Lining Up the Doctors

During the month of May, 5,000 U.S. doctors will join the Army as commissioned officers; in June another 3,000 will go. By the year's end, some 35,000 of the nation's 180,000 physicians will be in the armed forces.* How can qualified doctors be rushed into the Army at this rate and adequate medical service be maintained for the civilian population?

This question was discussed last week by Lieut. Colonel Sam Foster Seeley before the New York State Medical Society. (Colonel Seeley is head of the Procurement & Assignment Service, liaison agency between the American Medical Association, the veterinarians, the dentists, and Army & Navy.)

End of Individualism. Last year, U.S. doctors filled out reports for A.M.A. stating their training, experience, specialties. Last week, they filled out their third questionnaire. For many of them, it forecast an end to the old competitive practice of private medicine. The form made it clear to doctors that they would have to cooperate in some form of organized medical service, gave them four choices: 1) to accept commissions in Army or 2) Navy; 3) to work for the Public Health Service; 4) to accept assignments in such Federal civilian agencies as the Indian Service, Veterans' Administration, Panama Canal, Children's Bureaus.

More than half the doctors under 44 will be in the armed forces. Younger men enter the Army as first lieutenants, those over 37 as captains, those over 44 as majors. Once in the Army, many specialists will have to turn to general medicine. But if U.S. troops get into large-scale battles, many doctors will have to specialize. (During World War I many general practitioners had to become specialists in neurology, plastic surgery, orthopedics, etc.)

Special recruiting boards will be sent this week into all States east of the Mississippi. Doctors of draft age who are certified by Procurement & Assignment as nonessential to civilian practice will be sent into active service within 14 days. After May 9, the recruiting boards will move west.

Incision Hoarding? In some parts of the country surgeons have been kept busy performing operations that patients wanted done before their doctors were called up. In addition to such forehanded patients who will soon not be able to be treated by the physicians they prefer, there are others--in booming defense areas and towns stripped of doctors by the draft--who even now find it difficult to get any kind of medical attention.

"Our objective," says Colonel Seeley, "is to provide these communities from metropolitan areas which now have, and will still have after Army & Navy needs are met, more doctors and dentists than they really need."

Protecting the health of the whole population will involve much shifting of civilian doctors, most of them older men with established practices. Colonel Seeley gave a hypothetical example of the woes that these physicians will shortly face. Said he :

"Assume that three doctors move out of Podunk to accept commissions in the Army and Navy. This will create a dangerous shortage of medical and dental care in Podunk. Assume that in Brooklyn, however, we have an overabundance of doctors and dentists, after the Army and Navy have called up the men they want. . .

"We may have to . . . ask the doctor or dentist to go to Podunk. He may have to give up an established practice in Brooklyn to do this. The three doctors who left Podunk may say it is a hell of a note to put us in uniform and then turn our practice over to a stranger who will be too well established when we return for us to get back our former patients."

* Taking the total number of men in the armed forces as 4,000,000, the proportion of doctors in service will be roughly one for every 113 men or less, leaving one doctor for every 900 civilians. The Army's proportion of doctors is high for troops in training but Losses of Life Caused by War, a study published by the Carnegie Endowment in 1923, points out: "With respect to all military campaigns it has been observed that the medical corps were too small to handle the work they were called upon to do. The fact is that they should be large enough to take care, not only of their own sick and wounded, but also of those of the enemy, and at the same time to allow for losses in their own personnel. . ."

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