In approving this measure, it was the feeling of the committee on legislation that the purposes of the bill and the mechanism proposed were basically sound. Since the above action was taken, our association has considered and testified relative to legislation designed to effectuate a universal military training program. At that time the association did not take a position for or against the enactment of universal military training legislation. However, several proposals were advanced relating to the medical aspects of such a program. I would like to briefly restate certain of these proposals: (1) The continuation of preprofessional and professional education for qualified students: It has always been the firm belief of the American Medical Association that it is imperative that safeguards be adopted to prevent any disruption in the education of an adequate force of professional personnel. The necessity for such safeguards became particularly apparent with the introduction of proposals to institute a universal military training program. It is essential, not only to the maintenance of an adequate and effective corps of trained Reserves but to the general welfare of the civilian population, that the education of professional personnel be allowed to proceed without any impairment. In outlining recommendations relative to the general framework of universal military training, the National Security Training Commission recommended against split periods of preliminary training and deferment of professional students from the 6 months' training period. In testifying on S. 2441, we expressed the belief that the holding in abeyance of the Reserve obligation for National Security Training Corps "graduates" was the one remaining mechanism for insuring the uninterrupted flow of trained Reserves. It was our feeling then, as it is now, that two further points should be considered: First the 71⁄2 years of Reserve obligation required by universal military training legislation should be deferred until a physician has completed his internship and, in some instances, his residency training, and second, that no undue advantage should accrue to Armed Forces hospitals by allowing internship and residency service in such installations to count against total Reserve obligation. (2) Source and selection of medical and allied health personnel: There is considerable concern in the medical profession as to the method to be used in determining the medical and allied health personnel required to man a universal military training program. The American Medical Association is, as previously stated, in favor of vesting the authority for making such decisions in a national civilian board or a comparable agency in order to insure the proper distribution of medical and other health Reserves between civilian and military needs. Unless this is done it will be extremely difficult to insure that individuals serve in a manner that will contribute the most to the strength of the Nation. In our statement on S. 2441, Eighty-second Congress, it was also urged that preinduction, induction and periodic Reserve physical examinations should not be performed by full-time medical personnel of the Armed Forces. It is believed that the use of additional physicians in the Armed Forces for this purpose is undesirable and unnecessary. It is recommended, instead, that such examinations be conducted by civilian physicians on a fee basis or by Reserve personnel for the purpose of maintaining a satisfactory Reserve status. Section 226 of H. R. 5426 could be amended to cover at least the portion of this recommendation dealing with periodic Reserve physical examinations. S. 2441 as reported favorably by your committee did not include any of our recommendations. It is assumed, however, on the basis of the discussion which was had at the time of our last appearance and later official statements in connection with S. 2441, that the committee deems it preferable to consider these matters in connection with the over-all Reserve bill which is now before you. Despite the recent action by the House of Representatives in referring universal military training legislation back to committee, the pendency of such legislation before the Senate prompts the association to again stress the need for adopting these proposals. If favorable action is taken by the Congress on S. 2441 or similar legislation, the only way to insure the adoption of the safeguards suggested is to provide for their inclusion in H. R. 5426. (The statement of the American Osteopathic Association is as follows:) STATEMENT BY DR. CHESTER D. SWOPE, CHAIRMAN, DEPARTMENT OF PUBLIC RELATIONS, AMERICAN OSTEOPATHIC ASSOCIATION On behalf of the American Osteopathic Association I wish to thank the committee for this opportunity of expressing our views on H. R. 5426, a bill relating to the Reserve components of the Armed Forces of the United States. Section 4 (d) of the Universal Military Training and Service Act, as amended by Public Law 51, Eighty-first Congress, provides for a total period of liability of 8 years active training in the Armed Forces and in a Reserve component. By virtue of that law practically all able-bodied young men below age 26 are due to be in a Reserve component of the Armed Forces to round out their term of liability. During the Reserve liability period, whether after active training and service in the Armed Forces or after training in the National Security Training Corps, the recall to active duty of preprofessional and professional students, including interns and residents, in the osteopathic and allied health service professional fields should be held in abeyance until completion of their professional education or until they cease to satisfactorily pursue such education. Furthermore, having successfully pursued such education and having become licensed to practice their profession, the Selective Service System or some other comparable civilian agency should have the final say as to whether the individual can best serve the national health, safety, and interest by serving the military or civilian economy. A civilian selective agency for the recall of reservists is necessary because the military is incapable of objective determination of or evaluating a proper balance between military and civilian needs. An example of the unobjectivity of military evaluation is markedly demonstrated in the current attitude of the military in recall of reservists who are in training and preparation for the critical occupation of osteopathic physician or surgeon. On August 1, 1950, the Secretary of Defense issued a memorandum to the Secretaries of the military departments delineating the policy to be observed by them regarding recall of reservists to active duty. In order that persons engaged in occupations critical to the civilian economy who could be spared by the military might be retained in their civilian pursuits, the Secretary of Defense incorporated as a part of his memorandum a list of critical occupations prepared by the Labor Department. The labor list included the osteopathic profession as one of the critical occupations. However, on October 17 the Defense Personnel Policy Board issued a memorandum to the military services authorizing them to superimpose on the list of critical occupations a list of occupations of primary interest to each. Under that authority, the respective services made provision for delay in call of reservists who were engaged in preprofessional or professional education to become doctors of medicine as distinguished from doctors of osteopathy. Realizing the lack of objectivity in such a discriminatory practice, the Defense Personnel Policy Board on January 12, 1951, issued a memorandum to the services rescinding the authority to so discriminate. Notwithstanding the January 12 memorandum, the military services have continued the practice of permitting students to finish their training to become M. D.'s and at the same time rejecting applications of reservists in preparation to become osteopathic physicians or surgeons for delay to complete their professional education. The only reason given by the military for discrimination has been that M. D.'s are utilized by the services whereas at the present time the professional services of osteopathic physicians are not employed in the Medical Corps of the services. In so doing, the military graphically demonstrate their inability to think of critical occupations except in terms only of military objectives, without regard for balance with the necessities of the civilian economy. The lack of objectivity on the part of the military is even more apparent when reservists who are engaged in the critical occupation of osteopathy and surgery in their own localities are recalled to military service in capacities entirely foreign to their professional training. A selective service system or a comparable civilian selective agency would operate to diminish if not prevent such a dissipation of osteopathic professional manpower. Part III of the bill should be amended by adding "or osteopathy" after "medicine" in section 201 of Public Law 365, Eightieth Congress, to clarify appointive authority and avoid arbitrary recall decision. Another consideration which we would call to your attention is involved in section 226 of the pending bill, namely, the requirement that all commissioned and enlisted members of the Reserve components except those in the Retired Reserve be given physical examinations at least once every 4 years, and that the individual member be required to submit a report of physical condition each year. We submit that these examinations should be performed by civilian physicians rather than increasing the military medical contingent for the purpose. Regarding the eligibility of osteopathic physicians as civilian physicians for the purpose of conducting these examinations, it has been established that they are so eligible. With the permission of the committee, we wish to record a ruling by the Comptroller General together with our correspondence with the Adjutant General of the Army in order that the record may be clear in the matter, to wit: ASSISTANT COMPTROLLER GENERAL OF THE UNITED STATES WASHINGTON 25, D. C., March 18, 1949. There are before this Office for consideration the claims of E. W. Koester, doctor of osteopathy, 37068 Huron River Drive, New Boston, Mich., and Riverside Osteopathic Hospital, 165 George Street, Trenton, Mich., in the sums of $36 and $32.20, respectively, for professional services and hospitalization rendered Pvt. Sidney Snoddy, United States Army, during the period September 15 to 23, 1947, when he was suffering from an illness diagnosed as "bronchial asthma, chronic, with superimposed allergic phenomenae symptoms from ragweed pollen, acute," it appearing that such illness began while the enlisted man was on furlough from MD, 1257th ASU, Tilton General Hospital, Fort Dix, N. J., September 3 to 17, 1947, and that the treatment given him included the administration of oxygen and drugs. The Department of the Army transmitted such claims to this office for direct settlement because of decision of this office dated June 10, 1922 (1 Comp. Gen. 730), wherein it was held that osteopathic treatment, procured without specific or general authority, is not such medical treatment as is authorized to be procured at public expense from private practitioners by personnel of the Army on duty where medical service of the Army is not available. In such decision it was stated that: 66 * * Practitioners of osteopathy are not appointed in the Medical Corps of the Army and osteopathic treatment is not furnished by the Medical Department of the Army. It is only medical care and treatment of a kind or character furnished by the Medical Department of the Army that is authorized by the regulation without the prior approval of the Surgeon General-the equivalent of the service which the Government furnishes through the Medical Department. Treatment other than that must, under the regulations, be authorized in advance by the Surgeon General before the Government is obligated to pay therefor, that he may determine the necessity therefor and whether existing Army facilities may supply adequate treatment." The Surgeon General of the Army has reported that investigation has revealed Dr. Koester is a doctor of osteopathy, and that conditions in the Army with regard to osteopathic practitioners are now essentially the same as they were at the time the said decision was rendered. However, the vouchers covering both of the claims here involved bear certificates, signed by an officer of the Medical Service Corps, United States Army, to the effect that treatment by a civilian agency was necessary because no Government (Army, Navy Veterans' Administration, Public Health Service or Indian) facility for treatment was available. While the provisions in the Military Appropriation Acts for the fiscal years 1948 and 1949 (act of July 30, 1947, 61 Stat. 560, and act of June 24, 1948, 62 Stat. 657) for medical care and treatment of Army personnel are not materially different, insofar as the present question is concerned, than the comparable appropriation provision considered in the above-cited decision of June 10, 1922, other statutory provisions, enacted since 1922, together with changes in conditions and circumstances which have occurred since that time, seem to justify a reexamination of the question whether or not military appropriations may be considered available for the payment of osteopaths for treatment of military personnel. * The act of August 2, 1946, in section 41 thereof (60 Stat. 858), authorizes "The President, in his discretion * * to appoint, by and with the advice and consent of the Senate, graduates of reputable schools of osteopathy as commissioned medical officers in the Navy." Likewise section 5 of the act of February 28, 1948 (62 Stat. 40), provides that "Graduates of colleges of osteopathy whose graduates are eligible for licensure to practice medicine or osteopathy in a majority of the States of the United States shall be eligible * ** * * * for appointment as commissioned medical officers in the Public Health Service." And section 1 of the act of June 5, 1942 (56 Stat. 314), authorizes the employment in the Medical Department of the Army of internes who are graduates of, or have successfully completed at least 4 years' professional training, in reputable schools of medicine or osteopathy. While other statutory provisions of a somewhat similar character have been enacted by the Congress in recent years, the cited provisions suffice to indicate the legislative policy respecting the appointment or employment of osteopaths in the military and quasi-military services. When the decision of June 10, 1922, was rendered, the treatment at Government expense of Army officers and enlisted men in private hospitals, or by civilian physicians, was specifically prohibited if such personnel were on furlough when receiving the treatment and, by analogy, such prohibition was extended to other services. However, a provision contained in the act of April 28, 1942 (56 Stat. 228), and repeated in similar terms in subsequent military appropriation acts, marked a reversal of the prior legislative policy by providing "for necessary medical care and treatment in private hospitals of military personnel whether on duty or on furlough or leave of absence except when elective medical treatment has been obtained by military personnel in civilian hospitals or from civilian physicians or dentists." In recognition of that change in legislative policy, the rule theretofore applied, by analogy, to enlisted men of the Navy was modified to conform to the statutory authorization for private medical treatment of Army personnel while on leave or furlough. See 23 Comp. Gen. 980, the syllabus of which is as follows: "Prior decisions of the accounting officers negativing the allowance of the cost of civilian medical care and treatment of Navy enlisted men solely because they were on leave or liberty at the time-which decisions were based on the general legislative policy exemplified by provisions in annual Army appropriation acts prohibiting allowance of such expenses incurred by Army officers or enlisted men-are not to be regarded as applicable or controlling subsequent to the enactment of the act of April 28, 1942, which marked a reversal of such legislative policy by authorizing payment for medical care or treatment of Army personnel 'whether on duty or on furlough or leave of absence"." Pursuant to the provisions of the National Security Act of 1947 (61 Stat. 495), which established the National Military Establishment, the medical and hospital facilities of each of the military services are now available under controlled conditions to the personnel of the other services. While it is understood that the Medical Department of the Army has not utilized the services of osteopaths as commissioned medical officers in the Army, the services of osteopaths apparently are available to Army personnel in other Government installations and facilities. For such reasons, it is concluded that Army appropriations for medical treatment are now to be regarded as available for payments, otherwise proper, for the services of professionally qualified osteopaths in cases where Army personnel on duty or furlough or leave of absence at places where Government medical and hospital facilities are not available may avail themselves of such services for necessary medical care or treatment. Hence, the claims here involved, if correct in other respects, will be allowed. To the extent that prior decisions of this Office (including 1 Comp. Gen. 730, supra), are inconsistent with the foregoing they will not be followed hereafter. (Signed) FRANK L. YATES, Assistant Comptroller General of the United States. WASHINGTON 6, D. C., November 15, 1951. In re Department of the Army letter, Office of Adjutant General, 13 March 1951, File AGAO-S201.3A (12 March 1951) GI-MAGPT-P. Subject: Organized Reserve Corps Service Evaluation Program. The ADJUTANT GENERAL, DEPARTMENT OF THE ARMY, Washington 25, D. C. DEAR SIR: This letter is written on the telephonic advice of your Colonel Lott, to whose attention I brought the following telegram received on November 14 from Dr. J. W. Miller, Fort Lauderdale, Fla., licensed osteopathic physician and surgeon, to wit: "Subject: Physical Examinations of Officer Reserve Corps Evaluation Program: Letter under order of Colonel Tarkington. Florida Military District, Jacksonville, claims physical examinations performed by D. O. not acceptable to Medical Review Board. Military authorities have ordered my patient, Lt. Col. Harry A. Gervin, to arrange with licensed civilian doctor of medicine for physical examination. Are we ineligible to examine under the Officer Reserve Corps evaluation program? How shall I proceed in this case?" Colonel Lott informed me that the above mentioned subject, Department of the Army letter of March 13, 1951, provides that reservists may be examined "by a licensed civilian doctor of medicine," where Government medical facilities are not available, but does not authorize examination by a licensed civilian doctor of osteopathy under similar circumstances. We request amendment of the Department of the Army letter so as to authorize examination by a licensed civilian doctor of medicine or doctor of osteopathy, inasmuch as both doctors of medicine and doctors of osteopathy are civilian physicians within the meaning of the Department of Defense appropriation acts, Medical and Hospital Department, Department of the Army. See 23 Comptroller General Decisions 528, March 18, 1949, copy enclosed. Pursuant to above mentioned Comptroller General's opinion the General Accounting Office paid claim of an osteopathic physician and surgeon, claim No. 2969521 on May 17, 1949 for "professional services rendered incident to physical examination of applicants for enlistment in the United States Army during the period March 20 to April 12, 1948. (OCF#91694)." Please furnish copy of above mentioned Department of the Army letter with requested amendment and oblige. Very truly yours, L. L. GOURLEY, Legal Counsel, American Osteopathic Association. Mr. LAWRENCE L. GOURLEY, Washington, D. C. DEPARTMENT OF THE ARMY, OFFICE OF THE ADJUTANT GENERAL, DEAR MR. GOURLEY: This is in reply to your letter of November 15, 1951, regarding utilization of the services of doctors of osteopathy in the physical examination phase of the Organized Reserve Corps service evaluation program. The provisions of Department of the Army Letter, AGAO-S, 201.39 (March 12, '51) G1-M, subject: "Organized Reserve Corps Service Evaluation Program," dated March 13, 1951, limit the performance of physical examinations, under the circumstances cited therein, to civilian doctors of medicine. However, it is believed unnecessary at this time to amend this letter to include doctors of osteopathy since the service evaluation program was completed on October 31, 1951. The service evaluation program was a very broad program which had to be completed in a relatively short period of time. It was anticipated that Army and Reserve Corps medical facilities could not accommodate the large number of reservists within the period of time allotted for completion of the physical examination phase of the program. Accordingly, provisions were made for utilizing the medical facilities of other governmental agencies and for employing civilian physicians. The Department of the Army does not visualize a requirement for similar programs in the future. Although it is likely that reservists will be required to undergo future physical examinations at various intervals, such examinations will be spread over periods of time that will not overtax the normal operating staffs at Army and Reserve Corps medical facilities. Further physical examinations for reservists, and the details of such examinations with respect to the types of professional personnel and facilities to be utilized are contingent upon the final provisions of the Armed Forces Reserve Act which, it is believed, will be enacted into law at the next session of Congress. Until this bill becomes law and until definite information becomes available regarding future requirements for physical examinations for reservists as may be prescribed in this law, the Department of the Army cannot determine the re |