Events Leading to the Formation of the Women`s Medical Specialist Corps
Colonel Emma E. Vogel, USA (Ret.),
and Major Helen B. Gearin, USA (Ret.)
Dietitians, physical therapists, and occupational therapists became a part of the medical program of the U.S. Army during World War I. They served as civilian employees not only in hospitals in the United States but also in hospitals with the American Expeditionary Forces in France and with the army of occupation in Germany after the armistice.
In this period and in the years intervening until World War II, although they were subject to Army regulations, they were not accorded the rights or benefits authorized for military personnel with whom they served. During World War I, they were not eligible for the benefits of the war-risk-insurance program nor were they entitled to retirement pay for service-connected illness or disability. After the end of hostilities, they were not permitted extended hospitalization in Army hospitals for injuries or illnesses incurred while on duty with the Army; neither were they entitled to treatment in other federal hospitals. Overseas, they were required to wear the prescribed hospital and street uniforms but received no uniform allowance nor did they have any items of the uniform issued to them during the war by the Army. The American National Red Cross furnished many articles of the uniform and equipment free to those going overseas and provided the street uniform at cost price.
Among the many medical officers who were impressed with the value of the services rendered by these women during World War I was one young Regular Army medical officer who later became The Surgeon General of the Army. In this capacity, Maj. Gen. Norman T. Kirk (fig. 1) played a vital role in the passage of legislation which gave full military status in the Army of the United States to the nurses, dietitians, and physical therapists1 and the later legislation which authorized the establishment of the Women`s Medical Specialist Corps and Regular Army status for nurses, dietitians, physical therapists, and occupational therapists.2 It is unlikely that these bills would have been favorably considered by the Congress had it not been for General Kirk`s strong support and
- Public Law 350, 78th Congress, 2d Session, approved 22 June 1944.
- Public Law 36, 80th Congress, 1st Session, approved 16 Apr. 1947.
FIGURE l. Maj. Gen. Norman T. Kirk, USA, The Surgeon General, 1 June 1943-31 May 1947.
determination to improve the status of women serving in the Medical Department.
In July 1919, Miss Lenna F. Cooper, Supervisor of Dietitians, Surgeon General`s Office, recommended that (1) all female professional civilian personnel employed in Army hospitals be accorded a status similar to that of members of the Army Nurse Corps, and (2) a separate corps for dietitians be established, to be administered by a director of dietitians in the Surgeon General`s Office. (See Appendix A, p. 593.) No action resulted from these recommendations.
In January 1931, Miss Grace H. Hunter, Chief Dietitian, Walter Reed General Hospital, Washington, D.C., pointed out to The Surgeon General that there had been no appreciable change in the salary or status of dietitians since World War I.3 Army hospitals were losing their experienced dietitians because of more attractive salaries elsewhere. Miss Hunter recommended (1) a graduated salary scale, (2) salary increases commensurate with years of experience and responsibilities, (3) a military status for dietitians similar to that of the members of the Army Nurse Corps, and (4) centralized supervision and direction of dietitians.
In February 1931, similar recommendations were forwarded to The Surgeon General by Miss (later Col.) Emma E. Vogel, Supervisor of Physical Therapists, and Miss Alberta Montgomery, Supervisor of Occupational Therapists, both on duty at Walter Reed General Hospital.4 In addition to Miss Hunter`s recommendations, Miss Vogel recommended (1) the establishment of a Medical Auxiliary Corps to consist of dietitians, physical therapists, and occupational therapists separate from but with the same benefits as those authorized for the Army Nurse Corps, and (2) the establishment of a Medical Auxiliary Corps Reserve group to consist of graduates of the Army training courses in these three specialities and former employees in the Medical Department in these three categories.
In reply to these recommendations, The Surgeon General, in March 1931, approved in principle an increased salary scale. He pointed out, however, that funds for the salaries of civilian employees were constantly being curtailed and to accomplish salary increases it would first be necessary to effect a reduction in force of these employees. Centralized supervision of the dietitians was not approved and the question of a military status was held in abeyance. At the same time, in a letter to The Surgeon General, Col. (later Brig. Gen.) Roger Brooke, MC, Commanding Officer,
3 Letter, Miss Grace H. Hunter, Chief Dietitian, Walter Reed General Hospital, to The Surgeon General, 31 Jan. 1931, subject: Status of the Dietitian in U.S. Army Hospitals.
4 (1) Letter, Miss Emma E. Vogel, Supervisor of Physical Therapists, to The Surgeon General, 9 Feb. 1931, subject: Increased Salary and Recognition of Physical Therapy Aides. (2) Letter, Miss Alberta Montgomery, Supervisor of Occupational Therapists, to The Surgeon General, 12 Feb. 1931, subject: Graduated Salary Scale for Occupational Therapy Aides.
Fort Sam Houston Station Hospital, Tex., indicated that at least one hospital commanding officer also recognized the desirability of military status for the dietitian and the physical therapist. 5
The need for a permanent status was clearly demonstrated in 1933. That year, under the provisions of the National Economy Act, the number of veterans hospitalized in Army hospitals for non-service-connected disabilities was drastically reduced. Since the salaries of dietitians, physical therapists, and occupational therapists were largely paid from funds derived from the Veterans` Bureau (now Veterans` Administration), their services were abruptly terminated in many Army hospitals and markedly curtailed in others. Some of these services were partially restored the following year as funds became available for salaries (on a reduced scale) when the Medical Department assumed the responsibility for the treatment of patients referred by the Civilian Conservation Corps.
These women, however, continued to feel a sense of insecurity in their positions. Since civil service status was not authorized for them, there was no provision for retirement and limited opportunity for increase in salary. Economic pressure following the passage of the National Economy Act resulted in a steady but gradual decrease in the number of these specialists in the Medical Department. By April 1938, there were only 45 dietitians, 35 physical therapists, and 9 occupational therapists employed.6 Their morale was somewhat improved in June 1938 with the issue of Executive Order No. 7916 which directed that all civilian positions in the Medical Department at Large, paid out of appropriated funds, would be brought within the competitive classified civil service status not later than 1 February 1939.
The first congressional champion of military status for these groups was Representative Carl Vinson. During his many visits to patients at Walter Reed General Hospital over a period of years, he had observed the work performed by physical therapists and had become an ardent supporter for an improved status for them. Realizing that it would be impossible to initiate legislation to provide a military status for this group without the support of The Surgeon General, early in 1937, Representative Vinson requested his views on the subject.7
5 1st Indorsement, Col. Roger Brooke, MC, Commanding Officer, Station Hospital, Fort Sam Houston, Tex., to The Surgeon General, 26 Mar. 1931, through The Surgeon, Eighth Corps Area, Fort Sam Houston, Tex.
6 Memorandum, Lt. Col. R. D. Harden, MC, Office of The Surgeon General, for General Reynolds, 8 Apr. 1938.
7 Letter, Hon. Carl Vinson, Chairman, Committee on Naval Affairs, House of Representatives, to Maj. Gen. C. R. Reynolds, The Surgeon General, U.S. Army, 27 Feb. 1937.
In reply, The Surgeon General stated that physical therapists had no claim to a commissioned status which did not apply equally to dietitians and occupational therapists.8 He advised Representative Vinson that commissions for these employees would not be requested for they would not be required to enter a war zone or serve at the front as were members of the Army Nurse Corps. In view of this opinion, Representative Vinson did not pursue the subject at that time. Throughout the years, however, he continued to be vitally interested and influential in working for military status for these women.
In 1938, Brig. Gen. Wallace C. DeWitt, Commanding General, Army Medical Center (later Walter Reed Army Medical Center), Washington, D.C., wrote to The Surgeon General saying that, in his opinion, the time had come to insure that dietitians, physical therapists, and occupational therapists were accorded a military status similar to that of members of the Army Nurse Corps.9 This was not General DeWitt`s first effort in behalf of these women, for over a period of years he had often expressed his belief in the need for a military status for these groups. In spite of the fact that war clouds were already beginning to form on the horizon over Europe, The Surgeon General did not concur in this recommendation and took no action.
The first legislative effort to authorize a military status for these groups was initiated early in 1939 by Senator Morris Sheppard.10 His interest in promoting this action was stimulated by his niece, Miss (later Maj.) Olga Heard, a dietitian on duty at Walter Reed General Hospital. In reference to this bill, The Surgeon General stated that if dietitians and physical therapists were to properly fulfill their function in Army hospitals, they should be accorded a military status.11 In commenting on these bills, the Secretary of War recognized that the services of dietitians and physical therapists were essential, but stated that occupational therapists, although necessary in time of war, were not considered essential from the standpoint of becoming a permanent adjunct in the Medical Department.12 The proposed legislation, however, was not considered to offer sufficient advantage to the Army to justify the additional cost which would be involved. The Secretary of
8 Letter, Maj. Gen. C. R. Reynolds, The Surgeon General, to Hon. Carl Vinson, Chairman, Committee on Naval Affairs, House of Representatives, 3 Mar. 1937.
9 Letter, Brig. Gen. Wallace DeWitt, Commanding General, Army Medical Center, Washington, D.C., to The Surgeon General, War Department, 19 Mar. 1938, subject: Status of Dietitians, Physiotherapy and Occupational Therapy Aides.
10 S. 1615, 76th Congress, 1st Session, presented by Hon. Morris Sheppard, Chairman, Committee on Military Affairs, U.S. Senate, 27 Feb. 1939, A Bill, To authorize the appointment of female dietitians and female physiotherapy and occupational-therapy aides in the Medical Department of the Army.
11 Memorandum, Maj. Gen. C. R. Reynolds, The Surgeon General, for Assistant Chief of Staff, G-1, War Department (Liaison), 15 Apr. 1939, re: S. 1615 and H.R. 4934.
12 Letter, Harry W. Woodring, Secretary of War, to Senator Morris Sheppard, Chairman, Committee on Military Affairs, U.S. Senate, 7 July 1939.
War also stated that the legislation was not in accord with the program of the President, and consequently, no hearings were held.
Senator Sheppard was not easily discouraged, for he introduced his bills again in 1940 and 1941 including only dietitians and physical therapists. Neither of these bills was favorably considered, since the War Department saw no need for militarizing these women at that time. Such action also might have encouraged various other civilian groups employed in Army hospitals to importune Congress for similar legislation. At that time, it was generally considered that the services of dietitians and physical therapists would not be required overseas in the event of war, and therefore, the protection afforded by the military status would not be essential. Within a year after the presentation of the last bill dietitians and physical therapists were assigned to the first hospital units which went overseas early in 1942.
In each of these legislative efforts, Senator Sheppard had the strong support of Representative Vinson. Even though these early attempts to introduce legislation failed, they served a useful purpose for, in the discussion of these proposals, members of the various committees in Congress became familiar with the duties and responsibilities of these employees and their lack of military status.
World War II clearly demonstrated that civilian status for women serving overseas in a military organization was unjust. As in World War I, dietitians and physical therapists going overseas in 1942 were not permitted to wear the U.S. insignia or an arm brassard, so the only means of identifying them as citizens of the United States was a flimsy piece of paper about 4 by 7 inches, which was easily lost.13 Neither were these women entitled to avail themselves of war-risk insurance authorized for military personnel. For injuries incurred while in the actual performance of their duties in the United States, they were protected under the Federal Compensation Act but this act afforded no security to civilian employees serving overseas.14 This was an unfortunate status for professional women who were subject to the same risks and hazards as the military personnel with whom they served. It was exceedingly difficult for those not associated with the military to comprehend the reasons for these discriminations, and as a result, personnel procurement was slow.
In 1942, Brig. Gen. (later Lt. Gen.) W. D. Styer, Chief of Staff, Services of Supply, pointed out that dietitians and physical therapists were serving overseas with virtually no protection under international law. He directed that an immediate investigation be made concerning
13 Certificate of Identity, Form 61, Medical Department, U.S. Army (Revised), 17 Apr. 1915. This certificate was superseded by W.D. A.G.O. Form No. 65-10, 20 May 1942.
14 Compensation Act II (9-728), United States Employees Compensation 1938, subject: Right to Compensation for Personal Injuries of Civil Employees of the United States, Under Federal Compensation Act of 7 Sept. 1916, as amended.
the feasibility of initiating legislation to provide them with the protection to which they were entitled. In reply, Maj. Gen. James C. Magee, The Surgeon General, stated that the functions of dietitians and physical therapists were as important in the care of the sick as those of the nurse in Army hospitals and that they should have the same protection.15 Since legislation to improve the status of members of the Army Nurse Corps was under consideration at that time, it was expedient to include dietitians and physical therapists in the proposed bill. In testifying at hearings on this bill, Brig. Gen. (later Maj. Gen.) Miller G. White, Assistant Chief of Staff, G-1 (personnel), commented on the difficulties encountered in getting dietitians and physical therapists to go overseas in civilian status and in providing housing and subsistence for them. He recommended that they be accorded the same status as Army nurses.
At the hearings on 13 October 1942, Miss Helen S. Willard, Chairman, War Service Committee, American Occupational Therapy Association, said that her association strongly recommended that occupational therapists be included in the proposed legislation. At the hearing held on 16 November 1942, Brig. Gen. Larry B. McAfee, Deputy Surgeon General, testified that the reason for including dietitians and physical therapists in the bill was that, along with nurses, they were the only women authorized for oversea units. Following these hearings, the bill was rewritten to include dietitians and physical therapists as recommended by the War Department and was passed by the House of Representatives.
At the hearing before the Senate on 25 November 1942, Dr. Winfred Overholser, Chairman, Committee on Neuropsychiatry, National Research Council, and Superintendent, St. Elizabeths Hospital, Washington, D.C., testified in favor of including occupational therapists and pointed out that procurement of this specialized personnel would be exceedingly difficult if they remained in the civilian status. In the discussion, General McAfee stated that if a wounded man could not be returned to combat duty within 120 days, he would be evacuated to a hospital in the United States where the services of occupational therapists would be essential. The report submitted on 3 December 1942 recommended favorable consideration of the bill with several amendments, chief of which was the inclusion of the Navy Nurse Corps on the same basis as the Army Nurse Corps.
On 22 December 1942, the 77th Congress passed Public Law 828 which authorized for dietitians and physical therapists a military status with relative rank in the Medical Department for the duration of the war and 6 months thereafter. The military status was enthusiastically
15 Memorandum, Brig. Gen. W. D. Styer, Chief of Staff, Services of Supply, for Brig. Gen. James E. Wharton, Director of Military Personnel, Services of Supply, 11 June 1942, subject: Civilians Assigned to Medical Department Units, with 2d indorsement thereto, 14 July 1942.
welcomed by them for now they were part of the Army, not merely with it. They accepted their new status with pride. Because occupational therapists were not included in the bill, they continued to serve as civilian employees in Army hospitals in the United States. Their lack of military status was to have an adverse effect on the procurement of this group during the war years. Following enactment of the law, Helen C. Burns16 was designated as Director of Dietitians and Miss Vogel as Director of Physical Therapists. Both were appointed in the relative rank of major but received the pay and allowance of captains.
Under Public Law 77-828 the dietitians and physical therapists were not fully commissioned Army officers since their appointments were with relative rank in the Medical Department only. This law had been in effect several months when Congress passed legislation authorizing full military status in the Army of the United States for officers appointed in the Women`s Army Corps. In comparing the privileges authorized under these laws it was observed that officers appointed in the Women`s Army Corps were entitled to allowances for dependents--a privilege which was not accorded to the nurses, dietitians, and physical therapists. A bill (H.R. 3761) designed to amend Public Law 77-828 was introduced in the House by Representative Frances P. Bolton on 1 December 1943.
When the amendments were first discussed, there were some members of the Committee on Military Affairs, House of Representatives, who, at that time, favored legislation to authorize a permanent commissioned status for these women. However, in May 1944, the Secretary of War stated that while the War Department favored legislation to authorize for nurses, dietitians, and physical therapists a full commissioned status in the Army of the United States for the duration of the war and 6 months thereafter, it did not consider the time appropriate to enact legislation affecting the peacetime organization of the Army.17 He further stated that the War Department recognized the inequities which existed because of the relative rank status and would interpose no objection to enactment of the legislation under consideration. The bill, passed as Public Law 78-350 on 22 June 1944, authorized for these personnel full commissioned status in the Army of the United States with the same rights, benefits, and privileges as other commissioned officers. Another milestone in the long struggle for military recognition had been passed.
Shortly after the termination of World War II, a series of conferences began in the Surgeon General`s Office to formulate plans for the
16 Later Maj. Helen B. Gearin, WMSC.
17 H. Rept. 1512, 78th Congress, 2d Session, 25 May 1944.
postwar legislative program.18 On 29 January 1946, The Surgeon General recommended19 the establishment in the Regular Army of an Army Nurse Corps and a Women`s Medical Specialist Corps, the latter to consist of dietitians, physical therapists, and occupational therapists, both corps to consist only of officers. In summary, he stated that it was necessary that these corps be militarized in the peacetime Army, for the following reasons:
1. Nurses, dietitians, and physical therapists were officers in the Army of the United States during World War II, and in this capacity, had been a credit not only to the Medical Department but to the Army as a whole. Occupational therapists had served with distinction as civilians during the war and should also be militarized in the peacetime Army. Qualified personnel in these categories were being recruited by civilian and other governmental agencies, and if the Army were to retain their services, it was essential that they be offered commissions in the Regular Army.
2. These professional personnel were indispensable to the efficient operation of Army hospitals and their militarization would enable the Army to utilize their services when, where, and as needed both overseas and in the United States.
3. The cost of militarizing these specialists in the peacetime Army would be no greater than the cost of their employment as civilians.
4. Since the public had looked with pride on nurses, dietitians, and physical therapists as commissioned officers during World War II, it would be demoralizing to these groups if their commissioned status were not continued in the postwar Army.
5. The work of all--the nurse, the dietitian, the physical therapist, and the occupational therapist--was interrelated and their militarization would foster teamwork in the care of patients in Army hospitals and insure permanency and continuity in such care.
On 30 April 1946, the Assistant Chief of Staff, G-1, called a conference to consider legislation proposed to establish Regular Army status for dietitians, physical therapists, and occupational therapists. Because of the wide divergence in their duties, there was considerable discussion as to whether three corps, each headed by a director with the rank of lieutenant colonel might be preferable to one corps containing the three specialties headed by a director in the rank of colonel.20 The Legislative Branch of the War Department finally decided that there should be one corps, to be called the Women`s Medical Specialist Corps. It would parallel the structure of the proposed Medical Service
18 These conferences were usually attended by Col. Florence A. Blanchfield, Chief, Army Nurse Corps; Maj. Helen C. Burns, Director of Dietitians; Maj. Emma E. Vogel, Director of Physical Therapists; Miss H. Elizabeth Messick, Chief, Occupational Therapy Branch; and representatives of the Personnel, Legal, and Planning Divisions in the Surgeon General`s Office.
19 Memorandum, Maj. Gen. Norman T. Kirk, The Surgeon General, for Assistant Chief of Staff, G-1, attention: Lt. Col. E. P. Smith, 29 Jan. 1946, subject: Military Status for Army Nurses, Physical Therapists, Dietitians, and Occupational Therapists.
20 Memorandum for Record, 30 Apr. 1946, subject: Conference, General Kirk, General Paul, G-1 on Legislation to Create the Army Nurse Corps, Dietitian Corps, Physical Therapist Corps, and Occupational Therapist Corps in the Regular Army.
FIGURE 2. After signing Public Law 80-36, President Truman was photographed with (left to right) Col. Florence A. Blanchfield, Lt. Comdr. Ruth B. Dunbar, Maj. Helen C. Burns, and Maj. Emma E. Vogel.
Corps which was to consist of several distinct groups of male commissioned specialists. No action was taken on the legislation by the 79th Congress before its adjournment in August.
The 80th Congress convened on 3 January 1947. Within 5 weeks the proposed legislation was presented to a subcommittee of the Committee on Armed Services, House of Representatives, by Representative Margaret Chase Smith who had long endorsed full military recognition for women serving in the Armed Forces. She pointed out that passage of the legislation would not increase the per capita expenditures over those which existed during the wartime period. The bill was passed in the House on 10 March and on 24 March received favorable consideration in the Committee on Armed Services in the U.S. Senate,21 and subsequently was passed by the Senate.
On 16 April, President Truman signed Public Law 80-36, the Army-
21 Hearing before the Committee on Armed Services, U.S. Senate, 80th Congress, 1st Session, 24 Mar. 1947, on H.R. 1943.
Navy Nurses Act of 1947, establishing the Army Nurse Corps and Women`s Medical Specialist Corps in the Regular Army. The ceremony was witnessed by Representative Smith, author of the bill and chairman of the subcommittee; members of the committee; General Kirk; Col. Florence A. Blanchfield, ANC, Chief, Army Nurse Corps; Major Vogel; Major Burns; as well as Rear Adm. Clifford A. Swanson, The Surgeon General of the Navy; and Lt. Comdr. Ruth B. Dunbar, Assistant to the Chief, Navy Nurse Corps.
Later, President Truman invited Colonel Blanchfield, Commander Dunbar, Major Vogel, and Major Burns to his office in the White House. Expressing his pleasure at the passage of the bill, he had his photograph taken with them (fig. 2). Each was presented with one of the pens he had used in signing the bill.
Thus the corps was authorized. The permanent military status accorded the dietitians, physical therapists, and occupational therapists gave recognition to their 30 years of professional service in the Army medical program. Detailed in the chapters which follow is the development of the professional programs of the three constituent groups during World Wars I and II and their subsequent activities as components of the Women`s Medical Specialist Corps.