Doctor to 4,000,000

This particular doctor has so many patients that it takes him months to make his rounds. And his visits take him thousands of miles from his office, a grey building in Washington, D.C. a block from the White House. Dr. Paul Ramsey Hawley, medical director of the Veterans Administration, has more patients than any physician in the world's history ever had--about 4,000,000.

That is the number, of the 18 million living U.S. veterans of three wars, who will get V.A. doctoring this year. Five hundred thousand of them will be in V.A. hospitals. The annual medical bill: $500 million. And V.A.'s medical care of most of the veterans of World War II has only begun. In an openhanded mood at the war's end, Congress awarded all veterans, under certain conditions, free hospital care for the rest of their lives for any ailment whatsoever. V.A. estimates that its peak hospital load (if there are no more wars) will not come till 1975.

Many U.S. doctors are less impressed with the size of this vast medical plant than with its quality. In two years, Dr. Paul Hawley has worked a medical miracle.

The Call. When General Omar Bradley took over V.A. in 1945, he offered Dr. Hawley an unattractive job. Veterans' medicine, under fire from Congress and the press, was a mess of red tape, indifference, discouraged patients, scarce equipment, underpaid doctors. Major General Hawley, third in a line of Indiana family doctors, had been chief surgeon of the ETO, and he felt "called." He wanted not only to clean up V.A., but to give veterans the best medicine the U.S. could offer.

This week, like a general in mid-campaign, Dr. Hawley paused to review his progress. Said he, to a gathering of physicians in Indianapolis: "The first question to be answered was: Where is the best medicine in the country practiced? The answer was very simple--in teaching hospitals. If, then, we were to give the veteran the best... we had first to make as many of our hospitals as possible teaching hospitals."

Helped by Northwestern University's famed Surgeon Paul Magnuson, who had long wanted to team up veterans' hospitals with medical schools, Hawley began to train and attract topnotch doctors. Over the opposition of some big brass, he got a law taking the V.A. medical corps out of Civil Service and raising fees so that he might hire the ablest specialists as consultants.

Meddlers Beware. Politicians and chair-warmers who tried to fight blunt Dr. Hawley came out second best. Angered by pork-hungry Congressmen who wanted V.A. hospitals in out-of-the-way places, Hawley cracked: "I recommend that we build hospitals like they do hog houses in Indiana--on skids. Then they could be hauled around from one congressional district to another just before election."

In two years, the dynamic doctor has whipped into shape the finest system of medical care in the world. Of V.A.'s 124 hospitals, half are now affiliated with medical schools, and are giving resident training to some 2,000 doctors. Hawley rates 40% of his hospitals as first-class, i.e., "nothing better in the country," and only 15% below par (before Bradley and Hawley, 95% of V.A. hospitals were rated below par). V.A. now has nearly six times as many full-time doctors (3,501), more than twice as many nurses (10,715) and nearly seven times as many social workers (1,009) as it had two years ago.

About once a week, Dr. Hawley, fat and 56, threatens to resign his exacting, modestly paid job (in private practice, he could probably make three times his $12,000 Government salary). But he likes the work, and U.S. medicos keep urging him to stay on. In an organization that attracts political meddlers, General Hawley knows all he needs to know about the strategy of defense.

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