Senator HUNT. We have in mind, I am sure, that as these boys become reservists and may be called back they will again go through the process of being looked over by selective service boards, because their status will be changed-they will have family connections, they will have business conections they will be in school, various things like that which will occur between the time they finish their training course and before they might be called back in as Reserves.

There I think we would again take care of the situation. But your point is well taken.

Dr. EARNEST. That is all we ask.

Senator HUNT. Mr. Chairman, that is all the questions I have. Chairman RUSSELL. Thank you, Doctor, for a very clear and helpful statement.

Dr. EARNEST. Thank you, Senator.

Chairman RUSSELL. The next witness is Dr. F. J. L. Blasingame, chairman of the legislative committee of the American Medical Association.

Come around, Doctor.

Dr. BLASINGÁME. This is Mr. C. Joseph Stetler, secretary of the committee on legislation.

I have an original statement and an abridged copy or summary. If you prefer I would just read the summary, and if necessary we could discuss the other.

Chairman RUSSELL. You will read the summary and probably we will have a few questions for you, and then the full statement will be printed in the record.

STATEMENT OF DR. F. J. L. BLASINGAME, CHAIRMAN, LEGISLA

TIVE COMMITTEE, AMERICAN MEDICAL ASSOCIATION; ACCOMPANIED BY C. JOSEPH STETLER, SECRETARY OF THE COMMITTEE ON LEGISLATION

Dr. BLASINGAME. Mr. Chairman and members of the committee, my name is Dr. F. J. L. Blasingame. I am engaged in the active practice of medicine in Wharton, Tex., and am a member of the board of trustees of the American Medical Association. I am appearing here today, with my colleagues, on behalf of that association regarding S. 2441, Eighty-second Congress, and the report of the National Security Training Commission.

SCOPE OF TESTIMONY

At the outset, let me say that our purpose in appearing before the committee is to make certain suggestions relative to the medical aspects of universal military training rather than to comment on whether such a program should be adopted. If the Congress, in its discretion, determines that a universal military training program is necessary, the American medical profession is ready to cooperate to the fullest in its implementation. We believe, however, that we can make a contribution at this time in connection with the preliminary planning for such a program inasmuch as the various councils and departments of the association have been studying, for some time, the factors involved in the most effective utilization of medical manpower in time of

national emergency and in connection with a universal military training program.

I shall restrict my comments to three items:

(1) The continuation of preprofessional and professional education for qualified students.

In its report to the Congress, dated October 29, 1951, the National Security Training Commission strongly recommended against (a) split periods of preliminary training and (b) the deferment of professional students from the 6-month training period. On page 28 of the report the Commission does, however, discuss the holding in abeyance of the reserve status "of a number of medical, dental, and scientific students until the completion of their professional study."

With the rejection of split training periods and the deferment of professional students, it would appear that the holding of the Reserve obligation in abeyance is one of the remaining mechanisms for insuring the uninterrupted flow of trained reserves. Therefore, the association believes that it is imperative that this proposal be incorporated in the legislation under consideration.

We consider that item important.

The Commission's report on page 28 also notes that:

Under such an arrangement, the Reserve obligation of 71⁄2 years would not begin to run until graduation from medical, dental, or scientific school.

It is believed that this recommendation should be changed to refer to completion of professional education rather than graduation from medical school. Such a revision would encompass the completion of internship and in some instances residency training.

(2) The performance of preinduction, induction, and periodic Reserve physical examinations.

It is the belief of the American Medical Association that the use of additional physicians in the Armed Forces for the performance of preinduction, induction and periodic Reserve examinations 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 maintainng a satisfactory Reserve status. This system is now operating successfully with respect to the conducting of periodic physical examinations for reservists in the Armed Forces.

(3) Source and selection of medical and allied professional personnel.

The American Medical Association is in favor of vesting the authority for determining the number of medical and allied health personnel necessary to run a universal military training program and the extent of the need 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. In this way it will be possible to insure that individuals serve in a manner which will contribute the most to the strength of the Nation.

It is the belief of the American Medical Association that the National Security Training Commission is deserving of commendation for the extremely fine work it has done in studying this subject and preparing a report. We feel it deserves particular praise for its constructive comments with respect to the undesirability of adopting the present framework of veterans' legislation as a means of dealing with

disabilities and deaths among such trainees. The use of Veterans' Administration installations for such purposes would create a need for additional facilities and increased medical staffs, therefore adding to the growing strain upon the health and medical manpower resources of the Nation created by the existing emergency.

In conclusion, I would like to express the appreciation of the American Medical Association for this opportunity to appear before your committee and present our views on this extremely important subject. If the association can furnish any additional information or be of assistance in any other way, be assured of our willingness to cooperate.

Chairman RUSSELL. Thank you, Doctor. Your original statement will appear in the printed record.

(The statement referred to is as follows:)

SUMMARY OF STATEMENT BY THE AMERICAN MEDICAL ASSOCIATION TO THE COMMITTEE ON ARMED SERVICES, UNITED STATES SENATE, CONCERNING S. 2441, EIGHTY-SECOND CONGRESS, AND THE REPORT OF THE NATIONAL SECURITY TRAINING COMMISSION, DATED OCTOBER 1951

Mr. Chairman and members of the committee, my name is Dr. F. J. L. Blasingame. I am engaged in the active practice of medicine in Wharton, Tex., and am a member of the board of trustees of the American Medical Association. I am appearing here today, with my colleagues, on behalf of that association regarding S. 2441, Eighty-second Congress, and the report of the National Security Training Commission.

At the outset, let me say that our purpose in appearing before the committee is to make certain suggestions relative to the medical aspects of universal military training rather than to comment on whether such a program should be adopted. If the Congress, in its discretion, determines that a universal military training program is necessary, the American medical profession is ready to cooperate to the fullest in its implementation. We believe, however, that we can make a contribution at this time in connection with the preliminary planning for such a program inasmuch as the various councils and departments of the association have been studying, for some time, the factors involved in the most effective utilization of medical manpower in time of national emergency and in connection with a universal military training program.

I shall restrict my comments to three items:

(1) The continuation of preprofessional and professional education for qualified students

In its report to the Congress, dated October 29, 1951, the National Security Training Commission strongly recommended against (a) split periods of preliminary training, and (b) the deferment of professional students from the 6month training period. On page 28 of the report the Commission does, however, discuss the holding in abeyance of the Reserve status "of a number of medical, dental, and scientific students until the completion of their professional study." With the rejection of split-training periods and the deferment of professional students, it would appear that the holding of the Reserve obligation in abeyance is the one remaining mechanism for insuring the uninterrupted flow of trained Reserves. Therefore, the association believes that it is imperative that this proposal be incorporated in the legislation under consideration.

The Commission's report on page 28 also notes that: "Under such an arrangement, the reserve obligation of 71⁄2 years would not begin to run until graduation from medical, dental, or scientific school" [italics added]. It is believed that this recommendation should be changed to refer to completion of professional education rather than graduation from medical school. Such a revision would encompass the completion of internship and in some instances residency training. (2) The performance of preinduction, induction, and periodic reserve physical examinations

It is the belief of the American Medical Association that the use of additional physicians in the Armed Forces for the performance of preinduction, induction, and periodic reserve examinations is undesirable and unnecessary. It is recom

mended 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. This system is now operating succesfully with respect to the conducting of periodic physical examinations for reservists in the Armed Forces. (3) Source and selection of medical and allied professional personnel

The American Medical Association is in favor of vesting the authority for determining the number of medical and allied health personnel necessary to run a universal military training program and the extent of the need 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. In this way it will be possible to insure that individuals serve in a manner which will contribute the most to the strength of the Nation.

It is the belief of the American Medical Association that the National Security Training Commission is deserving of commendation for the extremely fine work it has done in studying this subject and preparing a report. We feel it deserves particular praise for its constructive comments with respect to the undesirability of adopting the present framework of veterans' legislation as a means of dealing with disabilities and deaths among such trainees. The use of Veterans' Administration installations for such purposes would create a need for additional facilities and increased medical staffs, therefore adding to the growing strain upon the health and medical manpower resources of the Nation created by the existing emergency.

In conclusion, I would like to express the appreciation of the American Medical Association for this opportunity to appear before your committee and present our views on this extremely important subject. If the association can furnish any additional information or be of assistance in nay other way be assured of our willingness to cooperate.

RESERVE STATUS AT COMPLETION OF INTERNSHIP

Chairman RUSSELL. Doctor, I am particularly impressed by your suggestion that the Reserve status commence upon the completion of internship or residency training rather than on graduation. It may be, however, that the Commission assumed that was real graduation when a man had completed his internship, because I do not think many men are permitted to practice medicine now in this country until they have served their internship.

Dr. BLASINGAME. I believe it is legal in several States, Senator, but we felt like these men would be definitely more useful than to use in the sense of the statement made by the Commission. In other words, they would not be in the realm of an apprentice but would be the finished product. Such a suggestion is made in the spirit of helpfulness and feeling that it is to the best interest of the public, not simply the profession, that the individual will be adequately trained so that when he does come to be of use to the armed service, he will be a finished product and able to deliver.

Chairman RUSSELL. I think that is undoubtedly true.

PHYSICAL EXAMINATIONS

I was interested in your comment here on the physical examinations. Do I understand it is your suggestion that civilian physicians or reservists examine each candidate for the military training in his home community and file a report as to his physical ability to undergo the training?

Dr. BLASINGAME. Yes, that is one possibility. And the other is that you have already reservists in the Armed Forces that could take on a part, if not all, of such a program.

Chairman RUSSELL. They would have 1 day a month beore a class was inducted to

Dr. BLASINGAME. That is right.

Chairman RUSSELL. They would be on active duty for that day? Dr. BLASINGAME. That is right.

Chairman RUSSELL. And would examine those who were proposed for induction into training?

Dr. BLASINGAME. Yes. Yet those same reservists could be useful in civilian life the remainder of the time.

Chairman RUSSELL. You think it would mean that we would have better utilization of

Dr. BLASINGAME. Medical manpower.

Chairman RUSSELL. Of our medical manpower of the country.
Dr. BLASINGAME. Yes.

Chairman RUSSELL, Senator Morse.

HOMETOWN CARE PLAN FOR VETERANS

Senator MORSE. I was interested in the doctor's comment here on page 3 in regard to the use of Veterans' Administration installations. He said:

We feel it deserves particular praise for its constructive comments with respect to the undesirability of adopting the present framework of veterans' legislation as a means of dealing with disabilities and deaths among such trainees. The use of Veterans' Administration installations for such purposes would create a need for additional facilities and increased medical staffs, therefore adding to the growing strain upon the health and medical manpower resources of the Nation.

Is it not logical to take that argument a step further and suggest that we ought to have our private practitioners in our localities in this country do more and more of the veterans' care and the veterans' hospitals do less and less, especially in those ailments that can be handled very readily in the home community?

Dr. BLASINGAME. Yes. Our profession has advocated that and, of course, there is a home town care plan for veterans that has been advanced.

Senator MORSE. What about its working? I have heard a lot about that, but as I talked to my doctor friends—and I have a few, not many

[Laughter.]

Senator MORSE (continuing). They tell me that they are still sending them on these cases to veterans' hospitals when they could be handled in the local community.

Dr. BLASINGAME. Well, Senator, there is unquestionably a defect of, I suppose, human relations which enters in there both from the professional standpoint and the standpoint of the veterans. Our profession has taken recognition of that fact and we are trying our best to work out something that will be constructive through the veterans' organizations. It is an unsolved problem.

The point here we had in mind is that there is considerable opinion that is expressed now that these facilities are already being used under the present veterans' program, and then if you superimpose upon that anything from this program you would be adding unnecessary burden, and we do not think it is necessary and desirable.