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HISTORY OF THE OFFICE OF MEDICAL HISTORY
Demobilization of Dental Corps Personnel
WORLD WAR I
Following World War I, demobilization of Dental Corps personnel was rapid and relatively uncomplicated. Those overseas had to be returned to the United States, and some dentists were retained to care for the 120,000 casualties under treatment in general hospitals when the armistice was signed,1 2 but reduction of the Army to a skeleton force soon after hostilities ended greatly simplified planning for the postwar period. Since no dental officer had to serve very long after the end of the war each man could be discharged as his unit was disbanded or as he became surplus to its needs. No elaborate plans for interchanging dentists between organizations or even between geographical areas on the basis of length of service, dependency, et cetera, were necessary. Under the policy of "down the gangplank and out," dental officers in units with a low priority for disbandment had to serve a little longer than those in more fortunate commands, but since all nonvolunteers could be ordered released by 1 October 1919, no man had to serve as much as a year beyond the armistice against his will.3 From 11 November 1918 through June 1920 the Dental Corps was reduced as follows:4
WORLD WAR II
Demobilization From V-E Day to V-J Day
The early losses of physicians and dentists at the close of World War I had, at times, seriously hampered the medical service. With this in mind, The
1Annual Report of The Surgeon General, U. S.
Army, 1919. Washington, Government Printing Office, 1919.
Surgeon General pointed out as early as August 19435 and later in April 1944 6 that demobilization of Medical Department officers would not only fail to precede that of other branches, but would lag behind if the needs of the sick were to be met and separation examinations carried out.
With the end of the war in Europe, pressure for the release of medical and dental officers increased rapidly. Within 1 month after V-E Day a Senate resolution was submitted calling for an investigation of "hoarding of physicians and dentists" by the Army,7 and this action was just one symptom of the general expectation that Medical Department personnel would be discharged in large numbers as soon as Germany was defeated. The Surgeon General, however, consistently discouraged this attitude for the following reasons:
1. The war was not ended; it was to a great extent merely transferred to the Pacific area. Many units in Europe would be held for occupation duties; others would be sent to the Pacific either directly or after furloughs and retraining in the United States.
2. Except in Europe The Surgeon General had no excess of Medical De-partment personnel. On the other hand, shipping priority went to units being transferred to combat areas, and other categories had to wait. In July 1945 it was reported that there were 6,000 surplus medical officers in Europe, but that current shipping schedules would return only 30 percent of them to the United States before the end of October.8 As early as September 1944 The Surgeon General had asked for the early shipment of Medical Department personnel after the end of hostilities in Europe,9 and in June 1945 the War Department had directed such return,10 but a force which had been building up for 3 years could not be moved in a few weeks. Also, some time was required to screen Medical Department personnel on duty in Europe to determine which should be sent to the Pacific, which held for occupation duties, and which returned to the United States. Meanwhile, units awaiting return had to be supplied medical care.
3. Shipping shortages had precluded the regular rotation of personnel between overseas theaters and the Zone of Interior. Now that units were passing through the United States en route to the Pacific it was necessary to replace men with the most overseas service with Zone of Interior personnel who had not had foreign duty. But each such exchange required 2 extra officers for a period of 2 months or more. The officer returning to the Zone of Interior had to be given leave and travel time before he reported to his new post; the officer
5Memo, Col R. W. Bliss for Dir Spec Planning
Div, WDGS, 16 Aug 43, sub: Demobilization planning. SG: 370.01-2.
replacing him had to be granted leave and travel time before he left for overseas; a third officer had to be assigned to provide care in the absence of the other two. The Surgeon General estimated that the necessity for reshuffling personnel to meet the needs of the Pacific theater would delay the separation of surplus European theater officers by nearly 5 months.11 From 20 June through 15 August 1945, 4,000 medical officers were exchanged between units.12
4. Casualties in Army hospitals had to be provided attention, and separa-tion and redeployment centers had to be staffed, regardless of the end of the war in Europe.
Based on these considerations, General Kirk predicted in July 1945 that there would be no large scale separation of Medical Department personnel before the end of the year.13
During this period the situation was further complicated by the necessity for a general reconsideration of all personnel assignments. The fact that a man with 18 months' service was surplus in Europe did not justify his release from active duty if men with 36 months' service were still being held in the Pacific, and it was essential that there be established a basis for the equitable discharge or reassignment of all Medical Department personnel regardless of current place of duty. This was accomplished by an "adjusted service rating" (ASR) scored on the following credits:14
(ASR scores were first calculated as of 12 May 1945; they were later adjusted as of 2 September 1945.)
On the basis of the ASR, personnel overseas were divided into the following categories:15
1. Men with the fewest points were put in units bound directly for the Pacific.
2. Men with slightly more points were put in units bound for the Pacific after a stopover for furloughs and training in the United States.
3. Men in the median ASR categories were returned to the United States for assignment to a strategic reserve for duty in the Pacific when and if needed.
4. Men in the moderately high point categories were held in Europe for occupation duties until eligible for release from the Army.
11Official announcement on redeployment and
separation of Medical Department officers. J. Am. Dent. A. 32: 1177-1182,
5. Highest point men were to be returned to the United States for immediate discharge.
On arrival from overseas any dental officer who was either over 50 years of age, or had an ASR over 100, was discharged.16 Officers on duty in the United States were supposed to be discharged on the same basis, but ASF had to hold temporarily dentists with less than 110 points and. refused to release any for age. A dental officer who: (1) was 40 years of age, (2) had 75 points, or (3) had 6 months of overseas service, was withdrawn from any unit on the way to the Pacific and replaced by one currently on duty in the United States. This "withdrawal score" was slightly lower than that for medical officers which required either age 45 or 12 months of overseas service. Officers who desired to remain on duty and who were wanted by the Army could voluntarily forego the privilege of separation. The fact that few dentists were expected to be discharged immediately is indicated by the estimate of the Resources Analysis Division of the Surgeon General's Office that under the criteria discussed only 31 men would be released in the United States and about 250 or 300 in Europe. Separation of men over 50 in the Zone of Interior was not recommended to start until September or October.17
Beginning on V-E Day, a special effort was made to, have certain in-structors released to resume their positions in dental colleges. The Procurement and Assignment Service notified the deans to name any five key men on their faculties whom they particularly needed. Names submitted were for-warded to The Surgeon General who in turn asked the theaters to return these men for discharge as soon as possible.18 This program continued from V-E Day until the end of 1945 but was overtaken by the general demobilization following V-J Day. The total separated under it is not known; 18 dental officers were discharged as essential to national health or interest, and 20 more were discharged as key men in government or industry. Instructors might have fallen in either group as well as in other administrative categories. It is probable that many instructors were released in the normal, accelerated demobilization which followed V4 Day before their discharges could be accom-plished under The Surgeon General's program. As late as 11 September 1945, for instance, overseas commanders were asked to release 19 dental instructors,19 and most of these must have been nearly eligible for release on other criteria by the time these requests could be carried out.
16See footnote 15, p. 334.
It will be noted in Table 16 that during the months of May, June, July, and August 1945, 610 dental officers were discharged from the Army.20
TABLE 16. DEMOBILIZATION OF DENTAL CORPS OFFICERS BY MONTHS, MAY 1945-JUNE 1947
The release of any large number of dental laboratory technicians immediately following V-E Day also proved impractical. In September 1944 The Surgeon General, foreseeing a moderate shortage of such personnel, had recommended that they be retained by Zone of Interior service commands until declared surplus by the surgeon.21 At first it was not expected that the shortage would be sufficiently severe to warrant transferring technicians from commands where they were surplus to others where they might be needed, but on 7 June 1945 the War Department directed that certain enlisted men, including dental technicians, be transferred to new commands when declared surplus in their own units. However, organizations receiving these men were to use them only in their special duties, and they were to be released as soon as replacements could be obtained; assignment overseas of technicians otherwise eligible for
20Table 16 assembled from data given the author
on 13 Feb 48 by the Strength Accounting Br, AGO. It should be noted that
the AGO did not process separations until the end of terminal leave which
was often several months after the last day of active duty. However, in
the demobilization of Dental Corps officers, as shown in Table 16, the
date indicates the actual month in which the officers were lost to the
effective, administrative strength of the SGO.
discharge was prohibited.22 By 31 August 1945 it was possible to direct that no dental technician would be transferred to another command when he became surplus in his own.23
Demobilization after V-J Day
(See Table 16 for separations by months)
The composition of the Dental Corps on W Day in respect to priority for discharge is not known. On V-E Day, however, there were approximately 14,700 dentists oil duty, distributed as follows:24
Most of the ASTP graduates listed were ineligible for separation until long after V-J Day so it can be assumed that the majority of the 610 dental officers discharged between V-E Day and V-J Day came from the category of AUS officers desiring early separation, leaving about 11,190 men in this group at the end of hostilities. Procurement from civil practice had practically ceased in December 1943, and over 9,000 dentists had come on active duty before the end of 1942, so that by V-J Day almost all non-ASTP AUS officers had had over 1 1/2 years of service and a large proportion of them had been in the Army more than 2 1/2 years. The release of such a number of high point men in the proper priority, according to length of service and dependents, and without jeopardizing the provision of essential care for an Army which at the end of 1945 still numbered over 4 million men, was certain to involve knotty problems.
It has been seen that prior to V-J Day dentists returning from overseas were separated only if they had 100 points or were over 50 years of age; in the United States they could be released only if they had 110 points. On 8 September 1945 new separation criteria for both the Medical and Dental Corps provided that field grade officers (colonels, lieutenant colonels, majors) with 100 points, and company grade officers (captains, lieutenants) with 85 points, could be released. On the same day the Resources Analysis Division, SGO, recommended that the criteria for medical and dental officers be further reduced to 80 points, and that additionally, any man 48 years of age or over, or who had been in the Army on 7 December 1941, should be released. On 12 September 1945 this recommendation was approved and published.25 Medical and dental officers thus enjoyed, temporarily, more favorable separation criteria than those of most other branches who were still required to have ASR's of 100 points for officers of field grade, and 85 points for men of company grade.
22WD Memo 615-45, 7 Jun 45.
On 14 September 1945 The Surgeon General promised to release 10,000 dental officers by the end of June 1946.26 A few days later it was stated that 3,500 dentists would be separated by 25 December 1945. An additional number of dental officers became eligible for separation when ASR scores were recomputed on 2 September to include credit for service subsequent to V-E Day. On 17 September 1945 it was announced that no dentist would be sent overseas if he was 40 years of age or had 45 points.27
On 22 September War Department Circular 290 emphasized and liberalized somewhat the provisions of WD Circular 485, 29 December 1944, concerning release of officers not eligible for separation on point scores.28 Specifically, it authorized separation of the following:
1. Officers who were surplus to the needs of the Army, and who could not be economically trained in new positions, if they had served a reasonable period.
2. Individuals presenting documentary evidence that they would be more useful to the nation in a civilian capacity.
3. Individuals who had suffered undue hardship by reason of military service.
4. Officers over 50 years of age, at their own request.
On 1 October 1945 separation criteria for male officers of most branches were reduced to a straight 75 points but medical and dental criteria remained unchanged, thus for the first time placing this group at a slight disadvantage. On 6 October the War Department notified all commands that civilian needs for Medical Department personnel were critical and directed them to be alert for the uneconomical use of physicians, dentists, and nurses. Persons found surplus were to be released without delay; overseas personnel were to be returned by the fastest transportation, and Medical Department officers processed expeditiously through separation centers.29 On 16 October, The Adjutant General asked Zone of Interior commands to release physicians and dentists with at least 2 years' service at any time they became surplus, regardless of points.30 Such cases were to be referred to The Surgeon General for final decision, but telephone communication was authorized. On 18 October The Surgeon General complained that Medical Department officers eligible for release were still being held as essential, and emphasized that such action was permissible only in very exceptional cases.31
On 20 October separation criteria for medical and dental officers were again dropped below those of the line branches when either an ASR of 70 points, or 45 months of total service, were specified.32 On 1 December 1945 separation criteria for line branches were dropped to 73 points and the maxi-
26Army to release more medical officers. J.
Am. Dent. A. 32: 1321, Oct 1945.
mum service requirement for medical and dental officers simultaneously reduced to 42 months, though the ASR remained at 70 points. Former ASTP students received credit only for time served after receiving their commissions and were required to put in at least 36 months regardless of points.
On 7 December 1945 all previous agreements to volunteer for additional periods of service were cancelled. By that time it was possible to give temporary officers more complete information on the possibility of entering the Regular Army, the length of time they could expect to serve on foreign service, et cetera, and it was felt that they should be given an opportunity to revise their earlier commitments and plan their future on a more stable basis than had been practical immediately following the war. All officers were at this time required to sign statements placing them in one of the following categories:33
Category I-Elect to remain on active duty for an unlimited
On 31 December 1945 new criteria became effective under which physicians and dentists could be separated if they were 45 years of age, had 42 months of service, or an ASR of 65 points. Line officers were required to have either 70 points or 48 months total service. Somewhat more than 5,000 dental officers were separated between V-E Day and 31 December 1945 (see Table 16).
During the period from V-E Day to the end of 1945 the demobilization program of the Army in general and of the Medical Department in particular was the target of considerable criticism from Congress, the medical professions,34 and from laymen. Such criticism will he covered in detail in other sections of the Medical Department history, and will be discussed here only in relation to the Dental Corps.
On 1 October 1945 the American Dental Association reported that it had received many complaints on the slow release of dental officers.35 At that time this organization stated that it was not in a position to say whether the Armed Forces were justified in their separation policies, and limited its comments to pointing out the need for the earliest possible release of medical personnel. On 21 November 1945 the Secretary of War notified the Chief of Staff that be had received criticism of delays in releasing medical and dental officers, and that a threatened senatorial investigation had been called off only on his promise to investigate and take necessary corrective measures.36 He directed The Surgeon
33WD Cir 366, 7 Dec 45.
General and the General Staff to conduct a study to determine how many officers could be released and how they could be separated with the least delay. A mission of senior officers was to be sent to the overseas theaters and Medical Department personnel were to be shipped to the Zone of Interior as soon as declared surplus, even ahead of other, higher point officers.
On 1 January 1946 the ADA published a bitter editorial criticism of dental demobilization claiming that the Army and Navy had, at the very least, been "ultraconservative and discriminatory," that hundreds of dentists were standing idle while their professional skills rusted, and that there had been no apparent effort to discharge dentists in the same ratio as enlisted men.37
There is some statistical justification for claims that dental demobilization lagged behind that of the Army as a whole. The ratio of dental officers to total strength went from 1.74 per 1,000 troops on V-E Day to a maximum of 2.93 per 1,000 in December 1945, and did not return to the V-E Day average until the middle of 1946.38 However, other factors must be considered in this connection. Procurement had been allowed to lag for several months before the end of the war in Europe and the number of dentists on duty in May 1945 was about 500 less than the authorized figure. If dentists had been discharged in the same ratio as enlisted men, it would have been impossible to maintain a ratio of at least 2 per 1,000; dental officers would be the first to insist that such a ratio was necessary to render effective care. Dentists were needed to provide treatment for patients remaining in Army hospitals, and to examine and treat men being processed in separation centers. Further, the loss of time of dental officers during demobilization was high. Thus, although delayed demobilization of dental officers from V-E Day to the middle of 1946 did result in the ratio exceeding the normal proportion over a period of 6 months, in only 2 months did it exceed the 2 per 1,000 ratio by as much as 5 percent.
The Army as a whole had set for itself a demobilization program which no senior officer would guarantee could be met. In the face of that situation The Surgeon General had two choices: He might delay the separation of Medical Department personnel slightly until it was clear that the Army would actually be reduced as planned, or he might gamble on the demobilization program being carried out according to schedule and release every officer who could be spared. In the first case he risked criticism for holding officers a month or two longer than necessary; in the second he risked a breakdown of the medical service if shipping shortages or other circumstances delayed general demobilization. If a gamble had to be taken The Surgeon General apparently preferred to be sure that the troops would receive adequate medical care.39 The
37The right to gripe: the fifth freedom. J.
Am. Dent. A. 33: 118-122, Jan 1946.
fact that the Army demobilization schedule was not only met but exceeded did not impair the wisdom of that decision.
Claims that dental officers were not always fully employed probably arose most often from the fact that the flow of troops through separation centers could not be constant. At times there was more work than could be handled; at others there was little to do. But personnel in these centers could not be juggled from day to day to meet changing demands.
The slight extent to which the separation of dental officers was delayed in 1945 as compared with the Army as a whole, is shown by an analysis of the situation existing in December 1945 when the excess of dentists was at its maximum. In that month there were 2.23 dental officers for each 1,000 men, but if those who were separated just a month later had been discharged in December the ratio of dentists would have fallen to 1.7 per 1,000, or considerably less than the number actually needed. It is thus apparent that even when the situation was most unfavorable, dental officers could not have been separated more than a few weeks earlier without causing a shortage of personnel to staff essential dental installations.
It is significant in this connection that after repeated hearings on the "hoarding" of Medical Department personnel, in which the matter was thoroughly discussed before congressional committees, none of the proposed legislation to force faster demobilization was passed.
By the first of January 1946, the Dental Service was faced with a rapidly developing shortage of officers. On 21 January a representative of the Military Personnel Division, SGO, pointed out that procurement to meet postwar needs was very uncertain and that unless replacements could be obtained it would soon be necessary to hold the remaining dentists to provide essential care for the troops.40 He advised The Adjutant General that a new objective of 750 men would have to be established without delay if a, "serious public rela-tions problem" was to be avoided. This recommendation was approved,41 but in the absence of the ASTP and without the stimulus of patriotism in time of combat, only 15 dentists were obtained by the first of May. Nevertheless, a new change in criteria, effective 1 February, reduced the separation require-ments for both medical and dental officers to age 45, 60 points, or 39 months total service.42 On 15 February, it was further announced that physicians and dentists who were declared surplus in any Zone of Interior command and who were within 4 months of being eligible for discharge, would be released immediately.43 On 23 April The Surgeon General recommended that the separation criteria, for medical officers only, be reduced to 30 months total service (other
40Ltr, Col Robert J. Carpenter to TAG, 21 Jan 46, sub: Procurement objective for appointment in the Army of the United States (Dental Corps). SG: 210.8.
41See Chapter III.
42WD radiogram 42485, 30 Jan 46.
43ASF Cir 40, 15 Feb 46.
requirements remaining unchanged).44 This request was approved and the new standards were published effective 1 May.45 Probably no action of the War Department caused greater unrest among dental officers than this maintenance of separate criteria for the Dental Corps, especially since it had been announced in March that male officers of the nonmedical branches would be released with 24 months' service after the end of August. However, it has since been shown in the discussion of medicodental relations in chapter I that no discrimination was intended, and that the termination of the dental ASTP, which precipitated this action, had been based on what were considered good and sufficient reasons.
In May and June 1946 arrangements were made to obtain 800 dental officers from the Navy, and another 1,500 through Selective Service, (see chapter III, p. 74), and on 27 May it was announced that dentists would be released after 36 months of service.46 On 1 September it was directed that dentists, including former ASTP students, would be separated after 30 months of service and finally, on 1 November 1946, dental officers were ordered released after 24 months of service under the same criteria as applied to male officers of most other branches.47
By October 1946 all of the 11,800 V-E Day nonvolunteers (excluding ASTP graduates) and 1,200 of the ASTP graduates had been separated.48 At the end of 1946, 14,200 dental officers, of 14,700 on duty at the end of the war in Europe, had returned to private practice, and it appeared that the last nonvol-unteer officer who had been in the Army on V-E Day would be released by the end of February 1947.49 After February 1947 the active duty Dental Corps consisted only of the Regular Army, former ASTP students, officers on loan from the Navy, and those who had signed voluntary agreements to serve after they became eligible for discharge.
After 11 January 1946 any temporary officer who had served in the grade of first lieutenant for 18 months, in that of captain or major for 24 months, or lieutenant colonel for 30 months, with 50 percent additional credit for overseas service, was eligible for a promotion of one grade on separation if he bad an efficiency index of 40 or above. This regulation also applied to any temporary officer with an efficiency index of 40 or over who had served at least 24 months without any promotion.50
Regulations in effect on V-J Day provided that until they could be re-placed or declared surplus dental laboratory technicians could be retained within their current commands after becoming eligible for discharge on points.
44Memo, Brig Gen R. W. Bliss for ACofS G-1,
23 Apr 46, sub: Demobilization of Medical Corps officers. SG: 210.8.
There was no change in this policy until the end of 1945 when it was directed that no dental technician would be held for more than 6 months after he was eligible for release under existing criteria.51 In February 1946 dental technicians were removed from the "scarce" category and it was directed that all men with 45 points or 30 months of service would be discharged by 30 April, and that all technicians with 40 Points; or 24 months of service would be separated, or en route to the United States for release, by 30 June 1946.52
The principal conclusions to be drawn from Army experience during the demobilization period are the following:
Pressure from civilian communities for the return of dentists after the fighting stops will generally be strong. The Armed Forces will be able to hold dental officers beyond the end of a war only when it can be shown that a clear and urgent need exists for their services.
Gradual replacement of dental personnel during a long conflict is highly desirable to permit the release of older men with the longest service and men who are less efficient than the average. Unless some "turnover" is maintained the Dental Corps will approach the end of hostilities with a high proportion of officers with such extensive service that public opinion will force their release regardless of the need for their services.
Voluntary procurement cannot be relied upon to furnish replacements for officers being demobilized after a war has ended if any sizeable force is to be maintained.
51WD Cir 382, 21 Dec 45.