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APHA Scientific Session and Event Listing

Recorded presentation

Stephen K. Trynosky, JD, MPH, School of Public Health, Dept. of Social and Preventive Medicine, State University of New York at Buffalo, Farber Hall, Room 270, 3435 Main Street, Buffalo, NY 14214, (716) 836-2989, trynosky@buffalo.edu

As the all-volunteer U.S. military maintains a presence in over 110 nations, the medical professionals that serve it no longer represent the face of American medicine. The composition of military healthcare professionals changed dramatically after the end of physician conscription in 1973. From 1950 through 1973, the “Doctor's Draft Law” brought over 23,400 physicians into the military. Drafted professionals completed a two-year term of service without financial incentives and since only 4% of draft-eligible physicians under age 35 did not serve, military doctors in Korea and Vietnam were a mirror reflection of American medical schools. Some observers contend that the short terms of service and healthy dose of skepticism among drafted doctors prevented many ethical conflicts between their role as physicians and military officers. Today's military physicians are drawn into service almost exclusively through financial incentives such as scholarships, loan repayment or the no-cost Uniformed Services University of the Health Sciences (USUHS). Most new doctors now serve an initial four year service obligation and some have commitments exceeding fourteen years. While Department of Defense officials laud this arrangement as “growing our own,” some question whether the military suffers by developing an increasingly separate medical community. Others express concern that USUHS and military residency programs “institutionalize” doctors, and coupled with lengthy service commitments, make them hesitant to intervene where conflicts between the role of physician and military officer arise. This discussion is essential for those interested in understanding who serves in our name.

Learning Objectives: At the conclusion of this session, the participant (learner) in this session will be able to

• Identify the key demographic and educational differences between pre-1973 military health care professionals and those that comprise the current all-volunteer force.
• List two ways that current accession programs for military health care professionals may create conflict within the dual-role of physician and military officer.

Keywords: Workforce, Federal Policy

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation