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Chapter XIII



Changes in Policies andProcedures Affecting the Occupancy of Hospital Beds in the Zone of Interior

An important feature of attempts to meet hospital requirements with limited resources was an extension of the practice begun on a small scale during the early war years of keeping patients who did not actually need hospital care from occupying beds. This could be done by limiting admissions and shortening length of stay.

Problem of Limiting Hospital Admissions

More was done to shorten periods of patient-stay than to limit admissions. Two factors worked against the latter: (1) the Medical Department's practice of admitting patients to hospitals before performing complete diagnostic procedures and (2) policies of the General Staff governing discharges from the Army. Normally, zone of interior patients were sent to hospitals after only preliminary examinations by dispensary physicians and were then given more thorough examinations by hospital staffs. Early in the war, it will be recalled, some hospitals had established diagnostic clinics for the examination of patients before their admission to wards. This practice did not become general, and hospitals continued to admit patients first and to perform diagnostic procedures afterward.1 Some policies of the General Staff tended to increase rather than to limit hospital admissions. In July 1943, for example, the Staff issued a directive, against The Surgeon General's advice, to discharge from the Army men who did not meet minimum physical standards. This flooded hospitals with patients whose disabilities had to be observed and evaluated before they could be given disability discharges.2 Toward the end of 1943, when a manpower short-

1See above, p. 121. Annual reports of hospitals are silent, with few exceptions, on the establishment of diagnostic clinics. See also Federal Medical Services-A Report with Recommendations, prepared for the Commission on Organization of the Executive Branch of the Government [Hoover Commission] by the Committee on Federal Medical Services (Washington, 1949), pp. 20-21.
2(1) WD Cir 161, 14 Jul 43. (2) An Rpt, 1943, Ft Bragg Sta Hosp. HD. (3) William C. Menninger, Psychiatry in a Troubled World (New York, 1948), pp. 551-52.


age developed, the Staff directed that men who could serve usefully in military assignments, despite minor ailments, should be kept in the Army.3 While this reduced the disability-discharge load, it increased the number of men who returned to hospitals repeatedly with the same complaints and led to a tug of war between line officers and the Medical Department over whether those who were not physically disabled but were noneffective should be given medical or administrative discharges.4 The Staff finally attempted to solve this problem by making it easier in the latter half of 1944 for line officers to grant administrative discharges and by authorizing in the spring of 1945 the discharge at separation centers of all combat-wounded enlisted men in the limited service category.5 To some extent these actions relieved hospitals of the care of men who did not need actual treatment at a time when these installations were reaching their peak load.6

Measures to Shorten the Length of Patient-Stay

Shortening the time spent by patients in hospitals was another way of limiting occupancy of beds to patients actually needing hospital care. Controlling the length of stay in an effort to limit the occupancy of beds to patients actually needing hospital care was a complicated and difficult process, for many factors affected it, some tending to increase and others to shorten it. Among them-aside from the seriousness of patients' wounds, injuries, and illnesses-were the speed with which patients were transferred to proper types of medical installations, the degree of recovery they were expected to achieve while in Army hospitals, the efficiency with which hospitals completed diagnoses and treatments, and the administrative problems that were encountered in disposing of patients after completion of treatment. Beginning in the fall of 1943 the Surgeon General's Office devoted more attention than formerly to these factors in particular and to the length of stay in general.

The attention given to the general problem is illustrated by studies made in the Surgeon General's Office and letters sent to service commands. During 1944 and 1945 the Facilities Utilization Branch and its successor, the Resources Analysis Division, made monthly studies of the length of time different hospitals kept patients before disposing of them. In the absence of more reliable data, the Branch measured the average duration of patient-stay by means of an "activity index." This index was the ratio of total patient days to the sum of hospital admissions and dispositions. Over a long period of time a number twice the size of the activity index was considered a close approximation of the number of days that the average patient spent in a given hospital.7 A low activity

3WD Cir 293, 11 Nov 43.
4(1) An Rpt, 1943 and 44, Ft Bragg Sta Hosp. HD. (2) An Rpt, 1944, Surg 7th SvC. HD. (3) Memo, SG for CG ASF, 1 Sep 44, sub: Disposition of Inapt and Inadaptable. SG: 300.3. (4) Memo, Dep SG for ACofS G-1 WDGS, 26 Sep 44, sub: WD Cir 370 (1944) II-EM. SG: 300.-5. (5) Memo, SG for CG ASF, 23 Mar 45, sub: Gen Hosp Program, ZI. SG: 322 "Hosp."
5(1) WD Cir 370, 12 Sep 44. (2) AR 615-368 and AR 615-369, 20 Jul 44. (3) WD Cir 71, 6 Mar 45.
6(1) Memo, Dir NP Consultants Div SGO for Dir Resources Anal Div SGO, 27 Nov 44, sub: Discharge of EM. SG: 220.811-1. (2) An Rpt, 1944, Surg 7th SvC. HD. (3) An Rpts, 1945, Baxter Gen Hosp and Ft Bragg Sta Hosp. HD.
7Draft article for ASF Monthly Progress Rpt, Sec 7, Health, entitled "The Disposition of Patients in Hospitals of Selected Size Groups [31 May 44]." HD: Resources Anal Div file, "Hosp."


index was therefore an indication that a hospital was treating and disposing of patients promptly. Monthly announcements of hospitals' activity indices kept before service command surgeons the importance of avoiding unnecessarily long patient-stays.8 This indirect pressure upon hospitals seemed insufficient after the patient load began to increase rapidly in the spring of 1945. In March, therefore, The Surgeon General urged general and convalescent hospital commanders, as well as service command surgeons, to accelerate dispositions.9 The following month he established tentative monthly quotas for the disposition of patients from convalescent hospitals.10 Meanwhile, during the preceding year and a half, attention had been given to various individual factors which influenced the length of patient-stay.

One of these was the transfer of patients between hospitals. Failure to transfer patients promptly from station hospitals to better staffed and better equipped hospitals, after it had been determined that they needed a higher type of care than that afforded in station hospitals, retarded their recovery. On the other hand, unnecessary transfers of patients between hospitals of different types consumed the time of hospitals involved, put an extra load on overburdened transportation facilities, and increased the time patients stayed on hospital rolls by causing repetitive physical examinations and more administrative paper work. Several steps were therefore taken to regulate the transfer of patients. In the fall of 1943 the Deputy Chief of Staff ruled that zone of interior patients need not be transferred from station to general hospitals merely because their injuries or illnesses were of particular types, provided station hospitals were equipped and staffed to give them the care and treatment they needed.11 In the spring of 1944, when regional hospitals were authorized, a policy was established under which patients were to be transferred "without any more delay than is compatible with sound professional judgment" to the "nearest adequate medical installations," regardless of their type-whether regional, convalescent, or general hospitals-and regardless of the command under which they operated.12 To implement this policy, both the Air Surgeon and The Surgeon General applied to regional hospitals the bed credit system which had been developed earlier to facilitate the transfer of patients from station to general hospitals.13 Soon afterward The Surgeon General established the Medical Regulating Unit (mentioned elsewhere) to control the transfer to general hospitals of patients debarked at ports in the United States. This office, in turn, devised an elaborate system by which general and convalescent hospitals reported vacant beds and debarkation hospitals reported patients received, indicating by code their sex, rank, home address, and disability.14 Theoretically this system assured the transfer of patients directly to hospitals staffed

8These letters are found in SG: 323.7-5 (each service command).
9Ltr, CG ASF (SG) to CGs all SvCs attn SvC Surg, and to COs all Gen and Conv Hosps, 24 Mar 45, sub: Furlough and Disposition Policy. Off file, Gen Bliss' Off SGO, "Med Clarification of Disposition Policy."
10Ltr, SG to CO Ft Story Conv Hosp, 12 Apr 45. Off file, Gen Bliss' Off SGO, "Med Clarification of Disposition Policy."
11See above, p. 183.
12WD Cir 140,11 Apr 44.
13(1) See above, pp. 35, 184-85. (2) The Planning and Oprs of ZI Hosps, Tab B to Memo, Dir Hosp Div and Dir Resources Anal Div SGO thru Chief of Oprs Serv SGO for Dir HD SGO, 18 Jun 45, sub: Add Mat for An Rpt for FY 1945. HD: 319.1-2.
14See below, pp. 346-49.


and equipped to care for their particular ills and injuries but it was not completely successful.

A study by the Resources Analysis Division early in 1945 showed that forty-five out of fifty-nine general hospitals were receiving patients who should have been sent to other medical installations. "Beyond a doubt," a report on the study continued, "there are a large number of overseas patients being transferred from the debarkation hospitals to the general hospitals who need little or no further surgical or medical treatment and could equally as well be cared for in convalescent hospitals. These cases consume a large amount of time in the general hospitals in examination and working up plus all the administration detail and the time involved in disposition."15

Another factor which affected the length of stay in Army hospitals was the degree of recovery which patients were expected to attain before being discharged. Those returned to duty were expected to be able to do an effective day's work as soon as they rejoined their outfits. To shorten the convalescent phase of hospitalization, The Surgeon General emphasized during 1944 the reconditioning program initiated the year before. Although no statistical studies were made of the effect of this program on the average period of hospitalization, many hospital commanders believed that it was shortened.16 Patients who could not be reclaimed for military service could be transferred to Veterans Administration hospitals if they needed further care. In the early part of the war, it had been Surgeon General Magee's policy to transfer such patients as soon as the Medical Department determined that they could not be restored to duty, thus shortening the time they stayed in Army hospitals.17

During 1943 public pressure upon the Army to keep patients for final treatment, along with the inability of Veterans Administration hospitals to accommodate large numbers of them18 caused a change in policy that tended to lengthen the period of patient-stay. In December 1943 Army hospitals began to keep all patients whose disabilities were incurred in line of duty, except those who were tuberculous or psychotic, until their definitive treatment had been completed.19 As seriously wounded casualties began to fill hospital beds during 1944, this policy had to be clarified for it was difficult to know when the definitive treatment of those with chronic disabilities was completed. In the fall of that year it was announced that such patients would be kept in Army hospitals until they had reached the "maximum degree of recovery."20 In the following December, the President confirmed this policy and broadened its application to include patients whose disabilities had not been incurred in line of duty.21 Hospital commanders interpreted this directive "very broadly," and by March 1945, as

15Memo, J. S. Murtaugh [Resources Anal Div, SGO] for Dr [Eli] Ginzberg, 16 Mar 45, sub: Summary of Replies to the Furlough and Disposition Study. Off file, Resources Anal Div, SGO.
16Richard L. Loughlin, [History of] Reconditioning [in the U.S. Army in World War II], (1946), pp. 198-208. HD.
17(1) See above, pp. 129-30. (2) AR 615-360, C4, 16 Apr 43.
18Ltr, Dep SG to Mr Donald C. Urquhart, Veterans of Foreign Wars of US, 24 Mar 44. SG: 220.-811-1.
19(1) WD AGO Form 026, prepared by Col William B. Foster, MC, SGO, 15 Nov 43, sub: Request and Justification for Publication. AG: 220.8 (2 Jun 42) (2) Sec 2. (2) AR 615-360, C 16, 15 Dec 43.
20(1) WD Cir 423, 27 Oct 44. (2) ASF Cir 374, 13 Nov 44.
21Ltr, Franklin D. Roosevelt to SecWar, 4 Dec 44. HRS: Hq ASF Control Div, 705 "Cutback in Gen and Conv Fac."


the patient-load neared its peak, The Surgeon General concluded that they were holding patients longer than necessary.22 Two months later his Office attempted to define more precisely the term "maximum degree of recovery." This term, it was explained, referred to the point in a patient's treatment when progress appeared to have leveled off and no further substantial improvement could be anticipated. Patients reaching that point, even though they had not made full compensatory adjustment to disabilities, were not to be kept longer in Army hospitals.23

A third factor affecting the length of time patients stayed in hospitals was the efficiency with which hospital staffs made diagnoses and initiated treatment. In the fall of 1943 representatives of the Surgeon General's Office and the ASF Control Division complained that hospitals were delaying diagnoses and treatment by having unnecessary laboratory work performed for each patient.24 At that time The Surgeon General urged hospitals to insist upon its elimination. A few months later he suggested that service command surgeons require hospitals to keep ward charts showing the duration of patient-stay, as a reminder that unnecessary procedures should be avoided and requisite medical treatment given promptly. Some, and perhaps all, service commands accepted this suggestion.25

A fourth factor affecting length of stay was the administrative work involved in disposition of patients, either by return to duty or by separation from the service. Their return to units or organizations from which they entered hospitals created no problem, but the reassignment of others who were physically unqualified for duty with their former units or whose units had gone overseas was fraught with delays. Reassignment was primarily an Army personnel procedure over which the Medical Department had no control. It was complicated by the fact that patients belonged to different major commands (Ground, Service, and Air Forces), were qualified for different types of duty (limited or full duty), came from different areas (theaters of operations or the zone of interior), and were of separate ranks (commissioned or enlisted). Because of these complications, directives governing the reassignment of men and women who had been hospitalized were numerous, frequently changed, often obscure in meaning, and sometimes in conflict with one another. Attempts were made to correct this situation, but the general problem so far as it pertained to Ground and Service Forces personnel remained unsolved throughout the war.26 The Air Forces, on the other hand, adopted a system of assignment in the fall of 1944 that was simple and effective. AAF headquarters placed liaison officers in some AAF regional hospitals and, with the concurrence of ASF headquarters, in each general and ASF regional hospital.

22Memo, SG for CG ASF, 23 Mar 45, sub: Gen Hosp Program, ZI. SG: 322 "Hosp."
23Ltr, SG to CGs all SvCs attn COs Hosp Ctrs, Gen Hosps, and Conv Hosps, 28 May 45, sub: Med Clarification of Disposition Policy. HD.
24(1) Rpt of SGs Pers Bd, 3 Nov 43. HD. (2) Memo, Dr Eli Ginzberg, ASF Control Div for Chief Oprs Serv SGO thru Dir Control Div ASF, 30 Nov 43, sub: Surv of Gen Hosps. SG: 333.1-1.
25(1) SG Ltr 193, 30 Nov 43. (2) Ltr, SG (init A. H. S[chwichtenberg]) to Surg 2d SvC, 8 Feb 44, sub: Prompt Prof and Admin Practice in Army Hosps. SG: 705 (2d SvC)AA. Similar letters were sent to other service command surgeons. (3) Ltr, CG 5th SvC (Asst SvC Surg) to SG, 30 Mar 44, sub: Prompt Prof and Admin Practice in Army Hosps. SG: 705 (5th SvC)AA. (4) An Rpt, 1944, 2d SvC Surg. HD.
26(1) Mins, SvC Conf, Ft Leonard Wood, Mo, 27-29 Jul 44, p. 17. HD. (2) Memo, SG for CG ASF, 14 Mar 45, sub: Improvement in Hosp Admin Procedures. SG: 300.7. (3) History of Control Division, ASF, 1942-45, App, p. 199.


These officers acted as representatives of the commanding general, Army Air Forces, reassigning both commissioned and enlisted personnel of the Air Forces. Subsequently it was reported that they returned flying officers to duty in the Fourth Air Force in 10 percent of the time formerly required.27

Aside from the necessity of securing reassignments, there was another cause for delay in returning patients to duty: the administrative procedure for the physical reclassification of officers. In July 1943 the General Staff directed that officers found by hospital disposition boards to be permanently incapacitated for full military service should appear before Army retiring boards instead of being returned to duty in limited service assignments.28 This meant that such an officer had to be kept in a hospital while its commander forwarded recommendations of his disposition board to service command headquarters; the service commander issued orders for the appearance of the officer before a retiring board; the board assembled and considered the case, and sent its findings to Washington for review by The Surgeon General, The Adjutant General, and the Secretary of War's Separation Board; and The Adjutant General issued orders for the officer's disposition. In the fall of 1944 the Surgeon General's Office, ASF headquarters, and the Adjutant General's Office attempted to find a way to avoid keeping such officers in hospitals after their treatment had been completed. The Adjutant General proposed returning them to their previous stations or to replacement pools after appearance before retiring boards, to await there the decision of agencies in Washington.29 The ASF proposal, which went further than this, was approved by the General Staff. On 14 October 1944 a War Department circular authorized hospital and station commanders to return to duty officers recommended for limited service by disposition boards, without referring them, except in a few cases, to retiring boards.30 This change in procedure reduced the length of stay in hospitals of officers in this category to such an extent that it saved, according to the estimate of ASF headquarters, 1,000 hospital beds annually.31

Improvements in Disability Discharge and Retirement Procedures

Officers and men whose physical disabilities prohibited return to duty were either retired or discharged from the service. Since both retirement and discharge for disability were personnel as well as medical administrative procedures, they involved agencies other than the Medical Department. Their simplification was therefore a complicated process and some-

27(1) A History of Medical Administration and Practice in the Fourth Air Force (1945), vol. I, pp. 79-81. HD: TAS. (2) Ltr, CG AAF to CG ASF, 25 Aug 44, sub: Disposition of AAF Pnts in Gen Hosps and Certain ASF Hosps. AG: 705(25 Aug 44)(1). (3) ASF Cir 296, 9 Sep 44. (4) AAF Ltr 25-1, 21 Sep 44, sub: AAF Liaison with Hosp. SG: 211 (Surg, Flight). (5) An Rpts, 1944, Fitzsimons, Thayer, and O'Reilly Gen Hosps. HD.
28Rad, ACofS G-1 WDGS to SvC Comdrs, Retiring Bds, and all Named Gen Hosps, 10 Jul 43. SG: 334.6-1 Retiring Bds.
29Draft of WD Cir, incl to T/S APGO-S 210.85 (6 Sep 44), TAG to SG, 8 Sep 44, sub: Disposition of Offs Appearing before Retirement Bds, with lst ind, SG to TAG, 24 Oct 44. SG: 300.5 (WD Cir).
30(1) Memo, CG ASF for ACofS G-1 WDGS, 25 Sep 44, sub: Physical Reclassification of Offs. AG: 210.85 (25 Sep 44)(2). (2) DF WDGAP 210.01, ACofS G-1 WDGS to TAG, 7 Oct 44, same sub. Same file. (3) WD Cir 403, 14 Oct 44.
31Rpt, Economies Effected through Procedures Studies Made by or jointly with Control Div ASF, 13 Apr 45. HRS: Hq ASF Control Div file, "Est Admin Savings Resulting from Procedural Revisions."


times slow, but for the Medical Department it was important because any delay in either procedure wasted beds by lengthening the stay of patients in hospitals.

Despite earlier attempts to remove causes for delays, the disability discharge procedure took more time than was considered necessary and in the fall of 194332 both the Surgeon General's Office and ASF headquarters began studies to simplify and standardize it. Because its Control Division was engaged in a more general study of Army administrative procedures, ASF headquarters directed The Surgeon General to discontinue his study. The ASF Control Division proceeded thereafter, with assistance from the Surgeon General's Office, to develop and test a revised procedure for disability discharges.33 In March 1944 this procedure was published in a tentative manual and each service command was directed to install it in one general and one station hospital for further testing. Reports from such tests were favorable, and on 24 July 1944 ASF directed all of its hospitals to begin using the new procedure. Six months later a War Department manual made it official for use in hospitals of the Air Forces as well as of the Service Forces.34

The new procedure for disability discharges covered actions taken within hospitals themselves, since measures adopted earlier had reduced administrative actions required by headquarters other than hospitals.35 This goal was more completely achieved during 1944 when additional post commanders delegated to hospital commanders their functions relative to disability discharges, and the War Department delegated to commanders of regional and convalescent hospitals, as it had earlier to those of general hospitals, authority to grant discharges without reference to higher headquarters.36 Under the new procedure, administrative actions within hospitals were simplified and speeded up. Hospital commanders were permitted to request records of former physical examinations and medical treatments from the Adjutant General's Office and from other hospitals as soon as ward officers made a diagnosis indicating eventual disability discharge, rather than after completion of treatment. This move was expected to eliminate delays in the consideration of cases by CDD (Certificate of Disability for Discharge) boards. To reduce the work of these boards and of all officers who participated in the procedure, paper work required for disability discharges was simplified. Separate forms and letters previ-

32(1) Memo, Dr Eli Ginzberg, Control Div ASF for Chief Oprs Serv SGO thru Dir Control Div ASF, 30 Nov 43, sub: Surv of Gen Hosps. SG: 333.1-1. (2) Notes on Visit to McCloskey, O'Reilly, and Percy Jones Gen Hosps, 11 Dec 43, by Col Tracy S. Voorhees, Control Div SGO. Same file.
33(1) Memo, SG (Control Div) for Dir Control Div ASF, 29 Oct 43, sub: Delays in Discharging Pnts from Hosps. (2) Memo, SG (Control Div) for CG Army Med Ctr, 29 Oct 43, sub: Delays in CDD Procedure. (3) Memo, CG ASF (Control Div) for SG attn Dir Control Div, 5 Nov 43, sub: Delays in Discharging Pnts from Hosps. (4) Memo, Act Dir Control Div SGO for Brig Gen Edward S. Greenbaum, Off of UnderSecWar, 16 Feb 44, sub: Improvements in CDD Procedures. All in SG: 220.811-1. (5) An Rpt, FY 1944, Control Div SGO. HD.
34(1) History of Control Division, ASF, 1942-1945, App, pp. 345-46. HD. (2) Memo, CG ASF for CG 1st SvC, 17 Mar 44, sub: Estab of Pilot Instl Covering Discharges and Release from AD. SG: 220.811-1. Similar letters were sent to each service command. (3) Draft of Tentative Procedures-Discharge and Release from AD, Hq ASF, 5 Mar 44. AG: 220.8. (4) ASF Cir 217, 13 Jul 44. (5) TM 12-235, Enl Pers-Discharge and Release from AD (Other than at Separation Ctrs), 1 Jan 45.
35See above, pp. 124-30.
36(1) AR 615-360, C 19, 17 Mar 44. (2) An Rpts, 1944, Fts Jackson, Bragg, and Cp Shelby Regional Hosps. HD. (3) WD Memo 615-44, 17 Aug 44, sub: Discharge Auth. (4) AR 615-360, 20 Jul 44, and C 1, 1 Feb 45.


ously used were eliminated or consolidated, and copies of different forms and the number of signatures required on them were limited. All forms were set up according to standard typewriter spacing to facilitate preparation and, in some instances, rubber stamp entries were authorized.37 To insure speedy, well co-ordinated action by all hospital officers concerned with discharges, a time schedule was established. It listed the actions taken by each officer on the days following the admission of patients to hospitals, the day before the CDD board meeting, the day of the meeting, and the three following days. Finally, the manual on the discharge procedure showed graphically each step in a disability discharge.

Except in procuring adequate supplies of new forms, hospitals encountered little difficulty in installing the new procedure. Their reaction was almost immediately favorable. For example, by the end of 1944 one of them reported that disability discharges were "no longer a matter of concern."38 The Surgeon General's Office likewise was pleased with the new procedure and with the saving in hospital beds which it produced.39 According to an estimate of the ASF Control Division in April 1945, this saving amounted to an average of seventeen days for each disability discharge and to a total of 6,205,000 hospital bed-days (the equivalent of seventeen l,000-bed hospitals) annually.40

As in the case of disability discharges for enlisted men, several agencies became concerned in the fall of 1943 about the time used in retiring officers for disability. Among them were the Adjutant General's Office, the Surgeon General's Office, and ASF headquarters.41 During the next two years they worked together to speed the retirement process and thereby to shorten the period of hospitalization of officers disabled for military duty. One method was to shorten the time that elapsed between completion of an officer's treatment and his appearance before a retiring board. In the middle of 1943 the procedure for getting an officer before a retiring board was complicated. After completion of treatment, his case was reviewed by a hospital disposition board. If the board recommended retirement, its recommendation was sent to higher headquarters, such as that of a service command, for review. If that headquarters approved the recommendation, it ordered the officer to go before a retiring board. At that point, the hospital requested his personnel records from the Adjutant General's Office. After they arrived, the retiring board could consider the officer's case. In the fall and winter of 1943 steps were taken to get records

37(1) TM 12-235, Enl Pers-Discharge and Release from AD (Other than at Separation Ctrs), 1 Jan 45. (2) History of Control Division, ASF, 1942-45, pp. 183-86, and App, pp. 345-46. HD.
38An Rpt, 1944, O'Reilly Gen Hosp. HD. Letters from hospitals reporting on the new procedure, dated May-June 1944, are filed in HRS: Hq ASF Control Div file, "Disability Discharge Corresp." See also: An Rpts, 1944, Fts Jackson and Bragg Regional Hosps and Ashford Gen Hosp. HD.
39An Rpt, FY 1944, Control Div SGO, and An Rpt, FY 1945, Hosp and Dom Oprs SGO. HD.
40Rpt, Economies Effected through Procedures Studies Made by or jointly with Control Div ASF, 13 Apr 45. HRS: Hq ASF Control Div file, "Est Admin Savings Resulting from Procedural Revisions."
41(1) T/S, Dir Control Div AGO to Chief Insp and Investigation Br AGO, 28 Aug 43, sub: Retirement Procedures Affecting Offs. AG: 210.85 (12-17-42) (1). (2) Memo, SG for Gen Malin Craig, Pres Army Retiring Bd, 30 Aug 43. SG: 334.6-1. (3) Memo, Dir Control Div SGO for Brig Gen Charles C. Hillman, SGO, 8 Sep 43, sub: Retiring Bd Procedures. Same file. (4) Memo, Lt Col Basil C. MacLean, SGO for Gen [Raymond W.] Bliss thru Col A. H. Schwichtenberg, 6 Nov 43, sub: Observations Based on Recent Visits to Gen Hosps. Off files, Gen Bliss' Off SGO, "Util of MCs in ZI" (19)#1


from the Adjutant General's Office at an earlier point in the proceedings. In September, on The Surgeon General's recommendation, the General Staff authorized hospitals to request records of officers as soon as disposition boards recommended their appearance before retiring boards.42 Later, on recommendation of the ASF Control Division, the Staff permitted hospitals to request these records as soon as it became obvious that officers would be considered for retirement, even though their cases had not been reviewed by disposition boards.43 In the latter half of 1944 another cause for delay was eliminated when the Staff authorized hospital commanders to order officers to appear before retiring boards without reference to higher headquarters.44

Another method of speeding the retirement of officers was to prevent the development of backlogs of work for retiring boards. This could be done, in part at least, by increasing the number of such boards. Until the middle of 1943 retiring boards were few in number and could be appointed only by the Secretary of War.45 In June of that year the Secretary delegated appointment authority to commanding generals of service commands and directed them to establish retiring boards at all general hospitals. Four months later the commanding general of the Air Forces, receiving similar authority, was directed to set up a retiring board at each AAF convalescent center.46 In the middle of 1944 the right to have retiring boards was extended to all convalescent and regional hospitals.47 Later, in October 1944, the number of cases referred to such boards was limited when, in connection with the movement to shorten the period of hospitalization of officers being physically reclassified for limited duty only, retiring boards were relieved of the consideration of such cases.48

An additional way of speeding officer retirements was to reduce the paper work of retiring boards. In the latter part of 1944 the ASF Control Division developed a standard form for such boards to use in reporting their proceedings.49 Following the success of the new manual on disability-discharge procedures, the same Division developed and published in 1945 a technical manual on the retirement and reclassification of officers.50 This manual, like that on the disability-discharge procedure, gave detailed instructions in diagrammatic and other explanatory forms on the completion of all administrative actions in the retirement process and established a time schedule to be followed by officers concerned. As a result, according to ASF headquarters, the period of hospitalization of officers awaiting disabil-

42(1) Memo SPMCH 300.3-1, Exec Off SGO for Publication Div AGO thru Procedure Br SGO, 7 Aug 43, sub: Proposed Change in AR 605-250. AG: 210.-85 (12-17-42)(1). (2) AR 605-250, C 1, 17 Sep 43.
43(1) Memo, Dir Control Div ASF for TAG, 18 Dec 43, sub: Request for Publication. AG: 210.85 (12-17-42)(1). (2) AR 605-250, C 5, 6 Jan 44.
44(1) T/S, Chief Insp and Investigation Br AGO to Dir Control Div AGO, 26 Jul 44, sub: Reasgmt of Pers Returned to Duty from Hosp. AG: 705 (5 Jul 44). (2) WD Cir 403, 14 Oct 44.
45AR 605-250, 1 Jun 43 and 28 Mar 44.
46WD Memo W605-28-43, 17 Jun 43, and WD Memo W605-41-43, 19 Oct 43, sub: Delegation of Auth to Appoint Retiring Bds. SG: 334.6-1.
47(1) AR 605-250, C 1, 22 Jun 44. (2) Mins, SvC Conf, Ft Leonard Wood, Mo, 27-29 Jul 44. HD.
48See above, p. 243.
49Memo, CG ASF (Dir Control Div ASF) for SG, 9 Oct 44, sub: Form for the Proceedings of Army Retiring Bds. SG: 315 "Gen."
50(1) Draft of Proposed WD Technical Manual, TM 12-245, Physical Reclassification and Retirement of Offs, 1 Jun 45. Off file, Physical Standards Div, SGO. (2) Tentative WD Technical Manual, TM 12-245, Physical Reclassification, Retirement, and Retirement Benefits for Offs, 1 Oct 45. Same file.


ity retirements was reduced enough to save 4,700 beds annually.51

The simplification and standardization of procedures for disability discharges and retirements were the culmination of efforts begun early in the war to limit the occupancy of hospital beds to persons actually needing them. Earlier measures to reform these procedures affected actions taken outside hospitals but were a necessary foundation for the later ones which were mainly intended to improve action within the hospitals themselves. Other efforts to restrict patients in hospitals to those needing medical and surgical treatment were less successful. Little if anything was done to screen patients by physical examination before admission to hospitals. The reassignment of those returning to duty continued to cause difficulty and delays in disposition. And the policy of giving all patients "maximum hospitalization," whether their disabilities had been incurred in line of duty or not, tended to lengthen the average period of hospitalization and hence to increase the occupancy of beds by men who could be of no further service to the Army.

51History of Control Division, ASF, 1942-45, App. pp. 481-83. HD.