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ACCESS TO CARE
THE POST-VIETNAM ERA
The ending of the physician draft in 1973 coincided with the ending of the Berry Plan, the program that had allowed drafted physicians to defer active duty until completion of specialty training. Lt. Gen. Richard R. Taylor, MC, surgeon general from 1973 to 1977, found his most pressing problem was dealing with the inevitable physician shortage, a condition that only grew worse during his tenure. When his successor, Lt. Gen. Charles C. Pixley, MC, became the surgeon general in September 1977, only 4,056 physicians were on active duty, over 1,200 less than needed. Indeed, the number of serving physicians had dipped to 3,700 earlier that year. Pixley regarded the situation as so bad that he hated to come to work.1
To alleviate the shortage, General Pixley expanded physician recruiting efforts, employing over fifty MSCs in forty-three field offices and giving them permission to call him at any time to speak to candidates. Hard work, a rising U.S. medical school enrollment, and a period of peace began to correct the situation, and the number recruited more than tripled from 106 in 1976 to 338 in 1979.2 The Health Professions Scholarship Program also helped, as did the establishment of new special pay programs for physicians that contributed to a better retention rate of Medical Corps officers beyond their initial tour. As a result of these various factors the recovery from the physician shortage was quicker than expected, dispelling overly pessimistic projections. The number of Army physicians on active duty had increased by nine hundred as Pixley's four-year term as surgeon general ended in 1981. Improvement continued, with the number reaching 5,214 in 1984 and 5,606 in 1991. Nevertheless, the recruitment and retention of physicians in both the active and reserve components remained one of the Medical Department's most vexing problems during the years immediately following the Vietnam War.3
Modernization of Field Medical Support
The Army modernized during the post-Vietnam period. A recruiting slogan, "Be All You Can Be," challenged soldiers to meet higher standards, such as a universally applied semiannual physical fitness test and strict weight control rules. Training also became more demanding and realistic; armored brigades, for example, maneuvered against a proficient aggressor force in the Mojave Desert at the National Training Center, Fort Irwin, California. The Army embraced an AirLand Battle doctrine that emphasized flexibility, mobility, and joint Army and Air Force operations.
The Medical Department also took steps to improve its doctrine, force structure, information systems, and equipment. It took a loss, however, when reorganization of combat service support units in 1982 removed the medical battalion from armored and mechanized infantry divisions in a change that established multifunctional forward support battalions (medical, maintenance, and supply and transportation companies) for the maneuver brigades. Conversion of the light divisions followed. This change necessitated forming a medical operations section in the Division Support Command to provide the medical operations staff capability for the division that had existed in the medical battalion. A development called Division 86 restructured division-level doctrine and equipment, converting the battalion surgeon to a warrant officer physician assistant and changing the MSC medical operations assistant in maneuver battalions to the medical platoon leader.4
Medical doctrine underwent reexamination, beginning in 1984 with a Medical Systems Program Review at the Academy of Health Sciences, Fort Sam Houston, Texas (which in 1991 became part of the newly organized U.S. Army Medical Department Center and School), a study conducted at the direction of General Maxwell R. Thurman, the vice chief of staff of the Army.5 The resulting operational concept was termed Health Service Support, AirLand Battle, in 1986 and was further revised in 1991 as Health Services Support for AirLand Operations. Planners focused on building medical units from cellular components and reducing the types of hospitals in the theater of operations. The doctrinal development continued in the early 1990s as Health Service Support (HSS) AirLand Operations. It was intended to improve the evacuation and hospitalization system for future theaters of operations in which combat action would be characterized by speed, lengthened lines of communication, and dispersed units. Automation support for medical command, control, and communications was addressed with the computer-based Theater Army Medical Management Information System (TAMMIS). This automated system had subsystems for patient accounting and reporting, patient regulating, blood management, and medical logistics.6
The five echelons of medical support were referred to as levels I through V health service support (Chart 5). Medical capability at level I was improved through expanded first aid training for all soldiers (buddy aid) and the creation of a combat lifesaver program that trained selected nonmedical soldiers in the techniques of lifesaving aid, such as administering intravenous fluids to control shock until the medic arrived. The intent was to have a combat lifesaver in every infantry squad or equivalent combat element. At levels III and IV the doctrinal changes were translated into Army organizational changes through Medical Force 2000 (also called MF2K), a force structure proposal based on four types of battlefield hospitals and a medical holding company (a reduction from seven hospitals).7
Field medical equipment improvements were highlighted by the Deployable Medical Systems (DEPMEDS), a modernization program for all military field hospital sets. DEPMEDS featured hard-walled expandable shelters for equipment-intensive functions such as surgery, x-ray, and laboratory, as well as special generators and power distribution equipment. DEPMEDS sets were issued to the
forward-deployed numbered hospitals in Europe beginning in 1988 and were pressed into service soon after the sets began arriving.
For example, the 196th Station Hospital, stationed in Casteau, Belgium, conducted the first full surgical inpatient use of DEPMEDS components by an operational Army hospital, using portions of its set for a four-month period beginning in July 1989 when it was forced to close its entire inpatient capability for renovations. Not long thereafter elements of the 5th MASH from Fort Bragg, North Carolina, commanded by Lt. Col. Stephen H. Johnson, MSC, deployed to Europe for the annual Return of Forces to Germany (REFORGER) exercises. It became the first REFORGER medical unit to set up and operate with DEPMEDS. Those experiences demonstrated the advantages of the new equipment.8
Developments in the Corps
MSC active duty strength stayed close to five thousand officers throughout this period. In 1982, a representative year, the active component MSC numbered 4,994 officers: 3,563 in the Pharmacy, Supply, and Administration Section; 840 in
the Medical Allied Sciences Section; 372 in the Sanitary Engineering Section; and 219 in the Optometry Section (see Appendix L). The number of specialties had dropped from forty-two in 1972 to thirty-five. In 1992 the corps numbered 4,920 in the active component, 1,175 in the National Guard, and 8,709 in the reserves, for a total of 14,804 in all components. The MSC also continued to serve as the carrier for various student programs, the graduates of which would be commissioned in other corps of the Medical Department. In 1982 this practice accounted for 205 Army medical students at the Uniformed Services University of the Health Sciences, Bethesda, Maryland (the DOD medical school).9
Brig. Gen. James J. Young, MSC, succeeded General Haggerty as corps chief in October 1977. He also replaced Haggerty as the surgeon general's director of resources management, a continuation of the practice of "dual-hatting." Young was followed in October 1981 by Brig. Gen. France F. Jordan, MSC, who continued as the surgeon general's director of personnel and commander of the U.S. Army Medical Department Personnel Support Agency. In March 1984 Jordan was selected as the first MSC to fill the two-star billet of deputy assistant secretary of defense for medical readiness. He was replaced as chief of the Medical Service Corps by Col. Walter F. Johnson III, MSC, the executive officer for the surgeon general. Johnson began his tour with the rank of colonel but was promoted to brigadier general in October 1985, when he also became the first MSC appointed as the surgeon general's director of health care operations. For the first time there were two MSC generals on active duty, a situation that continued until Jordan's retirement in 1987. Brig. Gen. Bruce T. Miketinac replaced General Johnson in November 1988 as corps chief and operations director (see Appendix G).
Throughout this period the evolution of the MSC continued. A committee headed by Maj. William E. Lohmiller, MSC, studied the administrative specialties in 1978 and concluded that the corps had emphasized specialization at the expense of more generalized capabilities. His committee recommended managing administrative officers as a group rather than as individual specialties and reducing the number of administrative specialties. All new MSC administrative officers were to have the entry-level skill of field medical assistant (coded as 67B), losing the B suffix when they received their primary and secondary specialties between the seventh and fifteenth years of service.10
The important aspect of Lohmiller's recommendations was the concept of administrative officers as a single group with increased flexibility of assignments within that group. The Medical Department was preoccupied with other problems at that time and the recommendations were not acted upon, but the basic principle remained alive. It was incorporated into an MSC management study, organized by General Johnson in 1987, that sought to include the scientific specialties as well. The study was continued by General Miketinac when he became corps chief in 1988.
The new corps structure as it emerged in 1994 from the MSC Management Study reduced from thirty-five to twenty-six the number of Medical Service Corps commissioned and warrant officer specialties, now called areas of concentration (health facilities planning, manpower management, physiology, and psychology associate were eliminated or combined with other specialties). Warrant
officers were unchanged, but commissioned officer specialties were arranged into eight groups called medical functional areas (see Appendix M). Four of these areas-health services (the administrative specialties), laboratory sciences, preventive medicine, and behavioral sciences-consisted of related specialties. It was believed that this would allow greater flexibility in assigning officers to specialty-immaterial positions in the senior grades. For example, it was estimated that over 90 percent of the colonel positions in the laboratory sciences medical functional area could be filled by officers from any specialty within that grouping. The other four medical functional areas-pharmacy, optometry, podiatry, and aeromedical evacuation-were stand-alone areas of concentration.11
Accessions to the corps during the post-Vietnam period were principally through ROTC and direct appointments in the various specialty areas. ROTC accounted for about three hundred new officers each year during much of this period, including graduates from an MSC ROTC program at the University of Pennsylvania. Of that total, the MSC offered about seventy Regular Army commissions to ROTC distinguished military graduates annually. Commissioning of West Point graduates, which had lapsed in the mid-1980s, was reinstituted in 1988 when the Army added the MSC, Adjutant General Corps, and Finance Corps to branches already available to cadets. In 1992 this source accounted for 12 of 435 accessions.12
The Army greatly expanded opportunities for women in the early 1980s, the exception being positions with the highest probability of direct combat. A suggestion surfaced in 1983 to commission all female ROTC cadets in the special branches (Chaplain Corps, Judge Advocate General's Corps, and the Medical Department branches). In effect, because of the particular training requirements of the other special branches, this proposal would have meant that most female cadets would be placed in the MSC for duty in the administrative specialties. However, since many MSC junior officer positions were in the category with the highest probability of direct combat, the proposal would have been difficult to implement. In any case, Maj. Gen. H. Norman Schwarzkopf, the director of military personnel management, wanted greater opportunities for women throughout the Army, and he rejected the measure.13
Women increasingly sought careers in the MSC. In 1968 there were only 7 women in the corps, but by 1987 the number had risen to 544. Most of the increase had occurred after 1977, and thus their number consisted predominantly of junior officers, with only twenty-six female majors and five lieutenant colonels in the upper echelons. In an attempt to gain insight into the situation of women officers, Capt. Susan R. West, MSC, a management intern in General Johnson's office, surveyed a hundred female MSCs. A common theme of the respondents was their struggle in establishing themselves as Army officers. In general, they indicated satisfaction with their careers, although there were complaints of lingering prejudice. Of those surveyed, 44 percent believed their opportunities were equal to or better than male MSCs, and more than two-thirds regarded the MSC as equal to or better than other Army branches.14
As women progressed through the ranks they achieved significant milestones in the active component MSC. In 1991 Donna C. Williamson became the first
female promoted to colonel. In 1992 Capt. Katherine H. Moore, MSC, was selected as one of the Ten Outstanding Young Americans by the national Junior Chamber of Commerce. Also in 1992 Lt. Col. Mary Anne Svetlik, MSC, became the first female deputy commander for administration (formerly the hospital executive officer), and in 1994 Lt. Col. Priscilla M. Alston, MSC, became the first female field grade commander. By January 1995 the MSC had 825 female officers, more than any other branch in the Army except the Army Nurse Corps. Nineteen percent of MSCs were women, an increase of 70 percent since 1987 as a percentage of the corps.15
Efforts to promote cohesion continued. General Jordan established an MSC medallion to be presented to MSCs retiring from active duty, and the chief's office undertook the manufacture and sale of MSC belt buckles and commemorative coins. An annual directory of all MSCs provided a resource not available to officers in other branches. General Johnson convened a meeting of senior MSCs in 1984 to prepare a strategic plan. They developed thirteen goals grouped into the areas of readiness, management, quality service, professionalism, and cohesion that the chief disseminated as a pocket-size handout.16
Generals Johnson and Miketinac both urged senior MSCs to serve as mentors for junior officers, an effort that was particularly needed with the loss of the MSC medical battalion commanders as role models. In Europe, for example, there were nearly two hundred MSCs-mostly lieutenants and captains-assigned to units outside the 7th Medical Command, prompting the command's chief of staff to ask the senior MSCs in each region to work informally with these younger officers as "mentors."17
In 1982 General Jordan announced establishment of the MSC Chief's Award of Excellence. It recognized two outstanding junior officers each year, one in the administrative specialties and one in the scientific specialties (Appendix N). Duane C. Goodno, a first lieutenant, and Erik A. Henchal, a captain, in 1982 were the first winners. Goodno was recognized for accomplishments as the logistics officer of the 421st Medical Company (Air Ambulance) in Germany; Henchal, a microbiologist at the Walter Reed Army Institute of Research, was honored for his research in dengue. In 1983 General Johnson added an award for a warrant officer. The first winner was CW2 Cornelius L. Reeder, recognized for his duty as a biomedical equipment repair technician at
Dewitt Army Hospital, Fort Belvoir, Virginia. In 1986 Johnson added a fourth category, an officer from the U.S. Army Reserve. Capt. Marisa P. Parker, MSC, 2d Hospital Center, Hamilton Field, California, was selected as the first winner for her contributions during a tour of duty with the Senior Army Reserve Adviser. The Army National Guard joined the lineup in 1990 with the selection of Capt. Mary L. Ivanhoff, MSC, 146th Combat Support Hospital, San Francisco, California.18
Another initiative was the establishment of an annual Junior Officer Day with the Chief. The first session in December 1982 was attended by eleven lieutenants and captains who toured the Pentagon, were briefed by MSC staff officers, and lunched with General Jordan and other senior MSCs. By 1987 the event had expanded to a two-day visit by eighteen participants, including commissioned and warrant officers. Yet another innovation began in 1985 when Capt. Eric G. Daxon, MSC, became the first management intern in the chief's office, another program begun by General Johnson.19
Some MSCs were recognized in competitive awards of the Association of Military Surgeons of the United States (AMSUS). In 1977 Maj. Richard V. N. Ginn was the first Army MSC awarded the Sir Henry Wellcome Medal and Prize, the oldest award of the association, presented annually for an essay reporting original work in military medicine. General Jordan received the first AMSUS Outstanding Federal Services Health Administrator Award in 1984. Col. Thomas C. Munley, MSC, became the second Army recipient in 1986, and General Johnson was the third in 1988.20
The identification of MSCs with field medical service flowered in a special way through the efforts of Lt. Col. Richard J. Berchin, MSC. His single-minded dedication to creating a memorial to the combat medic resulted in the Combat Medic Memorial, which was dedicated in ceremonies at Fort Sam Houston in November 1979. The bronze statue of a medic tending a fallen comrade became a popular icon.21
MSCs also figured in an Army initiative to increase unit cohesion by identifying soldiers with the traditions and customs of historic regiments. This led to the establishment of the Army Medical Department Regiment in 1986. All medical officers and enlisted personnel were formally affiliated with the regiment, to include wearing the departmental crest on their uniforms. In 1994 an MSC, Col. James G. Van Straten, Ret., became the second honorary colonel of the regiment, replacing Maj. Gen. Spurgeon Neel, MC, Ret. Primarily a ceremonial position, Van Straten's role was to enhance morale and esprit de corps through the perpetuation of the regiment's traditions and customs. Van Straten, who had retired in 1986, was dean of allied health sciences of the University of Texas Health Science Center in San Antonio.22
A continuing theme in military medicine is the ebb and flow of political pressure to reduce the number of physicians in administrative positions. In 1978 DOD representatives testified to the House Committee on Appropriations that
120 Army physicians occupied executive management positions. Congress asked for a 20 percent reduction, and that pressure, as well as the evident capabilities of senior MSCs, continued to open position opportunities. In 1976 Col. Neil J. McDonald became the first MSC appointed as director of personnel for the Surgeon General's Office, and in 1978 Colonel Van Straten became the first MSC assigned as the deputy commandant (later redesignated assistant commandant) of the Academy of Health Sciences. MSCs served as the chiefs of staff of the U.S. Army Medical Command, Europe (renamed the 7th Medical Command in 1978), in Heidelberg, Germany, and the U.S. Army Medical Research and Development Command (USAMRDC), Fort Detrick, Maryland. In 1981 Col. Donald H. Triano became the first MSC chief of staff of the Health Services Command, Fort Sam Houston. Col. Philip Z. Sobocinski became the first MSC deputy commander of the USAMRDC in 1984, and in 1987 Col. Carl E. Pedersen became the first MSC commander of the U.S. Army Medical Materiel Development Agency, a USAMRDC unit also at Fort Detrick.23
In 1978 Maj. Gen. Surindar Bhaskar, chief of the Dental Corps, created positions for MSCs as executive officers of U.S. Army Dental Activities (DENTAC). The new organizations, although attached to Army hospitals for support, were independent headquarters; by 1982 there were forty-two MSC administrative positions in grades from captain to lieutenant colonel. General Young believed that these positions were an excellent opportunity for officers who wished to broaden their managerial experience. This and other management changes contributed to a 48 percent increase of productivity by Army dentists from 1978 to 1983.24
Despite these advances, a promotion slowdown became a serious morale problem during this period. The reductions of the Army after the Vietnam War had not cut enough MSCs. That was due principally to the physician shortage that left the department with vacant Medical Corps authorizations each year. The Surgeon General's Office, fearing the loss of those spaces (the rule of "use or lose"), converted some to MSC so that it could keep the authorizations filled. Unfortunately, in so doing it retained more MSCs in low- to mid-level grades than could be accommodated by the corps' normally pyramidal rank structure. Thus promotions became more competitive for Vietnam-era officers, because selections were based on the year of an officer's entry on active duty. Vietnam-era year groups bulged, a problem compounded when the department was able to resolve the physician shortage and took back the authorizations it had temporarily placed with the MSC. The ensuing reductions in the overstrength year groups forced many promising officers out of the service or into other branches.25
The Defense Officer Personnel Management Act of 1981 (DOPMA) increased the size of the Regular Army, and the Army elected to have a career force (major and higher) of all Regular officers. The act allowed field grade reserve officers on active duty to apply for Regular Army integration, and many reserve MSCs applied. But the practice only added to the year group problem, because those reserve officers who would have retired when they reached their twentieth year of service tended to stay on active duty. Furthermore, DOPMA's ideal selection rates-80 percent for major, 70 percent for lieutenant colonel, and 50 percent
for colonel-were initially used by MSC promotion boards and added to the overstrength problem in certain year groups.
By 1983 MSCs were falling behind in promotions when compared to their peers in other Army branches. Predictions were that by 1989 they would be over three years behind the rest of the Army for promotion to major and four years behind for lieutenant colonel. General Johnson was able to gain the assistance of Delbert L. Spurlock, Jr., assistant secretary of the Army for manpower and reserve affairs, who told the Army chief of staff that the promotion problem was distressing.26 Some officers in other branches who worked for MSCs were promoted so rapidly that they ended up supervising their previous bosses. In a typical example, Captain Daxon, the chief's first management intern, was one year behind his West Point classmates when he was promoted to major in June 1985.
The problem was resolved through a combination of actions. The Army provided some relief through additional field grade promotion authority in 1986. The Medical Department tightened its management of year groups: it retired or separated officers in the overstrength year groups and approved their requests for transfers to other branches. In 1987 the MSC underwent the Army's first selective early retirement board, a process that picked officers for involuntary retirement.27 In addition, the Army used promotion rates generally lower than the goals of DOPMA. For example, the 1987 Medical Department colonel promotion board, which considered officers who came into the Army during the Vietnam War, had a 35 percent selection rate for those considered for the first time, a contrast to earlier boards that had used higher rates (such as the 1979 board that had used a 52 percent first-time selection rate). By using
lower selection rates, the Army was able to avoid stagnation of promotion timing. In other words, it promoted fewer officers, but those who advanced did so at an accelerated rate.
The corps continued to have the lowest percentage of general officers of any branch in the Army except the Army Medical Specialist Corps (AMSC). In 1982 the corps had one brigadier general for 4,901 officers. All other Medical Department corps (except the AMSC) fared better, and if the MSC were compared to the branches most frequently mentioned as possible substitutes-Adjutant General, Ordnance, Quartermaster, Chemical, Signal, and Transportation-it had an elevenfold disadvantage at best. For example, Ordnance Corps officers had a thirty-two times better chance for stars than MSCs. The MSC continued to lose promising officers because of the lack of opportunity beyond the rank of colonel.28
DOPMA also changed the basis for calculating the number of general officers and theoretically gave MSCs the same opportunity as other Army officers. However, that was subject to the constraints imposed by the number of generals that Congress appropriated for the Army and that the Army in turn allocated to the Medical Department, a number that totaled twenty-two in the post-Vietnam era and fell to sixteen by 1994.29 Lt. Gen. Bernhard T. Mittemeyer, surgeon general from 1981 to 1985, supported the appointment of a second MSC general officer, but that did not materialize.30
The promotion of General Johnson while General Jordan was still on active duty had been accomplished through the use of a Medical Corps star. Whether that situation would last depended on the desire of the surgeon general who would be serving when Jordan retired. When he did retire in 1988 the corps reverted to only one general officer on active duty. The pressure within the department for the star was such that Lt. Gen. Quinn H. Becker, Mittemeyer's replacement as surgeon general from 1985 to 1988, was unwilling to leave it in the MSC.31
Education and Training
Despite problems with rank, MSC educational levels remained high. In 1981 41 percent of the corps had master's degrees (as compared to 24 percent for all Army officers) and 7.4 percent had doctoral degrees (versus 1 percent for the Army). The corps provided two avenues for university training: baccalaureate degree completion for warrant officers and graduate programs for commissioned officers. The corps chief approved training starts based on validated requirements by specialty area, and officers could apply for graduate training between their fifth and eighth year of service. From 1980 to 1985 MSCs obtained 83 doctoral and 100 master's degrees at civilian universities. There was also opportunity for a master's of science in logistics at Army Logistics Management Center, Fort Lee, Virginia, and a master of military art and science for students in the resident course of the Command and General Staff College, Fort Leavenworth, Kansas. Fully funded university graduate school opportunities in 1988 included doctoral training in ten disciplines and master's in twenty-one. A new opportu-
nity appeared in 1995 when the Army provided the Medical Department with four openings in the Training with Industry (TWI) program. Officers selected for this graduate (but non-degree producing) training would be stationed with a private sector company for one year to obtain firsthand experience in management skills and business practices which they would then apply in a subsequent utilization assignment.32
By 1981 the Army-Baylor Program had awarded 991 master's degrees since its affiliation with Baylor in 1951, and by 1989 it was second of all U.S. graduate programs in the total number of degrees awarded each year.33 In 1976 the course changed from a semester to a trimester schedule of 42 graduate credit hours; class size was reduced to thirty-four students (including twenty-one Army MSCs); and most undergraduate-level work was removed. Later the course lengthened to a full twelve months with four semesters totaling sixty graduate hours. Class size averaged in the mid-thirties. For example, the class that entered in 1987 had thirty-two students, including eighteen Army MSCs. Baylor officials viewed the course as difficult, and students said all they did was "eat, sleep and study."34
The program maintained a one-year residency requirement in spite of a move away from residencies by many civilian programs, a trend that was challenged in the early 1990s as the profession found that students and faculty had lost touch with practical experience.35 Residencies were performed at Army hospitals. However, the class that entered in 1976 participated in three experimental residencies outside the Medical Department with the Department of Health, Education, and Welfare; the Veterans Administration; and the Office of the Secretary of Defense (OSD). The initiative was not supported by the surgeon general, and there were no others until 1990 when an OSD residency resumed.
A survey in 1981 by the Accrediting Commission on Graduate Education for Health Services Administration accelerated some changes. The report cited the program's strength in student motivation, but it faulted the faculty for conducting little research and publishing less, for its high turnover, and for credential weaknesses.36 Furthermore, the commission believed that admissions were more an Army administrative process than a genuine review of academic capability. General Jordan took corrective actions, stabilizing faculty tours, increasing opportunity for doctoral training for potential faculty members, encouraging research, and requiring completion of the advanced course as a prerequisite for attendance. Baylor tightened its admission requirements and made it clear that it would not waive a minimum Graduate Record Examination score of 1,000 and a 2.7 grade point average (or 3.0 for the last sixty undergraduate hours). The actions were effective, and the program tied with Duke University as thirteenth of the sixty U.S. graduate programs in a survey of program directors conducted in 1990. In 1993 the program received accreditation by the commission through the year 2001.37
The Medical Service Corps strongly emphasized the importance of military training throughout the post-Vietnam era, and MSCs were prominent figures in the Academy of Health Sciences (later reorganized into the Medical Department Center and School) at Fort Sam Houston, Texas, both as students and members of the staff and faculty. By 1979 the school was training 25,000 resident students a year.38 In 1982 its MSC Officer Basic Course increased from eight weeks to a
variable twelve- to sixteen-week length, depending upon individual background and specialty. There continued to be changes to the course, and by 1993 it had been reduced in length to nine weeks conducted in two phases. The first portion, attended by officers of all AMEDD corps, consisted of a core of instruction required by the U.S. Army Training and Doctrine Command in soldier skills and knowledge, leadership, and organization of the Army. The second phase was designed with courses pertinent to each corps.39
The Officer Advanced Course (OAC), also conducted at Fort Sam Houston, was twenty-two weeks long in 1982. It decreased to twenty weeks and remained a requirement for all MSCs, who attended between their third and fifth year of service. MSC aviators continued to attend the Aviation Branch advanced course at Fort Rucker, Alabama, but the follow-on portion at Fort Sam Houston was terminated. In 1992 the surgeon general directed the Center and School to establish a single OAC for all of the Medical Department's corps and to significantly shorten the course. A series of reviews ensued, a shortened course opened for the Medical Corps, and a single ten-week OAC for all corps was scheduled to begin in January 1997. Another OAC option for MSCs was the Combined Arms Logistics Advanced Course (CLOAC) conducted at Fort Lee, Virginia. The formation of multifunctional forward support battalions (FSBs) had led in 1992 to the development of a multifunctional logistics specialty, also known as functional area 90 (FA 90), and CLOAC was designed to support that concept. General Miketinac believed that MSCs would not be eligible for FSB command without attending CLOAC, and six MSCs were in the first class in 1992. Capt. Mary R. Martin was an honor graduate; Capt. Noel J. Cardenas was on the Commandant's List; and Capt. Raymond S. Dingle won the Ironman Award for physical fitness. The goal was to send between eighteen and twenty-four MSCs a year.40
In 1981 MSCs also began attending a new Army course, the Combined Arms and Services Staff School (CAS3 or popularly "CAS Cubed"). Structured to prepare captains for duty as staff officers, the course was conducted in two phases: a correspondence portion and a nine-week resident phase at Fort Leavenworth, Kansas. By 1986 CAS3 was mandatory for MSCs, and officers were scheduled for attendance at the second phase prior to their entering into the promotion zone for major. Some MSCs also attended the Combat Casualty Care Course (C-4), initially a one-week and later a two-week course conducted at Fort Sam Houston beginning in 1980 that taught medical officers field medicine. Another opportunity opened in 1983 when Col. Robert J. T Joy, MC, USA, Ret., chairman of medical history at the Uniformed Services University of the Health Sciences, collaborated with Col. Thomas C. Munley, MSC, chief of the Military Sciences Division of the Academy of Health Sciences, in establishing at the university a ten-month fellowship in military medical history to prepare officers to serve as instructors in the subject at the Academy of Health Sciences. Capt. William H. Thresher, MSC, was the first officer selected. A few MSCs attended the Program Manager Course, a joint course taught at the Defense Systems Management College, Fort Belvoir, Virginia, that prepared officer and civilian executives of the three Services for DOD materiel development and acquisition positions. Capt. Lawrence K. Lightner, the first MSC to attend, completed the course in 1986.41
Selection for attendance at the resident course of the Command and General Staff College at Fort Leavenworth or (until 1990) the Armed Forces Staff College at Norfolk, Virginia, remained extremely competitive, averaging between fifteen and twenty MSCs a year (nineteen in 1994). General Miketinac noted that while the number of resident seats was small (35 for the Medical Department in 1994), it could be argued that this was offset by the much greater opportunity for MSCs to attend graduate school. The Army placed great emphasis on completion of staff college, as did the Medical Service Corps, and it became essential for promotion to lieutenant colonel. Most Army officers completed it through nonresident programs; in 1980, 366 MSCs were enrolled in this way.42
The Goldwater-Nichols DOD Reorganization Act of 1986 (named for Senator Barry Goldwater and Congressman Bill Nichols) further tightened the unification provisions of the National Security Act of 1949 by forcing the three Services into "jointness," i.e., joint operations. The Norfolk command and staff course ended in 1990 as the Armed Forces Staff College assumed the mission of training officers of all the Services for joint assignments. Its centerpiece was a twelve-week intermediate Joint and Combined Staff Officer School that officers attended following completion of their Service staff college to prepare them for joint staff assignments. No MSCs attended the first classes.43
There continued to be fierce competition for the very small number of slots each year for the resident and nonresident courses of the Army War College at Carlisle Barracks, Pennsylvania, and of the Industrial College of the Armed Forces (ICAF) at Fort McNair, Washington, D.C. The nonresident course continued as a two-year program universally considered more difficult than the resident program, and in 1985 the Army combined the resident and nonresident selection boards into one board to establish a single order-of-merit list. In 1987, a representative year, eleven MSCs were among twenty-seven Medical Department officers selected for senior service college; six were enrolled in the resident and five in the nonresident courses.
New options for resident senior service college opened with the establishment of Army fellowships that awarded senior service college credit under the auspices of the Army War College. Lt. Col. Douglas A. Braendel, MSC, was the first Medical Department officer to enroll in this program when he was selected for an Army intragovernmental fellowship at the Department of Health and Human Services in 1988. Similarly, Col. Steven J. Stone, MSC, in 1994 was the first officer selected for an environmental policy fellowship at the Army Environmental Policy Institute at the Georgia Institute of Technology in Atlanta, Georgia. This fellowship was developed by Col. Robert J. Fitz, MSC, the chief of the Sanitary Engineering Section. Lt. Col. Scott S. Beaty, MSC, in 1994 was the first officer to enroll in a health policy fellowship at George Washington University in Washington, D.C., an opportunity created by Col. Timothy Jackman, MSC. In 1994 MSCs accounted for twelve of the twenty-nine Medical Department senior service college students with five resident and four nonresident Army War College seats, one ICAF seat, and two fellowship seats. Yet in spite of these changes the overall opportunity for Medical Department officers to attend resident senior service college continued to trail all other branches of the Army.44
MSCs competed for other advanced training programs. A special opportunity opened in 1986 when Lt. Col. William H. Bell, Jr., began a year's tour as a fellow at the Arroyo Center of the Rand Corporation in Santa Monica, California. One MSC enrolled each year through 1994 in this program, established to develop a stable of officers trained in health policy analysis. Some MSCs attended the Interagency Institute for Federal Health Care Executives, the well-established forum conducted in two two-week sessions each year. In 1985 the institute moved from St. Louis, Missouri, and sponsorship by the Washington University, to Washington, D.C., where it was conducted by the George Washington University. Ten MSCs each year were among a total of 110 health care executives selected annually by the Army, Navy, Air Force, Public Health Service, and Department of Veterans Affairs to attend the institute because of their potential for senior management positions. Lt. Col. Frederick R. McLain, MSC, and William H. Bell, Jr., now a colonel, served as president of the institute's alumni association from 1987 to 1988 and from 1990 to 1991, respectively. A new opportunity opened in 1995 for Medical Department officers to obtain skills in industrial procedures and practices by participating in the Army's Training with Industry Program. Officers selected for this program would spend a year with health care firms in the private sector as preparation for specific departmental positions. Eight MSCs were enrolled by the end of 1995.45
The issue of hospital command remained controversial. A 1978 War College paper by a Medical Corps officer argued that "the pendulum is swinging back,
rapidly, in civilian medicine to place the physician in firm, formal control of civilian hospitals," implying that the Services should follow that supposed trend.46 In 1980 the Strategic Air Command surgeon wrote a notorious letter objecting to the assignment of MSCs as hospital commanders by drawing an analogy to the rule that an aircraft commander must always be a pilot. "In the pecking order of the Military Health Care System, the physician is the biggest pecker. Let's keep it that way."47
Others disagreed. In 1987 Lt. Gen. Kenneth B. Cooper, the deputy commander in chief of the U.S. Army in Europe and Seventh Army, told the annual MSC meeting in Germany that he believed MSC health care administrators should be used as hospital commanders. Cooper repeated that recommendation in a letter to Robert N. Smith, M.D., the assistant secretary of defense for health affairs. He said he had discussed the matter with Maj. Gen. Marshall E. McCabe, MC, commander of the 7th Medical Command, and had concluded that progress would come only from pressure external to the Army and in Washington. Dr. Smith acknowledged that there was evolutionary development in hospital management, but he did not believe the time was right for his intervention.48
However, the issue continued to resurface. The shortage of physicians forced a succession of assistant secretaries of defense-John H. Moxley, John F. Beary, and William E. Mayer-to pressure the Army to reduce the number of physicians in administrative positions. Moxley noted that Navy and Air Force MSCs were commanding seven hospitals and twenty-five clinics in 1980. Beary criticized the Army for failing to implement the 1973 memorandum from Deputy Secretary of Defense William P. Clements that had directed the opening of command positions. Mayer reaffirmed the Clements mandate and argued that physicians should not receive the incentive pay bonus if they were not practicing their primary specialty.49
The Medical Department wavered in 1978 when a Department of the Army Inspector General report concluded that changing medical unit commanders upon the outbreak of hostilities constituted a threat to unit combat effectiveness. The surgeon general, required to take corrective action, responded that the best qualified officer would command medical units in peace and war "without regard to specific AMEDD corps."50 In fact, no action was taken to change the policy. Later, as the Army surgeon general was testifying to Congress that physicians must command hospitals, the Navy surgeon general was testifying to the contrary, and the Marine Corps, which had Navy MSCs commanding its medical battalions, made it plain that it rejected the Army's position.51
Although the opportunity to command operational medical treatment facilities was denied MSCs, a wide variety of other opportunities was opened. The Army established command selection boards to select lieutenant colonel and colonel commanders. As a rule, administrative specialty officers in the field medical service "track"-as exemplified by completion of the resident Command and General Staff College course-were selected to command garrisoned medical battalions. Officers in the health care administration track-characterized by completion of the Army-Baylor Program-were selected for command of garrisoned field hospitals. In addition, General Mittemeyer opened the command of medical groups and nondivisional medical battalions in both peace and war to MSCs.
Beginning in 1981 scientific specialty officers were also eligible to command field medical units, and additional billets, including scientific specialty units, were added to the initial Command Designated Position List, which had been restricted to field medical unit commands. For example, a 1982 change added the U.S. Army Medical Materiel Agency; the U.S. Army Environmental Hygiene Agency, Pacific; the U.S. Army Garrison, Fort Detrick; and the troop commands of two stateside medical centers.52
The loss of medical battalions in the heavy (armored and mechanized) divisions removed the opportunity for command of those units in garrison, but that was replaced with an opportunity for command (in both peace and war) of the forward support battalions, the maneuver brigade support units that absorbed the medical battalions, as well as the main support battalion (MSB) that provided divisionwide and area support. Presumably MSCs would command a third of the forward support battalions, since a medical company was one of the three support companies in each. In April 1982 Lt. Col. Jerry L. Fields, MSC, assumed command of the 3d FSB in the 9th Infantry Division at Fort Lewis, Washington, the first FSB organized in the Army. The opportunity for command of FSBs and MSBs also opened the way for MSCs to compete for Division Support Commands (DISCOMs), the next level of command. Col. Edward G. Bradshaw became the first MSC to achieve this distinction when he
assumed command of the 1st Armored Division DISCOM, Frankfurt, Germany, in 1988.53
Unfortunately, the Medical Service Corps fared poorly in the ensuing selections for FSB and MSB commanders, averaging just three officers each year from 1983 to 1989. It was argued that the principal reason for the poor selection rate was a failure to ensure that MSCs received experience as operations officers and executive officers of the battalions, the types of assignments that, in addition to company command, were necessary to be competitive for battalion command. General Miketinac set a goal of having at least five MSCs in each FSB and MSB, both for the leadership development of the officers to ensure that they could ultimately compete for battalion command and for their utility in advising the commanders on the employment of medical assets. Branch took measures to implement that guidance, and the average number of MSCs selected for FSB command increased to five per year from 1989 to 1992, although it dropped to zero in 1993. Most MSCs who actually assumed command of these units were selected from alternate lists, as the Army named a total of only two MSCs among ninety officers as primary selections for FSB command from 1989 to 1993. Only one MSC was among twenty-four officers on primary lists for command of MSBs during the same period.54
In 1994 MSCs had the opportunity within the Medical Department for 200 company commands as well as 24 lieutenant colonel commands and 13 colonel commands that were listed in the official Army Command Designated Position List (see Table 4). The overall story was mixed. The opportunity for command of operational treatment units remained blocked as the Medical Department continued to ignore the 1973 Clements memorandum. Opportunities that had previously existed for command of divisional medical battalions had diminished with the FSB and MSB experience. Further, there was a portent of things to come. In 1983, in a throwback to the period before World War II, General Mittemeyer began placing physicians back in command of some medical companies and battalions. The idea, soon abandoned, was to have physicians commanding sixteen medical companies and four medical battalions. The policy reappeared in 1991, when some TOE hospitals and the 44th Medical Brigade at Fort Bragg, North Carolina, were designated for Medical Corps commanders.55
Developments in the Administrative Specialties
In 1982 the Pharmacy, Supply, and Administration Section accounted for 3,563 officers (71.3 percent of the corps) in pharmacy and eleven administrative specialties (see Appendix L). Administrative specialties numbered 3,348 officers (67 percent of the corps). The largest specialty, with 1,677 officers, was field medical assistant, the entry-level designation for newly commissioned officers who
had not further specialized.
The special requirements placed on patient administration officers were demonstrated in 1985 when a battalion of the 101st Airborne Division (Air Assault) returning from peacekeeping duty in the Sinai crashed in Gander, Canada. With 256 victims, it was the greatest disaster in military aviation history.
Source: MSC Newsletter, March 1994, DASG-MS.
Identifying the victims became enormously complicated because the soldiers had their medical and dental records on the plane, and in many cases records recovered from the crash had been severely damaged by fire, water, and fuel. Lt. Col. Michael A. Shannon, MSC, led a team at the Pentagon's Army Operations Center that worked around the clock to coordinate efforts to reconstruct the records and provide the information to pathologists at the mortuary at Dover Air Force Base in Delaware. In some cases Shannon's team used dental records from hometown civilian dentists who had treated the soldiers and learned of the identification problems from news broadcasts.56
The capability of MSCs in a new specialty, biomedical information systems, was put to good use in the identification effort. On 18 December Lt. Col. Gary L. Swallow, MSC, and 1st Lt. Beverly J. Rice, MSC, reported to Dover with seven microcomputers. They automated preparation of the autopsy protocols and death certificates and led the processing effort that operated on eighteen-hour days through the rest of the month.
Officers in the personnel specialty (271 in 1982) provided the department's military personnel management support as a distinctive component of the Army's personnel system. Lt. Col. Thomas B. Pozniak, MSC, of the Surgeon General's Personnel Policy Division, organized the Army's Exceptional Family Member Program in 1982, a major undertaking that brought the Army into compliance with the statutory requirement for the Department of Defense Dependent Schools to provide services for handicapped children. Also in 1982, the Army established a system of personnel proponency, an initiative by General Edward C. Meyer, the chief of staff, to involve the functional proponents in the policy decisions affecting their specialties (for example, the commanding general of the Infantry School for infantry
soldiers). The Medical Department established an Enlisted Proponency Office in the Surgeon General's Office that was later expanded into the Personnel Proponency Directorate, organized at the Army Medical Department Center and School with Col. William J. Leary, Jr., as its head. It became the analytical arm of the Medical Department for all officer, enlisted, and civilian specialties.57
MSC personnel officers had to adjust their operating practices as the Army more fully integrated the management of Medical Department officers into its centralized personnel systems during the 1980s. In 1985, acting upon a study commissioned in 1982 by then Lt. Gen. Maxwell R. Thurman, the deputy chief of staff for personnel, the Army abolished the U.S. Army Medical Department Personnel Support Agency and transferred its personnel management functions to a newly formed Health Services Division (headed by an MSC) of the Officer Personnel Management Directorate (OPMD), a component of the U.S. Army Military Personnel Center, later renamed the U.S. Total Army Personnel Command (PERSCOM). While the surgeon general remained the proponent for military medical specialties, officer personnel management was centralized in PERSCOM, much as enlisted management had been earlier, and all Medical Department officers became "OPMD-managed." In 1988 the Health Services Division relocated from offices in Buzzard Point, Washington, D.C., to join the rest of OPMD in the Hoffman Center, Alexandria, Virginia.58
In 1982 there were 101 MSC comptrollers to handle the planning, programming, budgeting, and execution of the Army's medical programs as unit and DA and DOD staff officers. Graduate training was available through the Army
Comptrollership Program, a fourteen-month Syracuse University master of business administration program. Two MSCs were recognized during this period for being the top students in their classes: Capt. Fred Goeringer in 1979 and Capt. Kenneth L. Quaglio in 1991. A shortage of MSC comptrollers led the corps to establish a one-year master's degree program in public administration at Harvard University and to increase attendance at Syracuse from three to four MSCs in each class.59
There were 117 operations officers in 1982 (the Health Services Plans, Operations, Intelligence, and Training specialty). Opportunity for a master's in strategic intelligence at the Defense Intelligence School, Washington, D.C., began in 1980. A special event occurred in 1989 when the annual operations meeting at the Fitzsimons Army Medical Center, Denver, Colorado, was named in honor of Col. John R. Sperandio, USA, Ret., "a great soldier and dedicated Medical Service Corps officer" who had died the year before.60
New position opportunities opened on the staffs of the major medical commands, the Office of the Surgeon General, the Organization of the Joint Chiefs of Staff, and the Office of the Secretary of Defense. Some officers were assigned to the U.S. Army Center of Military History during the early part of this period, and 1st Lt. Gaines M. Foster, MSC, completed The Demands of Humanity: Army Medical Disaster Relief, published by the center. Some operations officers found challenge in military assistance assignments on advisory teams in Saudi Arabia and Central Africa. In May 1983 President Ronald Reagan ordered the deployment of a medical training team to El Salvador. Robert F. Elliott, now a colonel, was deputy chief of the team that trained 400 enlisted medics in six months and designed a medical infrastructure for the military forces. In 1987 the U.S. Army Medical Intelligence and Information Agency, Fort Detrick, became the Armed Forces Medical Intelligence Center, a tri-service activity under the command of Lt. Col. Jimmy Walker, MSC. Operations officer functions included operations security (OPSEC). An Army-wide program to recognize significant contributions to OPSEC resulted in the selection of Capt. William B. Miller, MSC, of Headquarters, Health Services Command, as the winner of the Individual Achievement Award for 1992.61
The perception that the operations specialty was overshadowed by others was largely reversed during this period. The 1977 annual meeting in Denver produced a report that listed fifty proposals to improve the specialty, including establishment of an operations course, incorporation of the manpower specialty, emphasis on a diversity of assignments, and increased recognition for officers who served in command positions.62
In 1979 a study group made nineteen further recommendations. Although many were routine changes to existing policies, others sought to improve the organizational climate, such as a recommendation to handle command assignments on a more personal basis. Some were adopted in part or not at all. Examples were the recommendation for the transfer of the manpower specialty-partially adopted in 1983 with the transfer of that division within the Surgeon General's Office to the director of health care operations-and the proposal for an operations course, which was dropped.63
In 1991 Col. Timothy Jackman, MSC, the specialty's consultant, published a handbook for operations officers that was a comprehensive guide to all aspects of a career in this specialty. In an article the following year he described operations officers as "keepers of the readiness flame" for the Medical Department. Training opportunities had expanded and now included a "track" in the Army-Baylor Program for operations officers. General Miketinac had agreed that they would retain their 67H operations identifier after completing the course rather than being reclassified as 67A, the specialty code for health care administration. He argued that 67 "Hotels" needed operational hospital experience, especially to prepare them for duties in medical center and regional strategic planning. The Baylor course was a step in that direction.64
MSC medical logisticians (343 in 1982) occupied key medical logistics positions, including chief of the Surgeon General's Logistics Division and commanders of medical depots; the U.S. Army Medical Materiel Agency (USAMMA), Fort Detnick; and the U.S. Army Medical Equipment and Optical School (USAMEOS), Denver, Colorado. In addition, some were assigned to various DOD logistics agencies and to the Army Combined Arms Support Center, Fort Lee.
They rested their case for medical control of medical supply on two principal points: the need for experts knowledgeable in its intricacies, and the need for a higher standard of performance than that required by the general supply system.65 While the arguments were clear to experienced medics, they were not so evident to logisticians outside the department, who continued to challenge the department's position. MSCs assumed a continuing responsibility in communicating those arguments to the general logistics community through such devices as articles in Army Logistician, an Army publication. The explanations began at the ground level, as
seen in an article published in 1995 by 1st Lt. Christine M. Nelson-Chung, MSC, the division medical supply officer for the 25th Infantry Division, Hawaii. Chung's article, "Medical Supply 101," was a primer for unit commanders.66
Medical depots of the theater of operations were organized into medical supply, optical, and maintenance (MEDSOM) units (later redesignated as medical logistics battalions), also under the command of MSC officers. MSCs commanded the depot in Pirmasens, Germany, a consolidation of three MEDSOMs into the U.S. Army Medical Materiel Center, Europe (USAMMCE), which the Secretary of Defense designated as the single manager for medical materiel in Europe. It provided medical logistics and optical fabrication support to Army, Navy, Air Force, and State Department activities in Europe, Africa, and the Middle East. Its staff of 641 processed 27,000 orders a month, maintaining an inventory of 16,000 different items in 800,000 square feet of warehouses on a 93-acre installation. USAMMCE shrink-wrapped stacked medical supplies in clear plastic, a technique introduced to the depot by Col. E. Kistler, MSC, to facilitate loading, shipping, and identification.67
Medical logistics officers completed the entry-level Medical Logistics Management Course at the Academy of Health Sciences. Advanced training was offered through two USAMMA courses: a six-month Medical Materiel Management Course and the Procurement Officer Program, a one-year course. In October 1982 Capts. Lawrence M. Foltz, MSC, and Warren F. Heinemann, MSC, were the first graduates of the Biomedical Equipment Maintenance Orientation Course, a four-month program at the U.S. Army Medical Equipment and Optical School (USAMEOS), Aurora, Colorado, that trained them in medical equipment installation, calibration, and repair. Some officers completed the Logistics Executive Development Course, a ten-month program leading to a master's degree in logistics management from the Florida Institute of Technology in Melbourne, Florida.68
The department appointed about ten warrant officers each year as health services maintenance technicians (there were a total of ninety-three in 1982). Candidates selected from enlisted applicants attended a fifteen-week course at USAMEOS, served in field positions, and returned for advanced training. MSC warrant officers also replaced Corps of Engineers warrant officers in field hospitals equipped with the new DEPMEDS sets.69
Health facilities planning became part of the logistics field during this period. Officers in this specialty (twenty-two in 1982) had opportunities for a master's degree and Ph.D. in architecture. Their principal assignments were as project officers at various construction sites. In 1975 the Army approved the formation of the U.S. Army Health Facilities Planning Agency (HFPA), an activity collocated with the Surgeon General's Office under the direction of Col. Charles E. Christ, MSC, its first commander. The agency (with a staff of thirty-two by 1995) provided a single point of control and continuity for all Army health facilities projects and oversaw an ambitious construction program of nearly $2 billion from 1975 to 1994. However, the trend of ever-increasing funding for construction projects was reversed in 1994 when the Office of the Secretary of Defense cut the Army, Navy, and Air Force program for fiscal years 1996 to 2001 by a billion dollars.70
MSC health care administrators belonged to an established profession. In the Army, the rules for awarding the specialty favored graduates of the Army-Baylor Program, but the corps did not close the door to other sources. Outside the military, the emergence of large hospital corporations and a host of smaller firms helped to turn health care administrators into hospital chief executive officers and the number of American hospitals with physicians as CEOs dropped to 202 by 1983. There was a return of women to the profession, and in 1981, 51 percent of the students in graduate programs were female.
The American College of Hospital Administrators numbered over nineteen thousand affiliates in 1985 when it changed its name to the American College of Healthcare Executives (ACHE), but only 200 of 1,200 military affiliates were Army officers, a reflection of the lack of emphasis by the MSC. Fourteen of the sixty-five military fellows (the highest rank in the ACHE) were Army MSCs, an improvement from eight in 1982, but still a small number. At the initiative of General Johnson, the corps sponsored the first "Army Day" at the 1986 meeting, and this added emphasis by the corps leadership resulted in increasing enrollment. Col. Douglas A. Barton, MSC, selected as the Army regent in 1992, spearheaded an effort to get the number over 500 so as to get a second regent for the Army. By August 1994 there were 517 Army affiliates, and his goal was assured. The number of Army fellows had increased to thirty-three, another indication of the improved record.71
General Johnson, with the support of Col. Gerald D. Allgood, MSC, the Health Services Command chief of staff, engineered a change in 1985 of the position title for the senior MSC in Army hospitals from executive officer to deputy commander for administration (DCA). This occurred as the title of the senior physician changed from chief of professional services to deputy commander for clinical services (DCCS). Johnson's intention was to equalize the authority between those two positions and to prevent a situation in which the executive officer would report to the DCCS rather than directly to the commander, although the department continued to prohibit the DCA from assuming command in the absence of the commander or the DCCS. The Health Services Command chief of staff position was given the additional duty of DCA for the same reason. Allgood believed that step could also help to restore the star his position had when the command was formed, thereby opening a new MSC opportunity. General Johnson planned to establish boards for selecting DCAs beginning in fiscal year 1986, but that plan was dropped and selections for those positions remained the province of the corps chief and the MSC Branch chief (the title reverted from Career Activities Office in 1985).72
Some MSCs gained regional and national recognition in health care administration. Col. Robert I. Jetland, MSC, retired from active duty in 1969, becoming the administrator of Harborview Medical Center in Seattle, Washington. He was named emeritus by that institution in 1985 and was honored as an outstanding retired alumnus by the Army-Baylor Alumni Club in 1990. Other MSCs were recognized with AMSUS awards. The Ray E. Brown Award, named for the pioneer in health care administration, was presented to General Haggerty in 1978 and to Col. James B. Stubblefield, Jr., in 1985. In 1981 Maj.
Richard V.N. Ginn was the first winner of the Young Federal Health Care Administrator Award. In 1987 Maj. Paul B. Mouritsen became the second Army officer to receive that award, and Maj. David A. Patillo was the third in 1991. Col. Philip L. Dorsey received the American Hospital Association's Federal Health Care Executive Award of Excellence in 1991, and Lt. Col. George V. Massi received the association's Federal Health Care Executive Special Achievement Award in 1993.73
MSC aviators (332 in 1982) played important roles in development of the Army's Utility Tactical Transport Aircraft System (UTTAS), a general-purpose helicopter that replaced the workhorse Bell UH-1 Huey models. Lt. Col. John W. Hammett, MSC, who worked with UTTAS from 1966 to 1970, found his biggest challenge was getting the Army to accept a requirement for a helicopter large enough to accommodate litters across the fuselage rather than longitudinally, as in the Huey. The resulting UH-60 Black Hawk, built by Sikorsky Corporation, was larger, more powerful, and faster than the Huey and met the desired medical requirements. It utilized a four-litter patient "carousel" that was inserted into the cabin. While a sophisticated device, it took up a lot of room and limited the patient capacity. Prototypes of an improved Black Hawk, the UH-60Q, as exhibited in 1993, abandoned the carousel for a specialized patient suite. The Q model incorporated twenty-three features that combined to make it a "Cadillac" of air ambulances. However, its cost was prohibitive, making it unlikely that the Army could procure it in its full array.74
In February 1979 1st Lt. Karen D. Anderson became the first female MSC aviator. There were thirty spaces for MSCs in flight school in 1980, a typical year, and 332 aeromedical evacuation officers in 1982. The Dustoff tradition continued, its camaraderie facilitated by the formation of the Dustoff Association, which held its first convention in 1980. In 1992 the association published a compilation assembled by Capt. Randall G. Anderson, MSC, of the unit histories of all sixty-nine active and reserve component air ambulance units.75
Nevertheless, the threat to the integrated Medical Department evacuation capability continued. In 1983 the Army formed the Aviation Branch, resurrecting the old Army Air Corps branch insignia. Immediately there were intense pressures to place MSC aviators in the new branch, and only concerted effort by the surgeon general's staff in actions coordinated by Lt. Col. Thomas C. Scofield, MSC, forestalled a takeover. Once again, a surgeon general laid it on the line: Mittemeyer protested that the Army's proposal would "result in death and suffering to our soldiers by changing a critical portion of total patient care which has already been tested and proven in combat." General Schwarzkopf, the acting deputy chief of staff for personnel, and General John A. Wickham, Jr., the vice chief of staff, weighed in with support, and Mittemeyer's argument was sustained. But Col. Douglas E. Moore, MSC, the surgeon general's executive officer, cautioned that the MSC could lose the next time. Paper bullets of the Pentagon could hurt worse than real ones.76
In 1985 the 52d Medical Battalion was activated in Korea under the command of Lt. Col. Jack R. Roden, Jr., MSC. It was the first evacuation battalion since Vietnam. Pilots of its 377th Air Ambulance Company were required to be
fully familiar with the entire 153-mile width of the demilitarized zone, and all operations stressed night flying. MSC aviators continued performing Military Assistance to Safety and Traffic (MAST) operations. By 1984 the thirty-one participating units (twenty-four of which were Army) had evacuated nearly 33,000 emergency civilian patients. MAST units had flown 30,500 missions, often at night, in marginal weather, and/or from unimproved landing sites.77
Dustoff crews were subject to immediate deployment. In 1985 two eruptions of a Colombian volcano unleashed avalanches of mud and water that crested at a depth of fifty feet, engulfing fourteen towns and villages. The disaster killed 23,000 people and left 22,000 homeless. The 214th Medical Detachment, stationed in Panama under the command of Maj. Robert E. Whiting, MSC, deployed two Black Hawks for the ensuing relief operations. The crews found that volcanic ash and rains had inundated areas with a sea of mud so deep that a nine-foot pole would not touch bottom. They subsequently conducted hoist missions to rescue survivors and used water trucks to hose off the victims, who were caked with crystallized mud.78 Elsewhere the 421st Medical Company, now stationed in Germany, was reorganized in 1987 into the 421st Evacuation Battalion. It participated in Operation DISPLAY DETERMINATION, an exercise in which three Black Hawks deployed to Turkey for training planned and executed by the 2d Platoon commander, Capt. Analou R. Eisner, MSC.79
Military training was affected by the formation of the Aviation Branch. The Army stipulated that MSC aviators attend the Aviation Branch advanced course at the U.S. Army Aviation Center, Fort Rucker, Alabama. That was followed by a special six-week MSC advanced course at the Academy of Health Sciences where the officers were "re-marooned" (the Army's heraldic color for medical branches is maroon). However, such matters are never completely settled, and in 1986 the center proposed that the Aviation Branch absorb the aeromedical mission into general aviation with "beans and bullets forward, bodies and blood to the rear." The measure was again rejected, but it promised to be a continuing concern. While this move died down, the practice of sending the aviators to the follow-on course at Fort Sam Houston after Fort Rucker ceased.80
Developments in the Scientific Specialties
A Defense Audit Service survey in 1982 of commissioned pharmacists, optometrists, clinical psychologists, and physician assistants in the military revealed a commonly held perception that opportunities for promotion in these areas were less than in the administrative MSC fields. But several analyses of the matter by the Surgeon General's Office failed to substantiate that perception. For example, the promotion opportunity from 1986 to 1991 for major, lieutenant colonel, and colonel was similar among the two groups; sometimes the scientific specialty officers fared even better. There were several reasons for this relative equity. The success of each specialty was closely monitored by the various consultants whose feedback to the personnel system was continuous and direct. The presence of scientific specialty officers on promotion boards also ensured promotion parity. The letter of instructions provided to each board was another. It typically mentioned the special requirements of officers in the scientific fields, and beginning in 1991 it also included "floors" (or mandatory minimum promotion quotas) for individual specialties as another guarantee of promotion equity.81
The issue of compensation for certain scientific specialties took a new turn in 1994. While the 1982 survey did not expose a morale problem associated with pay, the perception persisted over the years that military pay was a source of dissatisfaction for officers in certain specialties involved in direct patient care, especially psychology, which continued to have difficulty in retaining officers. In a move that surprised the Army, in 1994 the assistant secretary of defense for health affairs directed the military services to implement a special pay program ranging from $2,000 to $5,000 annually for a number of nonphysician health care providers. What had started out as a special pay program to reward psychologists who had achieved diplomate status was expanded to other categories of Medical Department officers who achieved board-certified status. In the case of the MSC this applied to audiologists, optometrists, pharmacists, podiatrists, and social workers.82
Pharmacy officers added capabilities in clinical treatment programs, the preparation of customized sterile intravenous fluid therapies, and inpatient unit dose systems of prepackaged medications for each patient issued daily to hospital wards (to reduce the potential for medication errors). The 215 pharmacy officers in 1982 was a slight increase from an average of 200 officers in the late 1960s. Most pharmacists were commissioned from ROTC, and in 1988 the newly formed U.S. Army Cadet Command was holding ten to fifteen spaces a year as delayed entry spaces for those ROTC students desiring to complete pharmacy training prior to entry on active duty. Pharmacy officers also had opportunities for graduate training leading to a master's of science, doctor of pharmacy, or Ph.D. in pharmacology.83
A nuclear pharmacy program at Letterman Army Medical Center, San Francisco, California, trained five Army officers who were among the first sixtythree nuclear pharmacists certified by national examinations of the Board of Pharmaceutical Specialties in 1983. That same year Capt. Michael S. Edwards, MSC, became the first resident in an oncology pharmacy practice program begun at Walter Reed Army Medical Center under Lt. Col. John J. Pelosi, MSC, one of
two programs in the United States accredited by the American Society of Hospital Pharmacists. By 1988 there were oncology pharmacy training programs at the Army medical centers in the United States; the residents administered chemotherapy and participated in all phases of clinical drug trials.
In 1974 Capt. Terry V. Guilbert, MSC, established the U.S. Army Allergen Extract Laboratory at Walter Reed Army Medical Center, which by 1988 provided diagnostic and immunotherapy stocks to a number of federal hospitals and maintained 20,000 patient profiles. Some pharmacy officers received national recognition. The AMSUS Andrew Craigie Award, recognizing advancement of pharmacy in the federal government, was presented to Col. George A. Sommers, MSC, in 1980; Col. A. Gordon Moore, MSC, in 1981; Col. Douglas J. Silvernale, MSC, in 1984; and Col. David L. Schroder, MSC, in 1991. In 1987 Lt. Col. Gerald L. Wannarka, MSC, shared the Secretary of the Army's Award for Outstanding Achievement in Materiel Acquisition for managing the Army's development of a cyanide antidote for chemical weapon defense. It combined a longer shelf life with a smaller size that made it easier for soldiers to use, while saving about $10 million a year.84
In 1982 the 840 officers of the Medical Allied Sciences Section represented 16.8 percent of the corps (see Appendix L). There were 253 social work officers, 163 psychologists, 70 audiologists, and 52 podiatrists. Laboratory sciences was the largest group, numbering 302 officers, with 56 microbiologists, 81 biochemists, 18 parasitologists, 30 immunologists, 92 clinical laboratory officers, and 25 physiologists. A byproduct of the MSC Management Study was a better understanding that requirements for those specialties were derived from military necessity. General Miketinac stressed that there was no need for scientific officers to believe they had to have administrative assignments along the way in order to be competitive for promotion; their duty was to perform in their designated specialty.85
Educational opportunities continued to be an attraction for military service. Offerings included doctoral programs in audiology, biochemistry, immunology, microbiology, psychology, and toxicology. Other programs included a master's in toxicology, a two-year advanced social work program in family studies, a one-year postgraduate residency program in podiatry, and a one-year medical technology program for clinical laboratory officers.
Some scientific specialty officers received national recognition. Lt. Col. Robert T Usry, MSC, as president and in other leadership roles from 1979 to 1982, oversaw the growth of the Society of Armed Forces Medical Laboratory Scientists to over 750 members. In 1983 the director of the Army Aeromechanics Laboratory of the Ames Research Center at Moffet Field, California, presented the Director's Award for Technological Achievement to Capt. James W. Voorhees, MSC, an engineering research psychologist. Voorhees, the first military officer so recognized, was honored for developing visual and speech symbols for a prototype "friend or foe" radar warning indicator. In 1984 the National Aeronautics and Space Administration (NASA) selected a reserve officer, Capt. Millie Hughes-Fulford, MSC, an associate professor of biochemistry at the University of California, as the only female scientist selected for the Spacelab program from outside NASA. In June 1991 Hughes-Fulford, then a Veterans Affairs researcher in San Francisco, con
ducted blood studies as a payload specialist on the shuttle Columbia. Maj. Daryl J. Kelly, MSC, a microbiologist at the Walter Reed Army Institute of Research, received the Army Research and Development Award in 1987 for developing a portable test kit for field diagnosis of typhus. Award of the "A prefix" designator to scientific specialty officers that began in 1961 continued as a distinctive recognition for selected officers.86
In 1978 there were fifty-three audiologists on active duty (forty-three at the master's level and ten at the Ph.D.); by 1982 there were seventy. The establishment of the Exceptional Family Member Program, an effort which included provisions for children with hearing impairment, added to the requirements for audiologists. But hearing conservation remained the primary reason for having military audiologists. In 1984 the Veterans Administration paid over $161 million to veterans with service-connected hearing losses, and DOD civilian employees collected over $25 million in claims.87
The Army continued to mandate that audiologists devote one-half of their time to hearing conservation, but the emphasis proved difficult to maintain at posts with heavy clinical demands. Consequently, Maj. Roy K. Sedge, MSC, the consultant, disapproved a proposal that all hospitals conduct hearing aid evaluation and aural rehabilitation. Sedge insisted on reserving those functions for the medical centers so as to ensure that smaller facilities would be able to perform their hearing conservation mission. The Army Audiology and Speech Center at Walter Reed Army Medical Center was the center of activity, ranking sixth of two hundred such centers nationally in 1979. Its developments included the use of biofeedback with hypertensive voice-disordered soldiers, brain-stem evoked response audiometry, and an inpatient aural rehabilitation program. Elsewhere, new initiatives included a mobile van developed by Capt. Michael J. Mouel, MSC, at Fort Carson, Colorado, that was able to test six soldiers simultaneously. In 1993 Col. Rodney M. Atack, MSC, the specialty consultant, said that Army audiology was one of the "great success stories" of military medicine for its development of new technologies in hearing conservation, training of hearing conservationists, and audiology research.88
The number of podiatrists on active duty increased to fifty-two in 1982. Capt. Peter C. Smith, MSC, a podiatrist assigned to Bassett Army Community Hospital, Fort Wainwright, Alaska, was recognized in 1993 with the William Kershisnik Award of the Society of Armed Forces Podiatrists, as was Capt. Katherine A. Ward, MSC, of Walter Reed Army Medical Center, in 1994. The shortage of physicians prompted their expanded use, and nine podiatrists were assigned to assist orthopedic surgeons during the worst period. The Medical Department also identified procedures that podiatrists could perform in emergency situations: they could serve as skilled surgical assistants, debride major wounds and second degree burns, and reduce fractures of the ankle and tibia. A move in 1984 to place podiatrists in the Medical Corps, where they presumably would have greater opportunities, was opposed by the American Medical Association on the grounds that reassignment would make them eligible for command of hospitals, "dilute the integrity" of the Medical Corps, and make it more difficult to attract physicians to Army service. The proposal died.89
A boom in personal fitness added to the demand for podiatric services and made it harder for the Army to compete for podiatrists. In 1980, 75 percent of MSC podiatrists had less than four years of active duty, a reflection of the specialty's expansion and the difficulty in retaining these specialists. It was necessary to offer educational opportunities to overcome inexperience and stimulate retention. A residency program began at Brooke Army Medical Center in 1981, and by 1988, 65 percent of its graduates went on to postgraduate residency training programs. The department also established a program of postgraduate residencies at accredited civilian institutions. Maj. Douglas R. Beirne, MSC, attended the University of Texas in 1980 as the Army's first resident selected in this program.90
There were 163 MSC psychologists in 1982, including 87 clinical psychologists, 45 research psychologists, and 31 psychology associates. The Health Professsions Scholarship Program (HPSP) was the prime source for psychologists, accounting for 42 percent of accessions from 1979 to 1981. Plans to increase accessions by quadrupling the number of scholarships were dashed when DOD restricted HPSP in 1981 to entering medical students. HPSP was reinstituted for psychology in 1990 with three spaces each year. The Ph.D. was the standard for Army practice and was the preferred prerequisite for commissioning in that specialty, although some psychologists were commissioned at the master's level pending completion of their doctoral requirements. Those officers who had completed all their Ph.D. requirements except the dissertation received the title of psychology associate (formerly behavioral science associate).91
Military requirements spanned the field's diversity. Maj. Larry H. Ingraham, MSC, told the 1975 meeting of the American Psychological Association that the Medical Department had to maintain a mix of skills to be able to respond immediately to changing needs. He cited the drug control program as an example of a mission that had required an immediate response. Hospital privileges of Army clinical psychologists now routinely incorporated patient assessment and treatment functions; some performed 24-hour on-call duty for psychiatric emergencies. Others were engaged in the Army's alcohol and drug treatment programs, an effort estimated to return to duty about 15,000 soldiers each year, the equivalent of a division. Psychologists assigned to divisions provided mental hygiene consultation services at the grass roots level.
Capt. Lawrence E. Klusman, MSC, stationed in Germany with the 1st Armored Division, surveyed his fellow Seventh Army psychologists and found their greatest success rate with problem soldiers came from early intervention. Their expertise was especially valuable in advising Army leaders in a time when over 56 percent of soldiers were married. Maj. Frederick N. Garland, MSC, and Lt. Col. Franklin R. Brooks, MSC, described this capability in an article they published in 1992 in Military Review, the journal of the Army Command and General Staff College. Their article, aimed at a line officer audience, discussed the special problems of military families who were potential targets of terrorist attacks, particularly those stationed overseas.92
In 1980 the clinical psychology consultant, Col. Cecil B. Harris, MSC, reported that 70 percent of all MSC psychologists would leave active duty by their eighth year of service. An Academy of Health Sciences survey of 130 psychologists on active duty and 69 who had left the Army indicated that these officers were satisfied with the work environment, supervisors, and coworkers, but dissatisfied with pay and promotions.93 A DOD request that the Army grant psychologists departmental autonomy was rejected by the surgeon general.94 Dissatisfaction with pay and promotions was offset to a degree by educational opportunities. In 1981 Madigan Army Medical Center, Fort Lewis, Washington, began postdoctoral fellowships in child psychology and neuropsychology. The latter was started by Capt. Raymond A. Parker, MSC, as training that linked behavioral change to neurological problems and was especially useful in treating brain-injured patients.95
Some psychologists filled assignments outside the specialty. In 1981 Colonel Harris left his post as assistant professor of medicine at the Uniformed Services University of the Health Sciences to become the executive officer of the 5th General Hospital, Bad Cannstatt, Germany. In 1984 Lt. Col. Frank J. Sodetz, Jr., became the first MSC to command the South East Asia Treaty Organization (SEATO) Laboratory in Bangkok, Thailand, a U.S. Army Medical Research and Development Command (USAMRDC) activity.
Research was another attraction, and Sodetz' appointment as the first research psychology consultant in 1979 marked the establishment of that field as a separate specialty. Major Ingraham and Maj. Frederick J. Manning, MSC, reilluminated the old problem of combat exhaustion, a problem that they called combat stress reaction. Manning also caught the eye of Army leaders with research on sleep deprivation. His team from the U.S. Army Medical Research Unit-Europe, a USAMRDC activity, observed the members of an artillery battalion during exercises in Germany. They found that sleep deprivation was risky for those in positions requiring mental alertness. Their report cut across ingrained beliefs that chronic fatigue was a mark of dedicated leadership. To the contrary, their findings demonstrated that sleep for leaders was an important factor in a unit's effectiveness.96
In 1979 there were 269 social work officers, 169 of whom were assigned to the Health Services Command where chiefs of social work reported directly to the hospital deputy commanders for clinical services. A 1982 study found that Army social workers were generally satisfied with their military careers. Some were assigned to duties outside their primary specialty. For example, Col. Paul F.
Darnauer, MSC, was appointed the inspector general of the 7th Medical
Command in 1980, and at the time of his retirement in 1986 he was the USAMRDC chief of staff. However, hospital-based social work remained a principal area of concentration, and in 1982 the social work consultant, Col. David P. Jentsch, MSC, coauthored Social Work in Hospitals, a practical guide for students and beginning social workers.97
The postdraft All-Volunteer Army with its higher percentage of family members increased the Army's attention to family support, and some officers completed the two-year Advanced Social Work Program in Child and Family Studies at Walter Reed Army Medical Center. The new emphasis was reflected in the activities of social work officers in family therapy and marital counseling in which they addressed such problems as family violence, terminally ill patients, rape victims, handicapped children, single parents, and pregnant unmarried soldiers and their dependents. Accordingly, social workers were assigned to family advocacy and community service programs and alcohol and drug abuse clinics. As Col. Robert A. Mays, Jr., MSC, the social work consultant in 1993, noted: "Commanders frequently use social workers to handle situations which require tact, diplomacy, sensitivity, and soldier skills."98
There were 372 officers in the Sanitary Engineering Section in 1982 (7.5 percent of the corps), including 94 sanitary engineers, 143 environmental science officers, 54 nuclear medical science officers, and 81 entomologists (see Appendix L). Accessions depended upon ROTC and direct commissions, and assignments included the U.S. Army Environmental Hygiene Agency (AEHA) at Aberdeen Proving Ground, Maryland, an agency commanded by MSCs. Some officers were assigned to the Army Corps of Engineers for duty with the Army Pollution Abatement Program. The USAMRDC provided other opportunities, and Col. John F. Erskine, MSC, a sanitary engineer, became the command's chief of staff in 1986.99
Demand for environmental science officers (ESOs) accelerated as the department assigned them to field units and converted positions for preventive medicine and occupational health physicians at twenty installations to ESOs. Capt. John Y. Young, MSC, Fort Ord, California, prepared a handbook for soldiers taking part in 7th Infantry Division maneuvers in 1985 on the Caribbean island of St. Lucia. Young, commander of an environmental sanitation unit, the 172d Medical Detachment (LB), provided guidance on topics ranging from water to insects. He warned soldiers to "be prepared or prepare to be miserable," but also related that snakes were almost nonexistent due to a large mongoose population which "seems to be taking care of the chickens as well."100
Nuclear medical science officers enabled the department to meet the strict requirements of federal regulatory agencies for the use of radioisotopes, x-ray equipment, and other electronic devices; there were fifty-four officers in 1982. The majority came directly from civilian life, but their retention was adversely affected by perceptions of inequities in promotion opportunity and pay. In 1978 the Medical Department estimated that a pay gap of twenty-five to thirty thou
sand dollars per year existed between the military and civilian sectors of their field and, as in other specialties, attempted to improve retention through educational and position opportunities. In 1982, for example, Col. Bobby Adcock, MSC, became the first nonphysician director of the Armed Forces Radiobiological Research Institute in Bethesda, Maryland.101
The Optometry Section accounted for 219 officers in 1982, or 4.4 percent of the corps (see Appendix L). Retention was a problem for this specialty. A 1979 study showed that 36 percent of all optometrists left the Army by the end of their third year on active duty, and 84 percent were gone by the end of the tenth. A difference in earnings between military and civilian careers, estimated at more than $278,000 over a 28-year period, made Army careers a hard sell. That had not been helped in 1975 when special pay for optometrists was halted. It was reinstated in 1979 at the original $100 monthly rate even though the Army had argued for much more. The number of optometrists on active duty dropped to 179 in 1985, and the department let hospitals in the United States go short in order to keep positions filled overseas, resulting in appointment backlogs of up to six months. Although the situation improved as the number rose to 219 in 1982, the gains proved temporary. By 1988 the number dropped to 150, of which 110 were committed overseas, again necessitating shortchanging stateside hospitals as the cycle repeated itself.102
Recruiting was hampered by an incident at the Academy of Health Sciences in 1976 when a group of optometrists in the basic officers course, already sensitive to perceptions of second-class status, were denied administrative absences to take their state licensure board examinations after being told, "You're not doctors, you're Medical Service Corps officers." With a generous dash of salt in an old wound, tempers flared. The flap went public in the Journal of the American Optometric Association. One optometrist solicited his colleagues for support in separating from the MSC; he received twenty-nine letters of support. The AOA president and three other officials met with General Pixley and his staff in the Pentagon. Their meeting resolved the contretemps, and a subsequent editorial encouraged graduates to consider the Army as a career.103
Recruiting was hurt by the ending of the HPSP scholarships for optometry students in 1980. It had provided about twenty accessions per year for the Army, almost the sum total of new officers annually. The optometry profession again cried foul, and Congressman Bill Nichols of the House Armed Services Committee asked the Department of Defense to lift the restriction. That was to no avail, and by 1987 there was again a shortage of optometrists. HPSP was finally reinstituted for optometry in 1988 with twenty-five openings per year, and by 1993 the program was accepting over fifty students a year.104
Col. Arthur R. Giroux, MSC, was appointed chief of the Optometry Section in 1975. He served as an effective spokesman until his retirement in 1983, spearheading a variety of initiatives. Those included recruiting trips to schools of optometry, increasing HPSP scholarships (until the program ended), and an advertising campaign that proclaimed that Army optometry "Deserves a Closer
Look."105 Position opportunities included head of the Optical Directorate of the U.S. Army Medical Materiel Center, Europe, an activity that fabricated 15,000 pairs of spectacles a month.106
Giroux established nineteen clinical clerkships for optometry students at Army hospitals, a good recruiting tool. He also began an annual three-day Optometric Management Course and designed a master's program in clinical optometric management at the Pacific University College of Optometry, Portland, Oregon. Giroux maintained close ties with the AOA, whose Council on Clinical Optometric Care began accrediting Army optometry clinics; that also added to the attractiveness of Army programs. The council surveyed eight hospitals in 1979 and nine in 1980.107
Optometrists were also unhappy over their inability to enter the service as captains, and Colonel Giroux was the catalyst in resolving that problem in 1980 with the "50-75 rule," a marvel of Byzantine language in DOPMA. Under this rule, a graduate of a professional school was eligible for constructive credit for all the time spent in the school-four years in the case of optometry-if it could be established that 50 percent or more of the professional schools for that specialty required three or more years of undergraduate studies and if 75 percent or more of the students in the entering classes of those schools exceeded that requirement by one or more years. The result was that physicians, dentists, veterinarians, optometrists, podiatrists, and clinical psychologists all entered active duty as captains.108
The efforts to improve recruitment and retention worked. Twenty-four optometrists were recruited in 1981 and twenty-one in 1982, as compared to five per year from 1977 to 1979. Retention of officers beyond their initial obligation, a dismal 5 percent in fiscal years 1975 to 1976, improved to 41 percent in 1979 and reached 55 percent by 1981. The recruiting efforts attracted optometrists who later received special recognition that attested to their contributions to military medicine. In 1990 and 1993 the Armed Forces Optometric Society elected Capt. Francis L. McVeigh and Maj. George L. Adams III, respectively, as the Military Optometrist of the Year. In 1991 the Society of U.S. Army Flight Surgeons presented its Outstanding Achievement Award to Maj. Morris R. Lattimore, Jr., MSC, a research optometrist of the U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama, for contributions to Army aviation through his work in contact lens wear by aviators. Lattimore was also recognized by the Medical Department's Award of Excellence in 1992 for this project.109
Scope of practice continued to be a sensitive matter. Although the Army permitted optometrists to use topical anesthetics and cycloplegic drugs for refractions, it required the immediate availability of a physician for adverse reactions. The AOA protested that civilian optometrists had never been under the supervision of physicians, and Maj. Gen. William C. Augerson, the deputy assistant secretary of defense for health affairs, formed a tri-service working group of optometrists and ophthalmologists to resolve the conflict. DOD pressure and Colonel Giroux's prodding produced results. In 1981 the surgeon general submitted a change to Army regulations authorizing optometrists to use
diagnostic drugs and to prescribe "glasses, contact lenses and other therapy as appropriate."110
General Haggerty had criticized the department for continuing to block MSCs from its top positions at the beginning of the post-Vietnam period. MSCs, he maintained, were the logical candidates for a variety of key posts such as Chief of Staff, Health Services Command; Commander, U.S. Army Medical Research and Development Command; Commandant and Deputy Commandant, Academy of Health Sciences; and Deputy Commander, 7th Medical Command. Two of his recommendations came to fruition.111 Col. Vernon McKenzie, a retired MSC and the principal deputy assistant secretary of defense for health affairs, said in 1984 that he would advise a young person contemplating a career in the MSC to consider it very carefully because of the barriers to reaching the top in the Army Medical Department. Those perceptions were not uncommon. However, such misgivings should not obscure the improvements that occurred in the growing opportunities for positions of increased responsibility, a point made by those who counseled that MSCs were "too good to be ignored." Yet McKenzie's caution remained valid, for the top jobs continued to be blocked.112
Promotion lags during this period were offset somewhat by educational opportunities. Recruitment and retention problems continued in certain specialties such as psychology; in some fields, such as optometry, the swings in the number on active duty were exaggerated, resulting in periods in which the department was unable to meet its mission requirements. Overall, there was increased professionalism through training, advancements in position opportunity, and the recognition of officers by professional guilds. The external associations continued to play a role in the internal developments of the corps, and their awards-for example, those by the Association of Military Surgeons-were evidence of the validation of MSC specialty groups and officers according to national standards.
Ironically, there was an obverse side to the expansion of position opportunity. The newly opened jobs were among the department's most demanding. Their pressures were very great and often required family relocations to areas that, if not undesirable, were more costly or at the least constituted one more move among many in a career. Yet the normal incentives of progression to the top jobs and fur-
ther promotions were not present. Indeed, some MSC colonels moved into positions vacated by generals, Col. Neil McDonald being an example. In other words, the department expected MSCs to take its most responsible positions without adequate opportunities for rewards, to shoulder "unusual challenges without hope of unusual recognition."113 The situation served to emphasize anew both the corps' steady progress and its continuing status as a less than equal partner in the Medical Department.
1Shortage: Rpt, Manpower Mgmt Div, OTSG (DASG-RMM), DCSPER-46, pt 1, sub: AMEDD Officer Strength, FY 64-82, 4 Jan 83, DASG-MS; Paul Smith, "Army Physician Shortage Finally Easing," Army Times (31 August 1981): 12. Pixley: "Improving Manpower: Pixley's Early Days," U.S. Medicine (15 September 1981): 19. Also see "Military Doesn't Attract Young MDs," U.S. Medicine (1 November 1978): 1.
2Physician recruitment: Neil Roland, "General Pixley Credited With Turning the Tide," Army Times, 22 November 1982. Also see Maj. Charles M. Lott, MSC, "USAMEDDPERSA History," 'Persanality', USAMEDDPERSA Newsletter, 31 October 1985 (final issue); Pixley, "Army Physicians: Medics on the Mend," incl to DF, Col Guy D. Plunkett, MC, Ch, Professional Svcs, BAMC, sub: Communication from Pixley, 1980; Pixley said they did a "magnificent job." Interv, Pixley with Ginn, Bethesda, Md., 1 Nov 84, all in DASG-MS.
3Pessimism: The variable incentive pay (VIP) program was structured in such a way as to encourage retention. It proved to be an effective initiative, and projections after its first full year of operation in 1976 that the overall DOD physician shortage would not resolve until 1981 were soon revised downward to 1979. Briefing, Capt Larry Kobe, Ofc of the Asst Sec Def for Health Affairs (ASD [HA]), sub: Variable Incentive Pay, 19 Aug 77, author's notes, DASG-MS. MC numbers: Information (info) papers, Maj Thomas C. Clegg, MSC, USAMEDDPERSA, sub: Medical Corps End Strength, and Medical Corps Specialty Shortages, 15 April 82; Lt. Rpt, Col Thomas E. Broyles, MSC, Manpower Div, OTSG (DASG-RM), sub: Medical Corps Strength (Actual), End Fiscal Years 1973 to 1991, 18 Dec 94, all in DASG-MS.
4Loss of medical battalion: DF, Deputy Chief of Staff for Operations (DCSOPS), toTSG, sub: Read Ahead for 5 Mar 82 CSA Decision Brief, 24 Feb 82, and CMT 2, TSG, 25 Feb 82, Health Care Doctrine Div (DASG-HCD); Info paper, Lt Col Joseph F. Yohman, MSC, DASG-HCD, sub: Division 86 Relook, 24 Feb 82, DASG-HCD; MSC Newsletter, 15 February 1985, all in DASG-MS. The loss of the medical battalion was a fundamental reordering of field medical support. The author agrees with critics who argue "We took a great step backward." Ltr to the editor, Maj. Neal Trent, MSC, "AMEDD and Readiness," Army 44 (December 1989): 5.
5Medical Systems Program Review (MSPR): The study reflected the personal involvement of the academy commandant, Maj. Gen. William P. Winkler, MC. Briefing slides, Winkler, sub: MSPR, 31 May 84, DASG-MS.
6Doctrine: Discussion based on U.S. Army Training and Doctrine Command (TRADOC) Pamphlet 525-5, AirLand Operations, 1 Aug 91; Field Manual 8-10, Health Service Support in a Theater of Operations, 1 Mar 91; TRADOC Pam 525-10, U.S. Army Operational Concept for Health Service Support, AirLand Battle, 11 Apr 86; Briefing slides, Ofc of Asst Ch of Staff, Opns (ACSOPS), 7th Medical Command (MEDCOM), sub: Health Service Support, AirLand Battle (HSSALB), 25 Feb 87, DASG-MS; Info paper, Maj Philip T. Martinez, MSC, ACSOPS, 7th MEDCOM, sub: HSSALB, 19 Feb 87, and Briefing, 25 Feb 87, Neckargmuend, Federal Republic of Germany (FRG), author's notes, DASG-MS; Rpt, Academy of Health Sciences, U.S. Army (AHS), sub: Health Service Support AirLand Operations, in AMEDD Stockholders Rpt, 27 Jul 91, pp. 1, 24; Memo, Col James J. Truscott, MSC, Asst Cmdt, Force Integration, AMEDD Center and School, sub: Health Service Support, 17 Jan 91, all in DASG-MS. FM 8-10 is described as "the keystone manual for the Army Medical Department" (p. iii). Experiments: One discarded concept was a "TOE carved out of TDA" in the stateside hospitals that would have identified field hospital units within the organization of the fixed facilities-with the field unit component deploying for contingencies. Health Services Support AirLand Battle (HSSALB): HSSALB was suspended in 1986 at the request of the commander in chief of the U.S. Army, Europe, and Seventh Army, who said it would clutter the corps area with recuperating patients and hospital units. The Seventh Army surgeon estimated it would increase the requirement for patient beds in the corps area from 15,000 to 33,000, an unacceptably large logistical "tail." Msg, CINCUSAREUR to DCSOPS, DA, (DAMO-FD), 171700Z Oct 86, sub: Programming of HSSALB, DASG-MS. Implications of changes: See Chapter 2 of this book and Karl D. Bzik and Ronald F. Bellamy, "A Note on Combat Casualty Statistics," Military Medicine 149 (April 1984): 229-31; Eran Dolev and Craig H. Llewellyn, "The Chain of Medical Responsibility in Battlefield Medicine," Military Medicine 150
(September 1985): 471-75; Ronald F. Bellamy, "Contrasts in Combat Casualty Care," Military Medicine 150 (August 1985): 409-10, and Ltr to the editor, Military Medicine 151 (January 1986): 63-64.
7Four hospitals: Medical Force 2000 hospitalization was provided by four hospital units: mobile Army surgical hospital, combat support hospital, field hospital, and a general hospital plus a medical holding company. FM 8-10, Health Service Support in a Theater of Operations, app. J, 1 Mar 91, PL.
8Deployable Medical Systems (DEPMEDS): Info paper, Capt John H. Brown, MSC, HQ, 7th MEDCOM, sub: DEPMEDS, 20 Feb 87; Msg, Sec Def (ASD-HA), 142227Z Apr 86, sub: FY87 DEPMEDS Budget; Presentation, Capt David Stanley, MSC, sub: DEPMEDS, at the MSC annual meeting, Garmisch, Federal Republic of Germany (FRG), 11 May 88 (author's notes), all in DASG-MS. Operational use: Brett D. Walker and Richard V.N. Ginn, "Continued Operations with DEPMEDS During Hospital Closure," AMEDD Journal, (August/September 1991): 13-20 (until 1987 the central house organ is cited as Medical Bulletin; thereafter it is cited as AMEDD Journal, plus the date, as the Medical Bulletin of the U.S. Army, Europe, was renamed in 1987 the Medical Bulletin of the U.S. Army Medical Department, and shortly thereafter, the Journal of the U.S. Army Medical Department); Briefing, Lt Col Stephen H. Johnson, MSC, Cdr, 5th MASH, sub: REFORGER After Action Report, HQ, 7th MEDCOM, Heidelberg, FRG, 12 Feb 90, notes by Lt Col David Forshey, MSC, DASG-MS.
9MSC numbers: MSC Newsletter, 30 September 1981; Rpt, Personnel Distribution Div, OTSG (DASG-PTH), 1 Sep 82; Briefing slide, DASG-PTH, sub: MSC Strength, 1 Sep 84; Rpt, Ch, MSC, sub: Directory of MSC Officers, 15 Jan 87; Rpt, Personnel Directorate, OTSG (DASGPTZ), RQTDEC91, 11 Feb 92, all in DASG-MS; Bernhard T. Mittemeyer, "Facing Challenges, Army Goals Endure," U.S. Medicine 18 (15 January 1982): 42. There were 4,957 MSCs in 1975; 4,834 in 1980; 4,901 in 1982; 5,025 in 1984; 4,981 in 1987; and 5,005 in 1991.
10Lohmiller: Memo, Maj William Lohmiller, MSC, for Dir Pers, OTSG, sub: MSC Officer Classification and Utilization System, 26 Sep 78, DASG-MS.
11MSC study: Presentation, Lt Col William J. Leary, Jr., MSC, AHS, sub: MSC Management Study, MSC Meeting, Garmisch, FRG, 14 May 90, author's notes; Info paper, Lt Col Peter Leventis, MSC, AHS, sub: MSC Management Study Implementation Update, undated; Info paper, Col Timothy Jackman, MSC, sub: MSC Management Study, 17 Oct 89; MSC Newsletter, 15 December 1987 and 29 March 1991, all in DASG-MS; AR 611-101, Commissioned Officer Classification System, change 5, 1 Jul 94.
12ROTC: Rpt, Col James M. Morgan, MSC, USAR, sub: Suggestions for Recruiting, Apr 78, DASG-MS. Of the 400 officers commissioned in 1981, 125 were direct appointments from 800 applicants. USMA: Bernard J. Adelsberger, "980 Academy Cadets Choose Branches," Army Times (18 April 1988): 10. 1992 accessions: 271 ROTC, 27 Health Professions Scholarship Program (HPSP), 60 USUHS (medical students), 32 direct commissions, 13 clinical psychology interns, 12 USMA, 16 other-total 435. This compares to 442 MC and 482 ANC accessions the same year. Info paper, Mil Pers Mgmt Div, OTSG (DASG-PTM), sub: AMEDD Officer Personnel Strength Management, 1 Feb 93, DASG-MS.
13Women in the Army (WITA): Policy statement, DCSPER, sub: Speaking With One Voice: Interim Position Regarding Women in the Army, 2 Sep 81, DASG-MS; Memo, Ginn for TSG, sub: Women in the Army In-Process Review, 13 Apr 83 (follow-up to DCSPER WITA Rpt, 12 Nov 82), DASG-MS.
14Women: MSC Newsletter, May 1968; Ch, MSC, MSC Directory, 1987, both in DASG-MS. Numbers and survey: On 15 January 1987, there were 544 women among 4,981 active duty MSCs (11 percent): 5 lieutenant colonels, 26 majors, 327 captains, 102 first lieutenants, and 84 second lieutenants. Rpt, Capt Susan R. West, MSC, DASG-MS, sub: Questionnaire, 30 Nov 87, DASG-MS.
15Numbers in 1995: On 15 January 1995, there were 825 women among 4,432 active duty MSCs (19 percent): 2 colonels, 28 lieutenant colonels, 151 majors, 323 captains, and 321 lieutenants. By comparison, the percentage of females in the other Medical Department corps was: Medical Corps, 16 percent; Army Nurse Corps, 71 percent; Dental Corps, 9 percent; Army Medical Specialist Corps, 36 percent; and Veterinary Corps, 24 percent. By January 1995 there were two deputy commanders for administration and two commanders. Rpt, Health Svcs Div, Officer Pers Mgmt Dir (TAPC
OPH), U.S. Total Army Personnel Cmd (PERSCOM), Alexandria, Va., sub: AMEDD Gender Statistics, 9 Jan 95, DASG-MS; Jim Tice, "Minorities, Women Gain in Downsizing Active Force," Army Times (21 November 1994). Williamson: Msg, 7th MEDCOM, 051159Z Aug 91, DASGMS. Moore: A. J. White, TAPC-PDA, info paper, 17 Jun 93, DASG-MS.
16Goals: Rpt, DASG-MS, sub: MSC Strategic Planning Conference, 30 October-2 November 1984; Handout, Ch, MSC, sub: MSC Goals and Objectives, 1985, both in DASG-MS.
17Mentors: Info paper, Maj Richard B. Parry, Jr., MSC, HQ, 7th MEDCOM, sub: MSC Officer Mentorship, 29 Jan 88, DASG-MS.
18Award: MSC Newsletter, 9 April 1982; OTSG Reg 15-31, The Chief, Medical Service Corps Award of Excellence, 22 Aug 83, DASG-MS. Winners: MSC Newsletters, 1984-90.
19Intern: MSC Newsletters, 8 October 1984 and 14 August 1987.
20AMSUS awards: Insert, "Annual Awards Program," Military Medicine 153 (January 1988); Richard V. N. Ginn, "Of Purple Suits and Other Things: An Army Officer Looks at Unification of the Department of Defense Medical Services," Military Medicine 143 (January 1978): 15-24; MSC Newsletter, 15 December 1987.
21Statue: AMEDD Medical Museum, Fort Sam Houston, Tex., insert included with prints of the statue, 1990, DASG-MS. In addition to Berchin, the Combat Medic Memorial Fund Committee included Col. Robert E. Mathias, MSC; Maj. Michael D. Cordy, MSC; Maj. Jerry P. Devine, MSC; CSM George J. Pierce; and CSM (Ret.) Edward O'Boyle.
22Honorary colonel: "AMEDD Regiment Gets New Honorary Colonel," Mercury (U.S. Army Health Services Command newspaper, March 1994), DASG-MS.
23Number: U.S. Congress, House, Department of Defense Appropriations Bill, 1980, 95th Cong., 2d sess., 1978, p. 43. Positions: MSC Newsletters, 2 August 1982, 5 December 1983, and 25 July 1984; Lott, "USAMEDDPERSA History"; Biographical summaries, unit directories, and MSC Newsletters, 1978-88, DASG-MS.
24Dental Activities (DENTACs): L. Robert Woods, "A New Managerial Approach: Army Dentistry and the Medical Service Corps Officer," Military Medicine 146 (December 1986): 886-88; MSC Newsletters, 1 December 1978, 4 January 1980, and 22 October 1982; U.S. Congress, House, Hearings Before the Subcommittee on the Department of Defense of the Committee on Appropriations, 98th Cong., 2d sess., 1984, pt. 3, p. 117, hereafter cited as HAC, DOD Appropriations for 1985. Productivity was measured by daily procedures per dentist.
25Promotions: Memo, Col Eugene Lail, MSC, Ch, MSC Career Activities Office, sub: MSCs Personnel Turbulence, 8 May 78; MSC Newsletters, 20 August 1978, 30 March 1979, 30 September 1981, and 15 December 1987; Col James D. Van Straten, CofS, 7th MEDCOM, to Jordan, 6 Sep 83; Info paper, Lt Col Jack O. Harrington, MSC, Pers Policy Div, OTSG (DASG-PTB), sub: Defense Officer Personnel Amendments Act 1982, 31 Mar 82; OCSA, Dir Program Analysis and Evaluation (PA&E), Major Commanders Conference 1984; Interv, Pixley with Ginn, Pentagon, 1 Nov 84, DASG-MS; Johnson to Van Straten, sub: MSC Washington Update, 11 Oct 84; Memo, Gen Maxwell R. Thurman, VCSA, Memo for TSG, sub: AMEDD Promotion Opportunity, 18 Jan 85; MFR, Col James G. Vermillion, MSC, Dep Dir Pers, OTSG, 18 Jan 85; Memo, Delbert Spurlock, Jr., Asst Sec Army (M&RA), for CSA, sub: Army Medical Department Promotions, 1 Oct 85; Memo, Spurlock for Principal Dep ASD (HA), sub: Army Medical Promotions, 17 Dec 85; Info paper, Lt Col Peter Tremblay, MSC, DASG-PTM, sub: AMEDD Force Management Process, 30 Dec 87; Info paper, Lt Col Ray Elizondo, MSC, DASG-PTM, sub: AMEDD (less MC/DC) Promotions, 28 Dec 87; Briefing slides, Col Thomas B. Pozniak, MSC, ACSPER, 7th MEDCOM, sub: OACSPER Issues, DCA Conf, Heidelberg, Germany, 25 Feb 88; Info paper, DASG-PTM, sub: Evolution of AMEDD Promotions, 12 Apr 91, all in DASG-MS.
26Promotion problem: Spurlock to CSA, 1 Oct 85.
27Retirement: Officers selected had to retire within six months of the secretary of the Army's approval of the board's recommendations.
28Stars: CMT 2, Col Fred L. Walter, MSC, 7 May 80 to DF, Maj Peter M. McLaughlin, MSC, Asst to Ch, MSC, sub: MSC Action Plan, 2 Apr 80; Johnson to Van Straten, sub: MSC Washington Update, 11 Oct 84; Rpt, DASG-PTB, sub: General Officer Distribution, 23 Jan 85; MSC Newsletters, 27 April 1984 and 30 October 1985; all in DASG-MS; HAC, DOD Appropriations for 1985, 3: 768. Loss of officers: An example of officers who sought their fortunes
elsewhere was Col. William H. Wunder, MSC, who transferred as a colonel to the Adjutant General Corps in 1975. Wunder retired in 1982 to follow a career in education that included the position of president of Marymount College in Kansas. In 1995 he was elected president of the International Association of Lions Clubs. U.S. Army War College Newsletter, Fall 1995, DASG-MS.
29AMEDD stars: 22 in 1985: 1 lieutenant general, 8 major generals, and 13 brigadier generals; 16 in 1994: 1 lieutenant general, 6 major generals, and 9 brigadier generals. The number by corps:
Source: HAC, DOD Appropriations for 1985, 3: 768; Rpt, Army Medical Department Center and School (AMEDDC&S), sub: AMEDD Immaterial Command Leader Development Action Plan, 7 Sep 94, DASG-MS.
30Support: Jordan to Brig Gen Manley Morrison, MSC, Ret., 22 Feb 84.
31MC star: SG Staff Conference, 15 Feb 85, as related to the author, author's notes, 15 Feb 85, DASG-MS. General Mittemeyer announced that a board would convene in May 1985 to select an MSC brigadier general, using a star taken from the Medical Corps. The ultimate disposition of that star would be at the call of General Becker, his replacement as surgeon general.
32Education: MSC Newsletters, 19 October 1979, 12 November 1980, and 30 October 1985; Rpt, MSC Career Activities Office (CAO), U.S. Army Medical Department Personnel Support Agency (USAMEDDPERSA), (SGPS-MS), sub: Active Duty Officers Who Failed to Complete LTCT, 30 Jan 80; Msg, Education and Training Div, USAMEDDPERSA (SGPS-EDA), 181900Z Feb 88, sub: MSC Long Term Civilian Training (LTCT) Selection Board, all in DASG-MS. Training with Industry: AR 621-108, sub: Military Personnel Requirements for Civilian Education, 3 Mar 92, PL; Info paper, Lt Col James E. Sutton, MSC, DASG-PT, sub: Medical Readiness Brief-AMEDD, 10 January 1994, DASG-MS.
33Army-Baylor: MSC Newsletters, 12 November and 30 December 1980; U.S. Army-Baylor University Alumni Club Newsletter, May 1987; MFR, Col George R. Krueger, Ch, MSC CAO, sub: Selection Board, U.S. Army-Baylor University Program in Health Care Administration FY 75, Jan 74; Rpt, Col Melvin E. Modderman, MSC, Dir, Army-Baylor Program, sub: A Report to Alumni and Friends, 1987; Memo, Young for President, U.S. Army-Baylor University Program in Health Care Administration Selection Board, sub: Corps Chief's Policy Guidance, 1979; Darryl E. Crompton, J.D., ACEHSA Fellow, to Lt Col Thomas Janke, MSC, Dir, Army-Baylor Program, 2 Aug 81; Office notes, Maj Peter M. McLaughlin, MSC, Office of Ch, MSC, 7 Nov 80, all in DASG-MS; Jay Green, "Graduate Programs Get Back to Basics," Modern Health Care (27 August 1990): 28-37, 52, hereafter cited as Green, "Graduate Programs." Flexible residencies: HEW: Maj. Franklin J. Goriup, MSC; VA: Maj. Eric H. Myrland, MSC; OSD: Maj. Richard V. N. Ginn, MSC.
34Quoted words: Nancy Barcus, "Fort Sam's Unique Students," Baylor (June-July 1984): 27.
35Residencies: See Green, "Graduate Programs," pp. 28-30.
36Report: Rpt, Darryl E. Crompton, J. D., ACEHSA Fellow, sub: Report of Visiting Committee Site Visit to Lt Col Thomas Janke, Dir, Army-Baylor Program, 12 Aug 81, DASG-MS.
37Ranking: Green, "Graduate Programs," p. 52. Accreditation: MSC Newsletter, August 1993.
38School: Venable, AHS History, 1981.
39Basic course: MFSS, Program of Instruction (POI) no. 6-8-C2O, sub: Army Medical Department Basic Course (MSC Officers), Apr 71; Briefing slide, AMEDDC&S, MSC Basic and Advanced Courses, undated (1993); MSC Newsletters, 2 August 1982 and 30 October 1985, all in DASG-MS.
40Advanced course: AHS, POI no. 6-8-C22, sub: AMEDD Officer Advanced Course, Jun 78, as revised 23 Aug 78; Briefing slide, AMEDDC&S, MSC Basic and Advanced Courses, undated (1993); Briefing slides, Lt Col James E. Sutton, MSC, OTSG, sub: Military Education Update, 18 Aug 94, hereafter cited as Sutton, Military Education Update; MSC Newsletters, 2 August 1982 and 30 October 1985, all in DASG-MS. CLOAC: MSC Newsletter, 15 January 1993. Functional Area 90: Memo, Col Boyd C. Bryant, General Staff (GS), Ch, Combat Svc Spt Div, Officer Pers Mgmt Dir (OPMD), PERSCOM, sub: Notification of Functional Area 90 Designation Board, 15 Dec 92, DASG-MS. Training policy: Memo, MSC Br, HSD, OPMD, PERSCOM, sub: Statement of Policy 93-1, undated (March 1993), DASG-MS.
41CAS3: Info paper, Maj Mary Anne Svetlik, MSC, SGPS-ED, sub: CAS3, 26 Mar 82; Info paper, Maj H. Berriman, GS, ODCSPER, sub: CAS3, 2 Sep 86, both in DASG-MS. C-4: Jay P. Sanford, "USUHS 'Innovative' in Teaching Design," U.S. Medicine (January 1988): 29. General Young said the MSCs who attended as role models for physicians in a field environment "performed magnificently." MSC Newsletter, 31 July 1980.
42CGSC: MSC Newsletters, 1 December 1978, 19 October 1979, and 30 September 1981; Speech, Young, sub: State of the Corps, 29 Feb 80; Info paper, Berriman, sub: To Provide Information Concerning the Nonresident Command and General Staff College, 2 Sep 86, all in DASG-MS; Sutton, Military Education Update, 18 Aug 94; Interv, Brig Gen Bruce T. Miketinac with Ingeborg Sosa, in AMEDD Journal (May/June 1993).
43Act of 1986: Department of Defense Reorganization Act of 1986, 100 Stat. 922, 1 October 1986. The bill was commonly referred to as the Goldwater-Nichols Act, after its sponsors, Senator Barry Goldwater and Congressman Bill Nichols.
44SSC: MSC Newsletters, 30 December 1980 and September 1994; Info papers, Maj Mark Leopold, ODCSPER, sub: SSC Selection Board Procedures and U.S. Army War College Corresponding Studies Program, 15 Aug 86; Memo, John O. Marsh, Jr., Sec Army, sub: Instructions to the 1987 Army Competitive Category Senior Service College (SSC) and Academic Year 1988-90 Army War College Corresponding Studies Course (AWCCSC) Selection Board, 21 Jul 1987; Sutton, Military Education Update, 18 Aug 94, all in DASG-MS. Difficulty: Jim Tice, "Senior Service College Board Meets July 6," Army Times (11 April 1988): 3. Fellowships: Maj Gen John C. Ellerson, Dir of Strategy, Plans and Policy, ODCSOPS, to Col Robert Fitz, MSC, 14 Oct 93; Ellerson to Col Timothy Jackman, MSC, 14 Oct 93, DASG-MS. Opportunity: The number of officers selected in 1994 for resident SSC compared to the number eligible reveals the following:
Source: Memo, Col Michael L. Leahy III, Ch, Functional Area Mgmt and Development Div, OPMD, PERSCOM, sub: FY 1994 Senior Service College Selection Board, 7 Sep 94, DASGMS.
45Advanced training: MSC Newsletter, 30 October 1985; OTSG Reg 5-6, Army Medical Department Programs at Arroyo Center, 6 Apr 90, DASG-MS; Sutton, Military Education Update, 18 Aug 94.
46Quoted words: Unpublished paper, Col Kenneth A. Cass, MC, sub: The Requirement for Medical Corps Officers (Physicians) To Be Medical Facility Commanders and Major Medical Staff Officers in NATO and HSC, 12 May 78, USAMHI.
47Quoted words: Brig Gen William H. Greendyke, MC, USAF, Strategic Air Command Surgeon, to Lt Gen Paul W. Myers, AFSG, 1 Mar 80, DASG-MS.
48Cooper letter: Lt Gen Kenneth B. Cooper, DCINC, USAREUR, to Robert N. Smith, M.D., ASD(HA), 16 Jun 77, and Smith to Cooper, 24 Aug 77, DASG-MS. Smith's response was drafted by Capt. Peter A. Flynn, MC, USN, who added: "There is no arguing that some physician commanding officers are absolute dolts-but then so are some senior MSCs-physicians have no corner on the market for stupidity." Flynn to Smith, 22 Jul 77, DASG-MS.
49Clements: Memo, William P. Clements, Dep Sec Def, for Secs of the Mil Depts, sub: Staff and Command Assignments of Health Professionals, 1 May 73, DASG-MS. Moxley: Memo, John H. Moxley III, M.D., for ASA-M&RA, sub: Physicians in Executive Management Positions, 16 Jul 80, DASG-MS. "I know of no substantive reason why the Army should not be moving in the same direction as the Air Force and Navy." Beary: The policy "is herewith restated." John F. Beary III, M.D., to Sen Daniel K. Inouye, 8 Mar 73, DASG-MS. The Army said it was "not mandated": Army response, 10 Aug 83, to Draft DOD IG Report, sub: Defense IG/Audit Service Report on Utilization of MC, DC, MSC, 10 Jun 83; Memo, Col Melvin E. Modderman, MSC, Dep Dir Pers, OTSG, to DSG, same sub, 12 May 83, all in DASG-MS. 1984: William E. Mayer, M.D., in HAC, DOD Appropriations for 1985, 3: 760-61.
50Field command: DAIG, inspection of 3d Armored Div, USAREUR, finding 140, sub: Medical Unit Commanders, May 78, with response, Col Charles A. Mateer, MSC, XO, OTSG, 13 Dec 78; Draft rpt, DOD IG, 10 Jun 83, all in DASG-MS; AR 600-20, Army Command Policy and Procedures, 15 Oct 80, PL.
51Army: General Mittemeyer testified that the physician "is the most qualified officer of the healthcare team to supervise direct hands-on care." HAC, DOD Appropriations for 1985, 3: 767. The Navy and Air Force surgeons general testified that seven hospitals and twenty-three clinics were commanded by USN or USAF MSCs. U.S. Marine Corps (USMC): Memo, Commandant, USMC, for DOD IG, sub: Review of the Utilization of Medical Service Corps Officers in Executive Management Positions (Project 21J-141), 21 Mar 83; Draft rpt, DOD IG, 10 Jun 83, all in DASG-MS.
52Command selection: MSC Newsletters, 31 July 1980, 30 September 1981, 26 February and 22 October 1982, and 28 June 1984.
53Fields: Lt Col Jerry L. Fields, MSC, to Maj Gen Robert M. Elton, CG, 9th Inf Div, sub: Award of Alternate Skill Identifier 92, 11 Jan 83, with 1st Ind, Col William J. Buchanan, Jr., Cdr, 9th Div Spt Cmd (DISCOM), 24 Jan 83; 2d Ind, Elton, CG, 9th Inf Div, 2 Mar 1983; and 3d Ind, Jordan, Ch, MSC, 5 Apr 83. Also see Ltr, Lt Gen Richard H. Thompson, DCSLOG, to Mittemeyer, 28 Jun 83, and Mittemeyer to Thompson, 26 Jul 83, DASG-MS. Forward Support Battalions (FSBs): Memo, Mittemeyer, DASG-PTB, for DCSPER, sub: Command Selection Procedures for FSB and DISCOM Command, 25 Oct 83; Jordan to Ginn, 2 Oct 1988. DISCOMs: Johnson to Van Straten, 11 Oct 84. DISCOM Commanders: A second MSC, Lt. Col. (P) Randy P. Maschek, MSC, was slated in 1995 for the 4th Infantry Division DISCOM at Fort Carson, Colorado, but was deferred from command when that unit was announced for inactivation. In 1987 Fields, then a colonel, had assumed command of the 6th Infantry Division DISCOM at Fort Richardson, Alaska, but not as an MSC since he had transferred to the Quartermaster Branch prior to assuming command. Field, was subsequently relieved of command.
54Command of FSBs: Rpt, DASG-PTM, sub: Battalion Commander Selections, 22 Oct 91; Rpt, Col John A. Sierra, Jr., MSC, Dep Dir Pers, OTSG, sub: Number of MSC FSB Cdrs, 1983-1992, 14 Feb 92; Memo, Brig Gen Gary L. Brown, OPMD, sub: Selection List for FY93 Lieutenant Colonel Level Command, 24 Jun 92, all in DASG-MS; Timothy Jackman, "Army Medical Department Plans, Operations, Training, Security and Intelligence Officers: Then, Now and Next," AMEDD Journal (May/June 1992): 6-10, hereafter cited as Jackman, "Operations Officers."
55MSC commanders: HAC, DOD Appropriations for 1985, 3: 766; MSC Newsletters, 22 October 1982, 28 June 1984, and March 1994; MSC Directory, 1991, all in DASG-MS. MC commanders: MSC Newsletter, 25 March 1983; Army Times 28 (March 1983): 2.
56Gander crash: Notes of interv, 1st Lt Beverly J. Rice, MSC, with Ginn, Pentagon, 16 Jan 86; Rpt, Lt Col Gary L. Swallow, MS, Automation Mgmt Ofc, OTSG (DASG-AMO), sub: Gander Crash After Action Report, 18 Jan 86; Rpt, Lt Col Michael A. Shannon, MSC, Professional Services Directorate, OTSG (DASG-PS), sub: Medical Records Construction, 26 Feb 86, all in DASG-MS. Also see David Fulghum, "Identification 'Tremendous Emotional Experience,'" Army Times (2 June 1980): 8, 46.
57Personnel: Memo, Col Richard C. Harder, MSC, Ch, Education and Tng Div, for Cdr, USAMEDDPERSA, sub: Organization of a Health Services Personnel Manager Task Force, 7 Jun 77; Draft ltr, Col Neil J. McDonald, MSC, Cdr, USAMEDDPERSA, to AMEDD Pers Mgmt Conf sub: Summary of Findings of the Health Services Personnel Managers Task Force (HSPM/TF), 17 Apr 79. Also see Col Marion Johnson, MSC, XO, BAMC, to Young, 12 Sep 80; all in DASG-MS. Proponency: Briefing slides, Maj Richard V. N. Ginn, DASG-PTB, sub: AMEDD Specialty Proponency, Apr 82; Mittemeyer TSG, to Maj Gen Raymond R. Bishop, Jr., CG, HSC, 17 Jan 83; Info paper, Lt Col R. Ginn, sub: AMEDD Enlisted Proponency, 4 Apr 83, all in DASG-MS. Exceptional Family Member Program: Info paper, Lt Col Thomas R. Pozniak, MSC, DASG-PTB, sub: Provision of Health Related Services to Handicapped Dependents, 1 Apr 82, DASG-MS.
58Personnel Command: USAMEDDPERSA Newsletter, 31 October 1985 (final issue); Info paper, TAPC-OPH, sub: History of the Health Services Division, OPMD, 1974-1994, 30 Jan 94;
Memo, Col Charles A. Henning, GS, Ch, Officer Div, ODCSPER, sub: Draft FY96 Officer Distribution Plan (ODP) Policy Guidance, 8 Dec 94, all in DASG-MS.
59Comptroller: MSC Newsletter, 29 September 1986; Msg, DA, sub: MSC LTC Selection Board, DASG-MS. Syracuse: Ms. Anne P. Twist, DAC, Student, Army Comptrollership Program (ACP), Syracuse Univ, to Ginn, 5 Sep 91; Rpt, ACP, sub: ACP 1952-1991, Syracuse Univ, 1991, all in DASG-MS.
60Quoted words: Ch, MSC, plaque presented at the Sperandio Conference, 11 Sep 89.
61Operations: DA Msg, 18 Feb 88; MSC Newsletters, 9 January and 30 December 1980 and August 1993; Information booklet, U.S. Army Health Services Command (HSC), sub: Fort Detrick, undated, 1988, DASG-MS. Foster: Brig Gen James L. Collins, Jr., Cdr, USACMH, to Cdr, USAR Components and Admin Ctr, sub: Active Duty Training-1LT Gaines M. Foster, 21 Jan 76, box 19/18, MSC-USACMH; Foster, The Demands of Humanity: Army Medical Disaster Relief (Washington, D.C.: U.S. Army Center of Military History, 1983). El Salvador: Msg, DA, 191923Z Jul 83; Memo, Col Robert F. Elliott, MSC, for Sec Def, sub: Medical MTT Objectives and MEDEVAC Requirements, 7 Sep 83, and Rpt, sub: Humanitarian Medical MTT, 20 Jan 84, all in DASG-MS. Col. Herman Morales, MC, was team chief.
62Role of operations specialty: Col Charles R. Angel, Ch, MAS Sec, to Young, sub: Visit to Fort Campbell, Kentucky, 23 Feb 76, DASG-MS. Proposals: Rpt, Col Charles A. Mateer, MSC, Course Dir, sub: Meeting, Current Problems in Medical Plans and Operations, June 1978, to Young, 8 Sep 78; Mateer to Young, 18 Oct 78, with DF, Young to DASG-RM, sub: Review and Evaluation of Current Problems and Trends in Medical Plans and Operations, 20 Oct 78, all in DASG-MS.
63Operations study: Young to Jordan, sub: Organization of a Health Services Plans, Operations, Intelligence and Training Task Force, 20 Jul 79; MSC Newsletter, 9 January 1980; Rpt, Jordan, Chm, 67H Study Gp, sub: A Review of Plans, Operations, Intelligence and Training, Jan 81; Staff notes, McLaughlin, Asst to Ch, MSC, 19 Jan, 24 Feb, and 2 Jun 81; Jordan to Ginn, 2 Oct 88, all in DASG-MS.
64Guide: Rpt, Directorate of Health Care Opns, OTSG (DASG-HCZ), sub: Health Services Plans, Operations, Training, Security, and Intelligence Officer Professional Development Handbook, Sep 91, DASG-MS. Quoted words: Jackman, "Operations Officers," p. 10.
65Logistics: MSC Newsletters, 9 January 1980, 19 April 1985 (issue devoted to medical logistics), and 15 December 1987. An MSPR session, 17-18 December 1984, chaired by General Maxwell Thurman at the Academy of Health Sciences, challenged this premise. Notes of discussion, Lt Col William D. Finical, MSC, DASG-RMM, with Ginn, 19 Dec 84. Other challenges are in Jordan, 3d Ind to Ltr, Lt Col Jerry L. Fields, MSC, sub: Award of Alternate Skill Identifier 92, 5 Apr 83; Lt Gen Richard H. Thompson, DCSLOG, to Mittemeyer, 28 Jun 83; Mittemeyer to Thompson, 26 Jul 83, all in DASG-MS.
66Articles: Thomas E. Kistler, "A Case for the Separate Medical Logistics System," AMEDD Journal (December 1985): 5; Richard V. N. Ginn, "Medical Logistics: A Lesson From Vietnam," Army Logistician (November/December 1993): 36-38; Philip E. Livermore and Angel Cintron, "Medical Logistics: Pillar of Health Care Delivery," Army Logistician (March/April 1994): 9-11. MSC logisticians were closely attuned to Army field programs. For example, see George E. Shultz, "NBC Protection-A Personal Matter," Army Logistician (May-June 1985): 22-24.
67USAMMCE: Irene Weber, "Medical Materiel: The Army's Best Kept Secret," MEDCOM Examiner (7th MEDCOM newspaper, March 1988): 1, 8-9; Weber, "Kistler: A Man for All Reasons," ibid., p. 9, DASG-MS.
68Training: Col George L. Brown, MSC, Cdr, U.S. Army Medical Equipment and Optical School, to Maj Peter Tancredi, MSC, Asst to Ch, MSC, 2 Nov 82; MSC Newsletters, 9 January and 12 November 1980, 23 January 1984, and 15 December 1987; DA Msg, 18 Feb 88, all in DASGMS.
69Warrant officers: MSC Newsletters, 1 December 1978 and 31 July 1980; Info paper, Maj Phil Dorsey, MSC, Asst to Ch, MSC, sub: Biomedical Equipment Repair Technician, MOS 202A, 13 Feb 78; Rpt, Hlth Svcs Div, OPMD, MILPERCEN, sub: AMEDD Officer Active Duty Strength Report as of 30 November 85, Jan 86; Info paper, Lt Col Roy A. Bryan, MSC, DASG-PTM, sub: Warrant Officer Issues, 30 Dec 87, all in DASG-MS; "Management Transition Stalls for WOs," Army Times (19 October 1987): 7. The specialty code changed in 1987 from 202A to 670A.
70Health facilities: Memo, Lt Gen Richard R. Taylor, TSG, for Asst Sec Army (Installations and Logistics), sub: Program Manager for Medical Facility Construction, 10 Jul 75; MSC Newsletter, 30 December 1980; DA Msg 18 Feb 88; Rpt, U.S. Army Health Facilities Planning Agency (USAHFPA), sub: Funding Trend for Army Health Facilities, 15 Aug 91; Rpt, Dedi Graham, USAHFPA, sub: Medical Appropriations, FY80 Thru FY93, 3 Aug 94. Program reductions: The five-year program was reduced from $2.273 to $1.232 billion. The cut included deletion of $223 million for a new Fitzsimons Army Medical Center. Briefing slides, Col Edward P. Phillips, Jr., Cdr, USAHFPA, sub: USAHFPA, 10 Feb 95, all in DASG-MS.
71Health care administration: MSC Newsletters, 30 March 1979, 26 February 1982, 15 February 1985, and 22 January 1986; Office notes, McLaughlin, 16 Sep 80; Van Straten to 7th MEDCOM XOs, 17 Oct and 24 Dec 84; DASG-MS, "The AMEDD in an Era of Transformation," Army Day Program, ACHE, 10 Feb 86; Col Douglas A. Barton, MSC, ACHE Army Regent's Newsletter, September 1994; Memo, Barton for Ginn, sub: ACHE Stats, 11 Oct 94, all in DASG-MS. Applicants for the health care administration specialty (67A) were required to have a master's in a field approved by the ACEHSA or in administration (MA, MPA, MS, or MBA) from an accredited university. In 1980 General Young unsuccessfully attempted to restrict degrees to those accredited by the ACEHSA in order to prevent the recognition of weak programs. Health care changes: Neuhauser, Coming of Age, pp. 2, 52-54, 69-71; Rpt, Korn/Ferry International and Association of University Programs in Health Administration, sub: Health Administration Employment, 1979-83, 1983, DASG-MS.
72DCA: Notes of telephone conversation, Col Gerald D. Allgood, MSC, Ret., with Ginn, 31 Aug 91; Notes of telephone conversation, Brig Gen Walter F. Johnson III, USA, Ret., with Ginn, 10 Feb 92, both in DASG-MS; AR 611-101, Commissioned Officer Classification System, 30 Oct 85, PL.
73Awards: MSC Newsletters, 9 April 1982, 22 January 1986, 15 December 1987, 17 December 1991, and August 1993; "Annual Awards Program," Military Medicine 153 (January 1988), insert; Rpt, Lt Col Glenn R. Willauer, USAF, MSC, ACHE Regent at Large, sub: Regent's Report, Jan 1986 and Jan and Jun 1988; The Bear Facts: U S. Army-Baylor University Alumni Club Newsletter, Winter 1990, all in DASG-MS.
74UH-60: Interv, Lt Col John W. Hammett, MSC, Ret., with Capt Peter G. Dorland, MSC, THU, OTSG, Oct 75, USACMH. UH-60Q: Rpt, Lt Col Richard R. Beauchemin, MSC, Aviation Consultant, OTSG, sub: Aviation Update, in Memo, Col Timothy Jackman, MSC, sub: Health Services Plans, Operations, Training, Security and Intelligence Newsletter, 15 Jun 93, DASG-MS, hereafter cited as Jackman, Operations Newsletter.
75Aviation: MSC Newsletters, 30 March 1979, 9 January and 3 July 1980, and 21 December 1984 (issue devoted to medical aviation); SG Report, 1970, p. 121; Meeting program and author's notes, Dustoff Assn Seventh Annual Mtg, San Antonio, Tex, 28 Feb-2 Mar 86; Author's notes of presentation, Lt Col Jack Roden, MSC, "The First Evacuation Battalion," Dustoff mtg, 1 Mar 86, all in DASG-MS; Reginald G. Moore, Jr., Peter P. Smith, and Mark W. Yow, "Twofold Challenge," Military Medicine (October 1987): 495-96. Unit histories: Rpt, Capt Randall G. Anderson, MSC, sub: The Dustoff Report, printed by the Dustoff Assn, undated (Nov 92), DASG-MS. Anderson's report listed 27 active component, 17 reserve, and 25 Army National Guard aeromedical detachments and companies.
76Threat: MSC Newsletter, 21 December 1984; Memo, Maj Gen H. Norman Schwarzkopf, ADCSPER, for CSA, sub: Aviation Branch Composition, 13 Apr 83, as annotated by the Director of the Army Staff, Vice CSA, and CSA; Memo, Mittemeyer for DCSPER with tabs A-E, sub: HQDA Aviation Implementation Plan, 5 Apr 83; Jordan to Ginn, 2 Oct 88, all in DASG-MS. TSG arguments also included the danger of losing protected status for Dustoff crews under the Geneva Conventions. Quoted words: Memo, Mittemeyer for DCSPER, sub: HQDA Aviation Implementation Plan, 5 Apr 83. Also see notes of telephone interv, Lt Col Thomas C. Scofield, MSC, with Maj Gen Spurgeon Neel, MC, Ret., Mar 83, all in DASG-MS. Moore: Speech, Col Douglas Moore, MSC, XO, OTSG, sub: DUSTOFFer, Dustoff meeting, 1 Mar 86, author's notes, DASG-MS.
77MAST: Info paper, OTSG, sub: Military Assistance to Safety and Traffic (MAST), Dec 84, DASG-MS. MAST had increasing competition from civilian programs. Editorial, Howard F.
Champion, "Helicopters in Emergency Trauma Care," Journal of the American Medical Association 249 (10 June 1983): 3074.
78Colombia: Presentation, Maj Robert G. Whiting, MSC, sub: Disaster Operations in Colombia, Dustoff mtg, Mar 86, author's notes, DASG-MS. This was the Nevado del Ruiz volcano.
79421st: Presentations, Lt Col William T. Stahl, MSC, sub: DUSTOFF Europe, and Maj Reuben G. Pinkson, MSC, sub: Pacific Deployment Training, Dustoff mtg, Mar 86, author's notes, DASG-MS.
80Quoted words: In notes of interv, CW4 Mike Novosell, Jr., U.S. Army Aviation Center, Fort Rucker, Ala., with Ginn, Dustoff mtg, San Antonio, Tex., 2 Mar 86, DASG-MS.
81Promotions: Memo, Merle Meling, Assoc Dir, Finance and Manpower Audits, Defense Audit Service, Arlington, Va., for ASD (HA), sub: Survey of Non-Physician Health Care Providers, 5 Aug 82 (the survey canvassed 9 percent of 2,472 officers); Memo, See Army for President, Colonel, Medical Service Corps, Army Nurse Corps, Army Medical Specialist Corps, and Veterinary Corps Promotion Selection Board, sub: Selection Board Procedures, 31 May 91; Info paper, DASG-PTM, sub: Evolution of AMEDD Promotions, 12 Apr 91, all in DASG-MS.
82Special pay: Memo, Stephen C. Joseph, ASD(HA), for Asst Sec Army (Manpower and Reserve Affairs), sub: Diplomate Pay for Psychologists and Board Certified Pay for Non-physician Health Care Providers, 22 Sep 94, DASG-MS.
83Pharmacy: Lt Col Alfred W. Gill, MSC, Pharm Br, AHS, Lesson Plan 31-365-320, sub: History and Traditions of Army Pharmacy, 1986, DASG-MS; Bernard J. Adelsberger, "Retention," Army Times (8 February 1988): 276; Scott C. Martin, "Oncology Pharmacy Residency at Walter Reed Army Medical Center," Military Medicine 153 (August 1988): 414, 416; Frank A. Cammarata et al., "Pharmacy Practice in the United States Army," American Journal of Hospital Pharmacy 44 (April 1987): 756-59; Msg, DA, 181900Z Feb 88, sub: MSC LTC Selection Board, hereafter cited as DA Msg 18 Feb 88, all in DASG-MS.
84Allergen laboratory: Cammarata, "Pharmacy Practice in the Army"; Notes of discussion, Ginn with Capt Ralph R. Watson, MSC, Ch, Allergen Extract Lab, WRAMC, 1985-88, at 196th Station Hospital, Casteau, Belgium, 6 Oct 88. Awards: MSC Newsletters, 20 September 1981, 15 December 1987, and 17 December 1991; "Annual Awards Program," Military Medicine 153 (January 1988): insert.
85Medical Allied Sciences Section: Rpt, DASG-PTH, 1 Sep 82; DA Msg 18 Feb 88, both in DASG-MS. Consultants: Col Dan C. Cavanaugh, MSC, Ch, MAS, to Young, sub: Staffing Responsibility of Laboratory Sciences Consultant, 10 Sep 80; Brig Gen Garrison Rapmund, ASG (R&D), to Consultants Div, OTSG (DASG-PC), sub: Consultant Roster Update, 16 Jul 81; Rapmund to Young, 21 Jul 81, and CMT 2, Lt Col William J. Shaffer, MSC, Asst to Ch, MSC, to Rapmund, 26 Aug 81; Ltr, Maj Gen Enrique Mendez, Jr., DSG, sub: Military Consultants to The Surgeon General, Department of the Army, FY 1981, 18 Sep 80, all in DASG-MS. Policies: Miketinac, remarks to senior MSCs at MSC mtg, Garmisch, FRG, 16 May 90, author's notes, DASG-MS.
86National recognition: MSC Newsletters, 22 August 1983, 3 December 1984, and 15 December 1987; Capt James W. Voorhees, MSC, to Jordan, 18 Dec 83, DASG-MS; "Reservist Picked for Astronaut Program," CAR [Chief Army Reserve] Notes (March-April 1984): 2, DASGMS; Terry Jemison, "VA Astronaut Will Stick to Lab on Earth," U.S. Medicine 27 (September 1991): 1, 43. "A" prefix: An OTSG board selected twenty-three MSCs for this honor in 1992, a typical year. MSC Newsletter, December 1992.
87Audiology: MSC Newsletters, 1 December 1978 and 4 January and 30 December 1980; Audiology Consultant, audiology newsletter, 1 September 1980; DF, Maj Roy K. Sedge, MSC, to Ch, Otolaryngology Service, WRAMC, sub: Transfer of 68M Consultantship to MSC 68M Audiologist, 14 Apr 77; Briefing, Sedge for Brig Gen Young, sub: The Army Audiology Program, 8 Feb 78; Maj Donald R. Ciliax, MSC, Ch, Audiology Sec, Dwight David Eisenhower Army Medical Center (DDEAMC), to Sedge, sub: Formulating Policies for HAE's and AR's for the SE Medical Region, 21 Feb 79, with 1st Ind, Sedge, 2 Mar 79; DF, Sedge to TSG, sub: Assignment of 68Ms, 20 Jul 79; Sedge to TSG, sub: Consultant Visit to Federal Republic of Germany, 25 Apr 1980; Maj Gen Spencer B. Reid, MC, Cdr, 7th MEDCOM, to Sedge, 5 May 80, all in DASGMS; Bernhard T. Mittemeyer, "Facing Challenges, Army Goals Endure," U.S. Medicine 18 (15
January 1982): 42, 51; J. Monique Bebout, "Audiology in the Armed Forces," Hearing Journal (September 1985): 7-14.
88Walter Reed: The ranking was by the American Speech and Hearing Association in 1979. MSC Newsletter, 4 January 1980. Quoted words: Rodney M. Atack, "Army Audiology: Yesterday to Today," AMEDD Journal (November/December 1993): 49.
89Podiatry: MSC Newsletters, 1 December 1978, 31 July 1980, 30 September 1981, and August 1993; Hamrick, Sylvester interv, 21 Feb 84; Rpt, Manpower Control Div, OTSG, sub: FY Reports, MSC, FY 59-67, 27 Jan 67, hereafter cited as OTSG, MSC FY 59-67; Rpt, DASG-PTH, 1 Sep 82; DA Msg 18 Feb 88, all in DASG-MS; SG Report, 1972, p. 110; Mittemeyer, "Facing Challenges," p. 42; Terry D. Weaver et al., "The Role of the Podiatrist in a Wartime Scenario,"
Military Medicine 153 (August 1988): 391-93. Quoted words: Rpt, James H. Sammons, M.D., Pres, AMA, to Senate Conferees on S. 2723, "1985 Department of Defense Authorization," p. A14, PL.
90Podiatry residency: MSC Newsletter, 31 July 1980.
91Psychology: MSC Newsletters, 30 March and 14 October 1979, 4 January 1980, and 30 September 1981; Memo, Col Franklin Del Jones, MC, Psychiatry and Neurology Consultant, for TSG, sub: Army Psychologists, 1978, including speech, Maj Larry H. Ingraham, MSC, sub: New Directions in the Procurement of Army Uniformed Psychologists, American Psychological Association Convention, Chicago, 30 Aug 75; Rpt, Maj Thaddeus A. Krupka, MSC, DASG-PTH, sub: Psychology, 13 Aug 78; Memo, Jones for TSG, sub: Army Psychologists, 1980; Col Robert S. Nichols, MSC, to Young, 4 May 79; Unpublished paper, Harold Rosenheim, sub: History of the Uniformed Clinical Psychologist in the U.S. Army, 2 Sep 80; Info paper, Col Cecil Harris, sub: Issues of Concern-Army Clinical Psychology, 1 Dec 80; DASG-PTB, DA Form 2028, Changes to AR 611-101, Dec 81, all in DASG-MS; Jones, "Proceedings," 1979. Health Professions Scholarship Program (HPSP): Fact sheet, Capt Frank E. Blakely II, MSC, DASG-PTH, sub: HPSP Scholarship Reductions, 31 Mar 82; Louis Marangoni, Ch, Mil Pers Div, HQ, U.S. Army Medical Research and Development Command (USAMRDC), to Ginn, 16 Sep 91, DASG-MS.
92Utilization: Presentation, Lt Col James L. Maury, MSC, sub: Alcohol and Drug Program, MSC mtg, Garmisch, FRG, 10 May 88 (author's notes); Memo, Capt Lawrence E. Klusman, MSC, 120th Med Det, 1st Armored Div, sub: USAREUR Psychologists' View of Problem Soldiers, 9 Aug 79, all in DASG-MS; Frederick N. Garland and Franklin R. Brooks, "Military Families: Strategic Targets in a Subtle War," Military Review 72 (April 1992): 55-56.
93Survey: Study, David A. Mangelsdorf, Ph.D., AHS, sub: Psychologist Retention Factors, Jan 78, Doc ADA 059374, DTIC; also see Meling, Defense Audit Service Survey, 5 Aug 82, both in DASG-MS.
94Autonomy: Vernon McKenzie, PDASD(HA), memo to ASA(M&RA), sub: Utilization of Psychologists in the Military Health Care System, 2 Aug 1978, and response, Pixley to ASD(HA), (drafted by Lt. Col. James Rumbaugh, MC), 11 Sep 1978, DASG-MS.
95Education: MSC Newsletter, 30 September 1981; DF, Capt Raymond A. Parker, MSC, Asst Ch, Psy Svc, Madigan Army Medical Ctr, sub: Request for Approval to Offer a Post-Doctoral Fellowship in Clinical Neuropsychology, 27 Mar 79; Memo, Col Ben F. Dobson, MSC, for Ch, MSC, sub: Establishment of a Post-Graduate Fellowship in Neuropsychology, 18 Apr 80; Memo, Col France F. Jordan, MSC, Dir of Pers, for TSG Policy Council, sub: Postgraduate Fellowship in Neuropsychology, 9 Jul 81.
96Combat exhaustion: Larry H. Ingraham and Frederick J. Manning, "Psychiatric Battle Casualties: The Missing Column in a War Without Replacements," Military Review 60 (August 1980): 20, 29. Sleep: Manning to Lt Col Richard E. Hartzell, MSC, TSG Psychology Consultant, 28 Nov 78; Rpt, Manning, sub: Human Factors in Sustaining High Rates of Artillery Fire (Final Report), 1979, both in DASG-MS; Manning, "Continuous Operations in Europe: Feasibility and the Effect of Leadership and Training," Parameters 9 (June 1979): 8-16. Ingraham also got attention with an article that attacked the Army's new officer efficiency report that was fielded in 1979. He charged that reports were inflated and were leading to an officer corps of "sequestered vegetables." He predicted its collapse by 1987. Ingraham, "The OER Cudgel: Radical Surgery Needed," Army 35 (November 1985): 54-56.
97Social work: Lt Gen Taylor, TSG, to Gen Frederick J. Kroesen, CINC, USAFORSCOM, and Gen William E. Dupuy, CG, USATRADOC, 24 Mar 77; Memo, Col David P. Jentsch, MSC, sub:
Army Social Work Program Up-Date, 4 Jul 80, all in DASG-MS; Col Jones, "Behavioral Sciences in a Changing Army," in Jones, "Proceedings," 1979; Bascom W. Ratliff, Elizabeth M. Timberlake, and David P. Jentsch, Social Work in Hospitals (Springfield, Ill.: Charles C. Thomas, 1982). Study: Rpt, Maj Edward R. Hamlin III, MSC, Elizabeth M. Timberlake, Col David P. Jentsch, MSC, and Maj Edwin W. VanVrankin, MSC, sub: U.S. Army Social Work in the 1980's, WRAMC, Washington, D.C., 5 May 82, JML. The researchers received 130 questionnaires from 259 social workers surveyed, a 50 percent return rate.
98Quoted words: Col. Robert A. Mays, Jr., MSC, in MSC Newsletter, August 1993.
99Sanitary engineering: MSC Newsletter, 4 January 1980; OTSG, MSC FY 59-67; Rpt, DASG-PTH, 1 Sep 82; Rpt, Lt Col James M. Morgan, Jr., MSC, USAR, sub: A Review of the Current Status of Environmental Science and Sanitary Engineering Officers in the United States Army Reserve, Jul 74; Rpt, Morgan, sub: Suggestions for Recruiting, Apr 78, all in DASG-MS.
100Quoted words: Pamphlet, Capt John Y. Young, MSC, sub: Preventive Medicine Considerations: Exotic Palm, 1985, DASG-MS.
101Nuclear science: OTSG, MSC FY 59-67; Rpt, DASG-PTH, 1 Sep 82; DF, Col Robert T. Wangemann, MSC, Nucl Med Sci Consultant, OTSG, to Ch, MSC, sub: Recruitment and Retention of Nuclear Medical Science Officers (NMSO), 29 Dec 78; MFR, Herndon, sub: Report of the Second Sanitary Engineering Section Senior Officer Meeting, 4 Jun 82, all in DASG-MS; Mittemeyer, "Facing Challenges," p. 42.
102Optometry: Rpt, DASG-PTH, 1 Sep 82; Info paper, Col Arthur R. Giroux, MSC, Ch, Opt Sec, sub: Army Optometry, 25 Sep 77; Memo, Giroux for TSG, sub: OSD Legislative Proposal, "Armed Forces Medical and Dental Special Pay of 1979," 22 Feb 79; Memo, Giroux, for Ch, MSC, sub: Retention Rates, 21 Nov 79; Optometry Newsletter, 1 August 1980, all in DASG-MS; Bernard J. Adelsberger, "Retention Troubles Plague Medical Corps," Army Times (8 February 1988): 26-27. It was called a "critical shortage" in 1980 (MSC Newsletter, 9 January 1980).
103Flap: Editorial, Milton J. Eger, in Journal of the American Optometric Association (JAOA) 48 (March 1977): 275-76. Gmelin: Lt Col Robert T. Gmelin, MSC, to attendees at FAMC Optometry Conference, 27-31 August 1984, DASG-MS. Meeting: DASG-MS file, sub: AOA Meeting, assembled for Brig Gen Young, including a variety of documents; Pixley to Eger, 16 Jan 78; Notes of address, Young to Military Optometry Short Course, FAMC, 18 Sep 78; Eger to Pixley, 15 May 78; Eger to Giroux, 3 Aug 78; Maj Jerry D. Davis, MSC, Optometry Instructor, AHS, to Giroux, 1 Oct 79, all in DASG-MS; Eger editorials in JAOA, March 1977 and June 1978. Editorial: Eger editorial, June 1978; Eger to Giroux, 3 Aug 78, DASG-MS.
104HPSP: MSC Newsletter, 30 September 1981; Survey, Meling, 5 Aug 82; Info paper, Giroux, sub: Manpower Status, Optometry Officers, 6 Nov 79; Lee W. Smith, Exec Dir, Assn of Schools and Colleges of Optometry, to Moxley, 20 Aug 80; Info paper, Giroux, sub: Issues of Concern-Army Optometry, 10 Nov 80; Rep Bill Nichols to Moxley, 20 Nov 80; DF, Beck, sub: SG Reports, 1976-1980; Col John Leddy, MSC, Ch, Opt Sec, to Ginn, 4 Sep 88; Lou Marangoni, Ch, Mil Pers Div, HQ USAMRDC, to Ginn, 16 Sep 91; Briefing slide, Officer Procurement Div, OTSG, sub: Recruiting Initiatives, 15 Mar 93, all in DASG-MS.
105Recruiting: MSC Newsletters, 30 July 1980 and 30 September 1981; Memo, Giroux for TSG, sub: Interim Report-Visits to Optometry Schools and Colleges, 14 Feb 79 and 18 Apr 80; Optometry newsletter, Giroux, sub: Army Optometry Information Letter, 1 Aug 80, DASG-MS. Quoted words: JAOA, 1977, in Young, AOA mtg folder, 28 Apr 78, DASG-MS.
106Positions: Irene Weber, "Medical Materiel: The Army's Best Kept Secret," MEDCOM Examiner (March 1988): 1, 8-9; DASG-MS.
107Course: MSC Newsletter, 31 July 1980. Accreditation: Optometry Newsletter, 1 December 1979.
108Constructive credit: Young, AOA mtg folder, 20 Apr 78; Alvin Levin, O.D., Pres, AOA, to Giroux, 23 Aug 79; Memo, John H. Moxley, M.D., ASD (HA), for Mil Depts, sub: Revised Constructive Service Credit for Optometrists and Podiatrists, 26 Oct 79; DF, Giroux to Ch, MSC, sub: DA Procurement Circular 601-1, 27 Feb 80; Giroux to 1980 optometry school graduates entering active duty, sub: Date of Entry on Active Duty and Entry Grade Determination, 7 May 80; Memo, Moxley, sub: Revised Constructive Service Credit, 14 Apr 81; Memo, Jordan, Dir Pers, OTSG, for Ch, MSC, same sub, 29 Apr 81; Optometry Newsletter, 1 December 1979, all in DASG-MS.
109Retention: MSC Newsletters, 31 July 1980, 30 September 1981, 22 August 1983, and 17 December 1991; Fact sheet, Consultants Div, OTSG, sub: Optometry, 1980; DF, Alfred M. Beck, USACMH, to Health Care Opns Dir, OTSG, sub: Surgeon General's Report, 1976-1980, 10 Feb 1984; Young, address to Military Optometry Short Course, FAMC, 18 Sep 78; Memo, Giroux for TSG, sub: After Action Report-USAREUR Optometry Conference, 19-23 May 1980, Jun 80; Optometry Newsletters, 1 December 1979 and 15 December 1980, all in DASG-MS. Awards: MSC Newsletter, August 1993; USAMRDC Newsletter, November 1991; Notes of telephone conversation, Col Jerry D. Davis, Ch, Optometry Sec, MSC, with Col Richard V. N. Ginn, 12 Oct 94, all in DASG-MS.
110Scope: Charles W. McQuarrie, Pres, AOA, to John C. Stennis, Chm, SASC, Nov 77, and to Melvin Price, Chm, HASC, same sub and date; Memo, Maj Gen William S. Augerson, MC, USA, Dep Asst SecDef for Health Affairs, for SGs, sub: Scope of Optometric Services in Military Health Care Facilities, 27 Sep 79; Augerson to SGs, sub: Eye Care Services in the Direct Care System, 16 Nov 79; Memo, Pixley for ASD(HA), sub: Policy Regarding the Utilization of Optometry Officers, 3 Dec 79, including DF, Col Frederick C. Biehusen, MC, Ch, Consultants Div, OTSG, sub: Optometry Policy Statement Update, approved by Lt Gen Taylor, TSG, 4 Apr 77; Pixley to ASD(HA), sub: Eye Care Services in the Direct Care System, 6 Dec 79; Memo, McLaughlin for Young, 17 Dec 79; McKenzie, PDASD(HA), to Mil Depts, sub: Eye Care Review, 22 Apr 80; Rpt, Giroux, sub: After Action Report-USAREUR Visit, 16 Jun 80; DASG-PTB, DA Form 2028, sub: Publication Changes, change to AR 611-101, Dec 81; Optometry Newsletter, 1 December 1979, all in DASG-MS; Amy Goldstein and Susan Schmidt, "In Annapolis," Washington Post, 6 March 1988.
111Haggerty: Haggerty, Israeloff interv, 6 Ju1 76, folder 130, box 9/18, MSC-USACMH.
112Frustrations: Vernon McKenzie, Ginn interv, 20 Jun 84. Quoted words: Jordan, remarks to staff luncheon, Washington, D.C., 5 Sep 84, author's notes, DASG-MS.
113Quoted words: CMT 2, Col Fred L. Walter, MSC, 7 May 80, to DF, Ch, MSC, 2 Apr 80, DASG-MS.