Will There Be Enough Trained Medical Personnel in Case of War?
HRD-81-67
Published: Jun 24, 1981. Publicly Released: Jun 24, 1981.
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Highlights
The military services medical departments have missions to: (1) provide peacetime care to eligible beneficiaries; and (2) maintain readiness to meet wartime contingencies. Pursuant to a congressional request, GAO reviewed the extent to which wartime military medical personnel shortages exist, what is being done or can be done to overcome the shortages, and how well available personnel are trained for wartime missions.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | The Secretary of Defense should make prearrangements for interservice assignments. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should obtain advance agreements with civilian medical personnel to fill key hospital shortages. |
Closed – Implemented
DOD is entering into agreements with the American Medical Association and the American Nurses Association to obtain health care providers' names, addresses, and specialty information. During mobilization, DOD would use this information to contact physicians and nurses needed by the services. These agreements, however, do not include personnel to fill shortage positions at predesignated hospitals.
|
| Department of Defense | The Secretary of Defense should make arrangements to use those Public Health Service (PHS) officers the Secretary of Health and Human Services (HHS) determines could be committed to DOD. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should require the Army to provide needed clinical skills training programs to field personnel on loan to hospitals. |
Closed – Not Implemented
DOD failed to implement any new procedures to standardize field unit personnel training at military hospitals. GAO believes that certain in-hospital skills should be emphasized to prepare medical personnel adequately for wartime roles.
|
| Department of Defense | The Secretary of Defense should direct the services to periodically report their requirements estimates to DOD medical mobilization planners for developing overall medical mobilization plans. |
Closed – Implemented
In August 1982, DOD began to require the military to submit time-phased personnel requirements data in conjunction with their annual program objective memoranda (POM) submissions.
|
| Department of Defense | The Secretary of Defense should identify and implement specific initiatives to recruit and retain nurses while continuing its initiatives to recruit and retain physicians. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should require the Army to establish firm criteria for the frequency and duration of in-hospital training to be given to field unit personnel. |
Closed – Implemented
Although DOD increased the emphasis on training overall, requirements for field unit personnel have not been standardized.
|
| Department of Defense | The Secretary of Defense should direct the services to develop a consistent and systematic method to estimate the rate at which reserve medical personnel can be expected to report for duty after mobilization. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should require the Army to increase in-hospital training programs for field unit personnel located within short distances of military hospitals. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should direct the services to develop consistent estimates of near-term medical personnel requirements based on total needs and needs as constrained by available military facilities. The estimates of constrained personnel requirements should be developed together with complete assessments of the availability of other medical resources, such as hospital beds, equipment, and logistic support. |
Closed – Implemented
The Secretary of Defense issued a DOD instruction in August 1982, which can be interpreted to mean that the services should consider the availability and constraints of all types of facilities in mobilization planning. However, the instruction does not specifically state that constraints in medical facilities be considered in developing medical personnel requirements.
|
| Department of Defense | The Secretary of Defense should develop specific plans to meet the early postmobilization requirements of DOD for: (1) surgeons and other surgical personnel in-theater; and (2) medical personnel in military-unique specialties. |
Closed – Implemented
DOD asked the services to conduct feasibility studies involving preassignment of physicians in critical specialties and nurses from the active reserve and Individual Ready Reserves to early deploying units. DOD does not have any preassignment plans for enlisted personnel in military unique specialties.
|
| Department of Defense | The Secretary of Defense should require the Army to structure in-hospital training programs to provide exposure to the full range of needed skills. |
Closed – Implemented
The Army took certain steps to improve combat readiness. However, the Army does not have an in-hospital training policy which requires hands-on training in all needed clinical tasks.
|
| Department of Defense | The Secretary of Defense should plan for near term contingencies by evaluating alternatives for overcoming postmobilization medical personnel shortages, which would occur before Selective Service inductees report and are trained for military duty. |
Closed – Implemented
DOD implemented only two of the three specific elements needed to comply with this recommendation. Also, DOD did not take the necessary action to identify additional alternatives to overcome postmobilization medical personnel shortages.
|
| Department of Defense | The Secretary of Defense should require the Army to develop a system for monitoring both clinical and combat-related training to ensure that they are given a high priority and are effectively accomplished. |
Closed – Implemented
Since the report was issued, the Army has placed greater emphasis on the training of medical personnel. However, the Army has not taken any action, during this time, to develop a system which monitors the extent and quality of training being provided to medical personnel.
|
| Department of Defense | The Secretary of Defense should require the Army to provide guidance to unit and hospital commanders giving increased priority to medical readiness training. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense should ascertain the extent to which courses, such as the recently developed triservice Combat Casualty Care Course, should be expanded to provide training to medical personnel not now eligible and ensure that such training is provided to all appropriate categories of military medical personnel. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense and the Director, SSS, should submit a proposal for a postmobilization draft of medical personnel to Congress as soon as possible. |
Closed – Not Implemented
Although DOD prepared a draft proposal, the Department has not submitted the proposal to Congress. DOD officials are opposed to submitting this proposal because they feel the initiatives DOD has underway will correct the shortages, and single out one group for a draft.
|
| Selective Service System | The Secretary of Defense and the Director, SSS, should submit a proposal for a postmobilization draft of medical personnel to Congress as soon as possible. |
Closed – Not Implemented
This recommendation is virtually identical to another recommendation in this report.
|
| Department of Defense | The Secretary of Defense should evaluate the applicability of the GAO recommendations regarding the Army's medical personnel training programs to the programs of the other services and, where appropriate, ensure that the other services take steps to implement them. |
Closed – Implemented
Please call 202/512-6100 for information.
|
| Department of Defense | The Secretary of Defense and the Director, SSS, should jointly develop provisions to be included in a standby legislative proposal for a postmobilization draft of medical personnel. |
Closed – Implemented
DOD had a standby legislative proposal in draft form since the early 1980's. DOD has never obtained formal comments from the Director, SSS, on the proposal.
|
| Selective Service System | The Secretary of Defense and the Director, SSS, should jointly develop provisions to be included in a standby legislative proposal for a postmobilization draft of medical personnel. |
Closed – Not Implemented
This recommendation is virtually identical to another recommendation in this report.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should ascertain the extent to which: (1) civilian medical personnel will be required and available in the civilian sector during mobilization; and (2) DOD can rely on civilian medical personnel as it plans its mobilization efforts. |
Closed – Implemented
HHS began implementing this recommendation through its participation in the Emergency Mobilization Preparedness Board (EMPB) and the National Disaster Medical System. It participated in an EMPB task force in assessing the availability of civilian physicians. In July and August 1986, HHS began assessing the availability of PHS uniformed physicians.
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