U.S. Army Medical Department, Office of Medical History
Skip Navigation, go to content

HISTORY OF THE OFFICE OF MEDICAL HISTORY

AMEDD BIOGRAPHIES

AMEDD CORPS HISTORY

BOOKS AND DOCUMENTS

HISTORICAL ART WORK & IMAGES

MEDICAL MEMOIRS

AMEDD MEDAL OF HONOR RECIPIENTS External Link, Opens in New Window

ORGANIZATIONAL HISTORIES

THE SURGEONS GENERAL

ANNUAL REPORTS OF THE SURGEON GENERAL

AMEDD UNIT PATCHES AND LINEAGE

THE AMEDD HISTORIAN NEWSLETTER

Chapter 4

A Decade of Progress - Contents

Personnel

Medicine is a strange mixture of speculation and action. We have to cultivate a science and to exercise an art. The calls of science are upon our leisure and our choice; the calls of practice are of daily emergence and necessity.- PETER MERE LATHAM.

THE SURGEON GENERAL'S PERSONNEL POLICY

General Heaton repeatedly said, "Our most precious commodity is man." Elaborating on this concept, he remarked on a number of occasions, "Our function revolves around man, man as the patient and the professional man-the doctor, the scientist, the research worker, the dentist, the veterinarian, and the nurse." In those words, General Heaton described his own essentially humanistic concept of the Department he commanded for 10 eventful years. This philosophy, to which he was firmly and completely committed as The Surgeon General, gave impetus to many plans and programs designed to recruit and retain men and women of the highest caliber for service in the six corps of the Army Medical Department. The comprehensive nature of General Heaton's direct interest and involvement in personnel matters ranged from personally counseling officers to attending time-consuming meetings to press for legislation which would encourage valuable personnel to stay with the Medical Department.


94

MILITARY PERSONNEL

Authorization and Strength

The period from 1959 to 1965 was marked by the steady and progressive growth of the Army Medical Department. In 1965, the first year major Army forces were committed to combat in Vietnam, the size of the Medical Department increased correspondingly. The authorized strength of Medical Department officers rose from 14,857 to 17,241, and actual strength increased from 15,205 in fiscal year 1965 to 17,820 in fiscal year 1966. Since that date, the number has continued to increase gradually to an authorized strength of 21,299 and an actual strength of 20,842 in 1968, as shown in table 2.

TABLE 2.-Authorized and actual strengths of Army Medical Department officers, worldwide, by corps, fiscal years 1959-68

Corps and year

Authorized

Actual

1959

 

 

Medical

3,489

3,614

Dental

1,789

1,801

Veterinary

400

402

Medical Service

3,517

3,480

Army Nurse

3,300

3,367

Army Medical Specialist

400

421

 
Total

12,895

13,085

1960

 

 

Medical

3,580

3,644

Dental

1,834

1,747

Veterinary

400

404

Medical Service

3,490

3,478

Army Nurse

3,390

3,314

Army Medical Specialist

410

418

 
Total

13,104

13,005

1961

 

 

Medical

3,592

3,623

Dental

1,849

1,781

Veterinary

400

400

Medical Service

3,490

3,430

Army Nurse

3,275

3,244

Army Medical Specialist

425

423

 
Total

13,031

12,901

 


95

TABLE 2.-Authorized and actual strengths of Army Medical Department officers, worldwide, by corps, fiscal years 1959-68- Continued
 

Corps and year

Authorized

Actual

1962

 

 

Medical

4,325

4,345

Dental

2,062

2,076

Veterinary

475

475

Medical Service

3,880

3,811

Army Nurse

3,600

3,220

Army Medical Specialist

450

430

 
Total

14,792

14,357

1963

 

 

Medical

4,324

4,345

Dental

2,092

2,332

Veterinary

490

488

Medical Service

4,091

4,042

Army Nurse

3,340

2,971

Army Medical Specialist

460

431

 
Total

14,797

14,609

1964

 

 

Medical

4,510

4,759

Dental

2,108

2,493

Veterinary

518

554

Medical Service

4,266

4,230

Army Nurse

3,340

2,961

Army Medical Specialist

460

450

 
Total

15,202

15,477

1965

 

 

Medical

4,510

4,662

Dental

2,108

2,149

Veterinary

533

562

Medical Service

4,306

4,305

Army Nurse

2,940

3,071

Army Medical Specialist

460

456

 
Total

14,857

15,205

1966

 

 

Medical

5,350

5,546

Dental

2,431

2,617

Veterinary

544

608

Medical Service

4,849

4,864

Army Nurse

3,590

3,725

 


96

TABLE 2.-Authorized and actual strengths of Army Medical Department officers, worldwide, by corps, fiscal years 1959-68-Continued
 

Corps and year

Authorized

Actual

Army Medical Specialist

477

460

 
Total

17,241

17,820

1967

 

 

Medical

6,519

6,303

Dental

2,703

2,656

Veterinary

576

637

Medical Service

5,601

5,639

Army Nurse

4,500

4,531

Army Medical Specialist

500

502

 
Total

20,399

20,268

1968

 

 

Medical

6,719

6,251

Dental

2,778

2,748

Veterinary

626

635

Medical Service

5,751

5,890

Army Nurse

4,875

4,734

Army Medical Specialist

550

584

 
Total

21,299

20,842

Despite the favorable overall growth, the decade was marked by a chronic shortage of officers in the Army Nurse Corps and, to a lesser degree, the Army Medical Specialist Corps.

Measures To Overcome Critical Shortages

In the past decade, the Army Nurse Corps under its four able chiefs-Colonel Inez Haynes, Colonel Margaret Harper, Colonel Mildred I. Clark, and currently, Colonel Anna Mae McC. Hays-grew in professional stature as one of the major corps of the Army Medical Department. Originally a female component of the Medical Department but now a co-ed corps, with approximately 22 percent of its strength being male, the Army Nurse Corps enjoyed the same privileges of rank, pay, and promotion as did the predominantly male corps, even to the extent of being authorized the grade of briga-


97

dier general for its chief. This prestige was achieved despite the handicap of a perennial shortage of qualified personnel.

The chronic shortage of Army Nurse Corps officers on active duty reflected the nationwide shortage of qualified nurses. General Heaton appreciated the complexity of the problem of attracting and retaining well-trained nurses for Army service under these circumstances. Recognizing the seriousness of this shortage, he wholeheartedly supported the recruitment efforts of the Army Nurse Corps.

Walter Reed Army Institute of Nursing.-When traditional recruiting methods and programs failed to reach their goals, General Heaton proposed a bold, new approach to the problem, recommending that the Army reestablish a school of nursing to train men and women for a career in the Army Nurse Corps.

Major General Conn L. Milburn, Jr., Deputy Surgeon General from July 1963 to May 1965, described General Heaton's great personal and untiring efforts which led to the reestablishment of an Army school of nursing. "General Heaton recalled," wrote General Milburn, "that the Army had conducted its own School of Nursing at Walter Reed from 1917 to about 1931. This school was most successful in producing outstanding nurses for the Army. It was discontinued when it became uneconomical to operate in light of the fact that the Army could get as many nurses as it needed from the civilian schools and profession." With the knowledge, however, that national nurse resources were inadequate, General Heaton decided in mid-1963 to reestablish the Walter Reed School of Nursing to help alleviate the shortage of Army nurses. He also decided that the school should offer a 4-year degree course so that the best educated and trained nurses could be obtained for the Army.

Giving this essential program his full attention, General Heaton personally pushed it successfully through the Department of the Army and through the Congress


98

and obtained the necessary authority, approval, legislation, and funds.

Since the military departments do not have the authority to grant professional degrees, it was necessary to arrange an affiliation with a college or university to grant the graduates of the school the degree of bachelor of science in nursing. "Overcoming many hurdles," wrote General Milburn, "including resistance from some circles of the civilian nursing profession, an affiliation between the Army Medical Department and the University of Maryland School of Nursing was finally achieved."

The nursing school program first became effective in the fall of 1964, and as a recruitment program, its objectives were long range rather than immediate. It was believed, however, that as a superior school program it would focus attention on the many fine career opportunities available in the Army Nurse Corps and would attract increased numbers of qualified nurses so greatly needed for leadership positions within the Army. Those selected to enter the Walter Reed Army Institute of Nursing program were enlisted in the U.S. Army Reserve and concurrently called to active duty for 4 years.

For the first 2 years of study, the applicant might choose any accredited 4-year college or university which offered a curriculum leading to a bachelor's degree. After successful completion of these first 2 years, the student was transferred to the Walter Reed Army Institute of Nursing to begin clinical and hospital professional training at Walter Reed General Hospital, the second half of the 4-year nursing course. The faculty at Walter Reed was comprised of both Army nurse instructors and University of Maryland School of Nursing instructors.

Upon completion of the 4-year course, the University of Maryland awarded the graduate a bachelor of science degree in nursing, and the Army offered a commission as second lieutenant in the Army Nurse Corps of the Regular Army. The newly appointed officer was obligated to serve on active duty in the Army Nurse Corps for 3 years.


99

The first class of 58 students entered in the fall of 1964 and was graduated in June 1968; each graduate accepted the Army commission. Since that first class, four additional classes entered each fall, with an annual enrollment calculated to assure that the Army Nurse Corps would acquire 100 registered nurses each year. That these nurses were trained in an Army hospital provided better Army nurse personnel, in that upon graduation they were already familiar with Army methods and procedures.

Because of General Heaton's foresight and his imaginative approach to the resolution of a severe and chronic problem, the Army not only had a superior school program but also was assured of a cadre of Army-oriented trained nurses entering active duty each year. Furthermore, it was not unlikely that these nurses, already familiar with the Army milieu, would stay in service well beyond the 3 years for which they were obligated. This expectation was based upon experience with the medical internship and residency training programs; young physicians trained in Army hospitals tended to remain in service beyond their required time at a greater rate than those whose training was entirely in civilian facilities.

Recruitment program of the Army Medical Specialist Corps.-Since its establishment by the Congress in 1947, the Army Medical Specialist Corps has well earned General Heaton's description of it as "a young and progressive corps." These qualities were reflected especially in its educational programs and in the ever-constant assessment of its activities to assure the highest professional standards.

In this last decade, the Army Medical Specialist Corps made marked scientific advances and achieved greater professional growth under the able leadership of Colonel Harriet S. Lee, Colonel Ruth A. Robinson, Colonel Lois M. Forsythe, and Colonel Mary L. Hamrick. That it enjoyed the same privileges of rank, pay, and promotion as did the other five corps of the Medical De-


100

partment was evidence of the full professional stature of its three component professions-dietetics, physical therapy, and occupational therapy. Initially a completely female component of the Medical Department, it is now, like the Army Nurse Corps, also co-ed, with approximately 28 percent of its strength being male.

During the early part of the past decade, the Army Medical Specialist Corps was faced by a shortage of personnel qualified in its three professional fields. This, too, paralleled the problem faced by the Army Nurse Corps and the known nationwide shortages of such professional specialists.

The Army Medical Specialist Corps recognized that the most effective means of meeting personnel requirements under such conditions was through education and training programs, to which General Heaton wholeheartedly agreed and to which he gave unstintingly of his support.

By the end of fiscal year 1968, as a result of a well-defined and progressive program, for the first time in many years, the Corps' actual strength of 584 officers on active duty significantly exceeded its authorized strength of 550; this was not even matched during the Army buildup in support of the fighting in South Vietnam, when the 460 actual strength of the Corps was 17 short of its authorized 477 spaces.

Of the total Army Medical Specialist Corps strength, approximately 25 percent was outside the continental United States in 1968, from Japan and South Vietnam, to Germany.

Career Planning

General Heaton recognized the particular importance of career planning in advancing all professional capabilities and gave unreserved support to forward-looking training. During his tenure as The Surgeon General, each of the Corps developed a dynamic career planning program tailored to its peculiar needs and requirements.

Medical Corps.-In consonance with General Heaton's


101

dictum that "The physician is, and always will be, the central figure in the practice of medicine," policy changes in career-planning activities for officers of the Medical Corps inaugurated a cohesive program of improvements and advancement. These policies soon began to attract the highest caliber of personnel and to provide them the maximum opportunity to become outstanding physicians, soldiers, and leaders. Emphasis was placed on extended career planning, with assignments designed to achieve the long-range objectives. Such opportunities were made available to the young Medical Corps officer who was just starting his professional and military career, and in equal measure to the outstanding medical specialist, to increase the depth of his qualifications with command and staff experience.

For the young Medical Corps officers, particularly those finishing residencies, who demonstrated and indicated a sincere desire to achieve status not only as medical specialists but also as soldiers, medical executives, and leaders, plans extending for 10 to 15 years were made, with fairly firm commitments on specific assignments to achieve their goals.

The significance of this long-range career planning was that it ensured to the Medical Department a corps of medical officers of exceptional motivation, who possessed specific training for both the military and the professional aspects of their dual responsibilities.

Indicative of General Heaton's deep concern and personal involvement in guiding and directing the development of promising younger officers in the Medical Corps was the fact that he or a representative from his office personally interviewed Medical Corps officers in the field. During these interviews, both in the United States and overseas, subjects discussed included those bearing on future assignments, job-related problems, and career opportunities. This personal interest on the part of The Surgeon General raised morale and stimulated esprit de corps, particularly among the medical officers in the combat zone. Equally indicative was the fact that a new


102

position, Assistant Surgeon General for Medical Corps Affairs, was established in the Office of The Surgeon General to plan, program, and direct the activities of the Corps.

Dental Corps.-In working toward the objective of providing quality dentistry to every patient who was entitled to care, the Army Dental Corps reflected General Heaton's concept that the soldier must go "first class" where medical service was concerned.

During the past decade, the Dental Corps, under the leadership of three outstanding dental officers-Major General James M. Epperly, Major General Joseph L. Bernier, and Major General Robert B. Shira-strived to achieve this objective through the aggressive pursuit of activities aimed to enhance the professional and leadership qualities of its officers and to find new and better means of detecting and eliminating oral diseases.

Under General Heaton, the Education and Training Program of the Army Dental Corps expanded steadily during the past decade. By fiscal year 1965, the goal of formal training for all outstanding career dental officers was in sight. Training programs were available in all recognized specialties, in allied disciplines, and in staff and administrative positions. The long-range training program made available further educational opportunities.

During this 10-year period, a significant change in the career planning of dental officers took place. Previously, only a small percentage of career officers could expect to attend the Army Medical Department's Career Course at Brooke Army Medical Center; under the revised policy every career dental officer was scheduled for the career course as soon as possible after completion of 3 years of service.

The former Dental Continuing Education Program ensured that each dental officer on active duty would continue his professional courses, short civilian courses, clinics, seminars, study clubs, and other educational activities.


103

Army Nurse Corps.-The basic concept of the Army Nurse Corps career planning was to provide the Corps with officers who were clinically qualified in patient care, capable of functioning in all types of medical facilities under all conditions and at various levels of responsibility, and capable of training and directing enlisted and civilian personnel of the nursing service. Assignments were carefully planned to include clinical experience in teaching and nonteaching hospitals, and in field units whenever possible.

To assure progressive career-planning patterns, The Surgeon General directed the reorganization of the Army Nurse Corps Branch to combine career planning and assignments. This reorganization increased individualization and personalization of the career development of Army Nurse Corps officers and enabled personnel officers to follow through on career plans for individual officers. These officers, while training and experience gained through a carefully planned career, will provide the Corps with replacements for retiring chief nurses and staff officers.

Medical Service Corps.-The development of the Medical Service Corps in the period since 1959 illustrated General Heaton's firm belief in the importance of the paramedical elements of the Army Medical Department in accomplishing its mission. Further, it reflected General Heaton's profound understanding and appreciation of the interrelation of all facets of the Medical Department to achieve his goals.

The Medical Service Corps, through allied sciences and medical administration and management, assisted The Surgeon General in attaining the major objective of his office-to provide the American soldier and his dependents with the finest medical service possible.

The Corps comprised trained specialists in pharmacy, sanitary and industrial hygiene engineering, physical reconditioning, clinical psychology, optometry, psychiatric social work, medical supply, and general and hospital administration. They were called upon to meet


104

the same rigorous professional standards as demanded in the other corps of the Army Medical Department. That they meet these standards was evident in the mark the Medical Service Corps made in the field of education. Commenting on the level of education of officers in the Medical Service Corps, Major General Laurence A. Potter said: "We have in the Medical Service Corps by far the highest percentage of officers with advanced degrees of any comparable group of officers,"-of course, with the exception of the doctors of medicine, dental science, and veterinary medicine. Fiscal year 1968 statistics showed that approximately 91 percent of all Medical Service Corps officers had earned at least a bachelor's degree, about 20 percent possessed master's degrees, and 3 percent held doctorates. This compared to overall Army figures showing 67 percent of all commissioned officers with bachelor's degrees or better, 8 percent with master's degrees, and less than 1 percent with doctorates.

Under General Heaton, the Medical Service Corps "came of age" in 1962. On 20 August of that year, General Heaton authorized the chief of the Corps, then Colonel Roy D. Maxwell, to exercise managerial control over the Corps. The traditional role of the chief of the Medical Service Corps as an adviser to The Surgeon General was thus changed to one of direct supervision of staff functions relating to the recruitment, utilization, and career management of members of the Corps. By this action, General Heaton accorded official recognition to the fully achieved professional stature of the Medical Service Corps-for the first time, the chief of the Corps was on a par in authority as well as in responsibility with the chiefs of the other corps in the Army Medical Department.

With Colonel Maxwell's retirement in February 1963, Colonel William A. Hamrick became the Corps chief. In 1966, as a result of his untiring efforts in behalf of the Army Medical Department, General Heaton achieved a major objective-legislation authorizing the Medical Service Corps one officer in the grade of brigadier gen-


105

eral. The Corps chief was promptly promoted to the grade of brigadier general and Brigadier General Hamrick became the first Medical Service Corps officer to hold general officer rank.

Concurrent with those actions taken to raise the Medical Service Corps to a par with the other corps in the Army Medical Department, General Heaton directed other organizational changes to achieve better long-range career planning and assignment, stable uniform personnel policies, and improved staff procedures. As a result, all aspects of the career-planning program, by which attrition rates for specialists were determined to assess needs and shape training accordingly, were enhanced. All Medical Service Corps officers enjoyed excellent career-development opportunities through inservice training or by acquiring advanced education at military or civilian institutions.

Of the 5,751 Medical Service Corps positions authorized in fiscal year 1968, approximately 33 percent were in overseas locations, and a substantial proportion of these were in South Vietnam. There, Medical Service Corps officers made outstanding contributions to the war effort-they provided sophisticated medical supply support; served as Medical Service Corps aviators in evacuating casualties from the combat zone; and assisted civilian paramedical personnel in support of relief and rehabilitation programs.

The first Army Medical Department facility to memorialize a Medical Service Corps officer was the Charles L. Kelly Heliport at the Brooke Army Medical Center, dedicated in April 1967. Major Charles L. Kelly, MSC, was the first Army Medical Department pilot to be killed in action in Vietnam.

Veterinary Corps.-Soon after he became The Surgeon General, General Heaton paid tribute to the performance of the Veterinary Corps in World War II in these words: "It is impossible to overemphasize the contribution to the war effort made by the Veterinary Corps in the maintenance of the health of the Army by its food inspection


106

service." Since then, his directives-implemented successively by Corps chiefs Brigadier General Russell McNellis, Brigadier General George A. Kuhn, and Brigadier General Wilson M. Osteen-served to raise even higher the capabilities of the Corps to carry out a wide variety of assignments. All activities of the Corps assisted the Army Medical Department in protecting the health of men and animals.

During the past decade, the purpose of career planning activities was to prepare Veterinary Corps officers to meet new commitments. Thus, from time to time, new courses were added to the curriculum of the Army Medical Department's Veterinary School. One addition, for example, Veterinary Public Health, International Aspects, provided selected officers with the knowledge of methods of preventing and controlling veterinary-related diseases occurring in areas where American troops were located. A new professional short course in biostatistics and experimental design was also added at the Veterinary School, dealing with statistical methodology for biomedical research.

The mission of the Veterinary School was expanded in fiscal year 1967, when the school was directed to provide mobile veterinary teams, for assignment upon request of major commanders. These teams were prepared to give instruction in areas of urgent need, as determined by the command, or to perform special inspection duties in any part of the world.

In fiscal year 1968, 197 officers participated in various officer skill courses providing instruction in phases of veterinary medicine applicable to a military environment. This included 144 officers who successfully completed Veterinary Preventive Medicine and Food Inspection, the basic course for newly inducted officers preparing for food-inspection assignments.

At the same time, 173 officers graduated from the officer professional courses, an aspect of the integrated career-planning program of the Corps. This training emphasized the role of the veterinarian as a military


107

officer in the Army Medical Department and imparted general military skills.

Army Medical Specialist Corps.-A major objective of the well-defined and progressive career-management program of the Army Medical Specialist Corps, a program which provided professional, undergraduate, career-orientation, and graduate education and training, was to alleviate a shortage of personnel qualified in its three professional fields. Another was to enhance the professional stature of the officers serving in its three component professions-dietetics, physical therapy, and occupational therapy.

Throughout the past decade, the Army hospital food service program, which was under the direct supervision of dietitians, was conducted in an outstanding manner. In recognition of this, General Heaton, in August 1967, directed that dietitians be given new duties and responsibilities. Then for the first time in the history of the Corps, dietitians were officially authorized to the personnel complement of field hospitals. Several were sent to South Vietnam, and a dietitian was also appointed to the staff of the U.S. Army surgeon in Japan.

Qualified dietitians for the Army Medical Specialist Corps were selected mainly from graduates of the Dietetic Internship Program. By June 1967, because of the increased requirements of the war in Vietnam, this source was no longer adequate to meet dietetic personnel needs, for the current interns had completed only about 9 months of their 12-month internship. The Surgeon General, therefore, requested the American Dietetic Association, the approving authority for the internship program, to agree to the assignment of interns to staff positions upon completion of 10 or 11 months of training. This interim measure helped temporarily to alleviate the shortages.

An indication of General Heaton's interest in providing the best medical care to Army personnel was reflected in the revised organization and administration of physical therapy clinics, which was introduced into


108

Army hospitals with assigned physical therapists. By this reorganization, the knowledge, skill, and understanding of administration as it applied to physical therapy sections of Army hospitals increased. This in turn demonstrated the contribution physical therapists made to improve patient care.

To continue improvement in the quality and quantity of patient care, physical therapists were encouraged to obtain more comprehensive on-the-job training or advanced formal instruction. One physical therapy training program grew, in part, out of the 2-week Advanced Occupational Therapy Course conducted at the Walter Reed Army Institute of Research. The course as given in August 1963 was subsequently expanded to include physical therapy, and designated as the Advanced Occupational Therapy-Physical Therapy Course. Physical therapists also attended both military and civilian courses. Several in the latter category completed requirements for the master's degree.

The growing need for physical therapists had a continuing effect on training. In fiscal year 1965, the one-phase program for the Physical Therapy Course went into effect and soon proved its merits. A successful innovation was the complete integration of didactic and clinical work. The faculty of the Medical Field Service School was augmented by the addition of the Chief, Physical Therapy Section, Brooke General Hospital, and the section supervisors.

At the end of the decade, the training program for physical therapists included active duty for training. In fiscal year 1967, 11 physical therapists participated in the active-duty-for-training program. After a month at the Medical Field Service School, these officers were assigned to Brooke, Walter Reed, Valley Forge, Letterman, Fitzsimons, and William Beaumont General Hospitals for 5 additional months of training. The following year, 13 Reserve physical therapists participated in the training program, and after 6 months' service, seven of


109

these officers applied and were accepted for 18 months of additional active duty.

During fiscal year 1968, 10 physical therapists were assigned to South Vietnam in response to a change in procedure there. At that time, the practice of evacuating patients immediately to hospitals in Japan or elsewhere was changed in favor of retaining them for a longer period in hospitals in South Vietnam. This immediately resulted in a demand for physical therapists and brought about these assignments. It was a case of demand outracing organization, for the 10 therapists did not occupy authorized table of organization spaces. In addition, the therapists reached South Vietnam before their equipment, and at first had to improvise facilities and equipment to fulfill their mission.

Occupational therapy measures for use in hospital and outpatient treatment are designed, in part, for patients with a disability which will be directly benefited by the application of such measures; for patients with psychiatric disability; and for those patients whose disabilities are directly affected by their emotional state. Significant in the development of occupational therapy was the increase in the number of outpatients being treated by occupational therapy measures, and the extension of the practice of occupational therapy beyond the confines of the hospital environment.

An occupational therapy program, begun in fiscal year 1966, within the framework of the Mental Hygiene Consultation Service at Schofield Barracks, Hawaii, demonstrated the efficacy of the treatment tools of occupational therapy. Initially, this program was directed mainly to children, adolescents, and female dependents of military personnel, but subsequently, active-duty personnel profited from the experience thus gained. At the same time, hospital facilities were, in effect, extended by these methods, since they reduced the number of patients requiring hospitalization.

In the hospitals, occupational therapists continued to provide meaningful and therapeutic work for patients


110

suffering from various character disorders, and tested, evaluated, and treated dependent children with perceptual motor dysfunctions.

Noteworthy also was the expanded role of the occupational therapist. For the first time, occupational therapists were assigned to surgical research units and biomechanical research laboratories to serve as liaison officers among patients, physicians, and laboratory personnel and to contribute to the designing of prosthetic devices.

As with other segments of the Medical Department, occupational therapy programs were affected by the Army buildup in South Vietnam, with three class I hospitals establishing such programs, thereby increasing assignment areas for occupational therapists.

To keep pace with the advances in medical and surgical procedures which had changed the character and time-span of treatment programs, occupational therapists were continually encouraged to obtain further education and attend courses and conferences that would result in improved patient care.

During the past 10 years, the development of the Army Medical Specialist Corps reflected The Surgeon General's keen personal interest in building a complete, well-rounded Army medical establishment. The youngest of the six Army Medical Department corps, the Army Medical Specialist Corps is a valuable adjunct to the Army Medical Department team.

Measures To Retain Career Military Personnel

Recognizing that the possibility of improving the operation of the Army Medical Department diminished in direct relation to an increase in the rate of exodus of career officers, General Heaton sought in a variety of ways to make long-term service more attractive. As one means toward this end he sought to change, amend, and liberalize Department of the Army promotion policies to fit the special needs of the Medical Department. One result was that members of the Medical Service


111

Corps who held the doctoral degree in any of the allied sciences were made eligible for promotion to the grade of captain 18 months ahead of other officers with the same date of rank on the Army Promotion List. A second was an increase in the number of authorized spaces in the grade of colonel in the Army Nurse Corps and the Army Medical Specialist Corps from five to 20 and from one to four, respectively. In 1966, legislation authorizing the Medical Service Corps one officer in the grade of brigadier general was enacted. The Corps chief, then a colonel, was promptly promoted. In 1967, the Congress authorized the grade of brigadier general for the chief of the Army Nurse Corps and the Army Medical Specialist Corps. As late as March 1969, however, the chiefs of these corps had not been promoted to that grade.

Another measure was to press for legislation that would encourage talented personnel to remain with the Army Medical Department. These efforts resulted in Federal legislation which provided progressive opportunities for advancement in the medical service. Apart from these acts which have been discussed, several other laws enacted in the past 10 years are of note.

Public Law 90-228, enacted in December 1967, excluded Medical Corps officers from the ceiling imposed by the Officer Grade Limitation Act. This allowed the creation of a separate and improved promotion system for Medical Corps officers, independent of promotion time for all other corps. This new system, based on professional training and experience, provided automatic consideration for promotion to major after 8 years, or 3 years' time in grade; lieutenant colonel after 13 years' training and experience, or 5 years' time in grade; and colonel after 20 years' training and experience, or 7 years' time in grade. As a result, 187 lieutenant colonels were promoted to colonel during July 1968.

Public Law 89-152, the Variable Reenlistment Bonus Program, became effective throughout the Army in January 1966. It provided a bonus for enlisted personnel


112

in certain critical military occupational specialities, several within the purview of the Army Medical Department, who reenlisted.

Public Law 90-207 was essentially an extension of this same bonus concept to the Medical Corps. It provided for continuance pay for certain selected officers who would be difficult to replace. By obligating their services an additional length of time, these specialists were awarded additional compensation.

A third method used to encourage officers to remain in the medical service was the prompt and explicit recognition of professional proficiency. The degree of professional proficiency in a military occupational specialty is indicated by the use of letter prefixes, "A," "B," "C," and "D." "A," denoting attainment of the highest possible level of skill within an occupational specialty, is awarded only to a select few. That 60 Medical Corps officers were awarded the "A" prefix was indicative of the high degree of professional excellence attained by Army physicians under General Heaton's guidance.

The use of letter prefixes to denote professional proficiency in the Army Nurse Corps was again authorized in November 1962 after having been discontinued the year before. The prefix indicated the degree of proficiency gained by a combination of formal training, years of experience, and competence in a specialty within the field of nursing.

CIVILIAN PERSONNEL

More than 28,000 civilian doctors, nurses, scientists, technicians, and clerical and administrative personnel were a part of the Army Medical Department team by the end of the decade. Since he became chief of the Army medical service, General Heaton sought to attract and retain civilians of quality and merit to complement and supplement the military component of the Medical Department.


113

Recruitment Policies

The 10-year period during which General Heaton was The Surgeon General was marked by sharp competition between Government and industry and within the Government itself for qualified and experienced scientists, technicians, administrators, and managers. Recruitment of well-trained and experienced personnel for top-level medical research and scientific as well as managerial positions was a difficult and chronic problem. At no time, for example, had the quota for supergrade positions allotted to the Army Medical Department been completely filled.

Concurrently with his untiring effort to recruit mature and experienced personnel for higher grade positions, General Heaton directed his attention to the recruitment of suitable candidates for a long-range career development program. As a result of this effort, about 20 trainees were hired by the Army Medical Department for career development in a variety of fields ranging from comptroller functions to supply management, from civilian personnel administration to safety management.

Career Management Programs

Beginning in 1959, formal career management programs for civilian employees in 12 major occupational groups-civilian personnel administration, comptroller functions, safety management, supply management, procurement, education and training, equipment specialist, librarians, information and editorial, automatic data processing, intelligence, and engineers and scientists-were started in the Office of The Surgeon General and at class II activities.

The objective of these programs was to improve the effectiveness of the civilian work force by providing organized and systematic opportunities for employees with demonstrated abilities to advance progressively to positions of increasing importance and responsibility.

In another effort to develop the capabilities of civilian


114

employees, the Medical Department Central Funding Program was established in the Office of The Surgeon General in 1964. Similar to the program for military personnel, it was designed to finance off-post training of civilian employees. Since the program was established in 1964, the number of civilians participating in off-post training programs doubled.

Support of Federal Employment Policies and Programs

General Heaton fully supported the Equal Employment Opportunity Program. When it was inaugurated, he wrote personal letters to his installation commanders, urging them to employ the mentally retarded and physically handicapped as well as members of disadvantaged groups to the maximum extent possible. Since its introduction throughout the Army Medical Department, the Equal Employment Opportunity Program has been progressively and successfully expanded by making more positions available to disadvantaged persons, by giving wide publicity to job opportunities for minority groups, and by encouraging self-development and education. In 1967, Valley Forge General Hospital was awarded a citation by the President's Committee on the Employment of the Handicapped for its outstanding efforts in developing job opportunities for mentally retarded persons.

Army Medical Department participation in the Youth Opportunity Program has also progressively increased. From a modest beginning in 1965, when 86 disadvantaged young people were employed during the summer months, the program has grown to the extent that the Medical Department hired about 650 summer employees under the program in 1968, including about 200 in the Washington area.

General Heaton described the practice of medicine in the Army Medical Department as "a team effort in the broadest, and at the same time, most exacting possible sense." The responsibility of medical administration, he added, was "to forge the separate elements into a perfectly balanced team."


115

As chief administrator of the Army Medical Department, General Heaton implemented that responsibility through actions broadly planned and closely coordinated throughout. The results of this effort were evident everywhere; nowhere did they show to better advantage than in his military and civilian personnel policy which was to recruit the best and retain the finest.

Ten years of leadership by General Heaton produced a functional entity of which it can be said, in truth, that the whole exceeded the sum of its parts.