-1400 
Journey to Navy lied leal Center, 
Bethesda, Maryland 
1400-1420 
Joint Medical Problems 
Dr. Richard L. Mailing 
Director of Medical 
Serviees, Offic e o f 
Secretary of Defense 
1420-1500 
Question and Answer Period 
1500-1515 
Recess 
1515-1700 
Joint Discussion of Cross 
Hospitalisation 
(10 min.) 
Care of Army and Air Force 
Patients in a Navy Hospital 
Capt. N. T, Broun, MC 
(U3u) 
(10 min.) 
Care of Navy Patients in 
Army General Hospitals 
Lt Col J. T. McGibony, 
MC (USA) 
Thursday. 10 November 19A9 - Military Surgeons Conference, Statler Hotel, 
/Washington, D. C. 
Friday, 11 November 194-9 - Military Surgeons Conference, Statler Hotel, 
/'Washington, D. C. 
'Saturday. 12 November 194-9 - Military Surgeons Conference, Statler Hotel, 
"/Washington, D. C. 
146