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| Pharmacy at Percy Jones General Hospital, Battle Creek, Michigan |
While researching the military
medical system for my World War II novels, I read about physicians and nurses,
dentists and veterinarians. But where were the pharmacists? In the civilian
world, the physician prescribes medication, the pharmacist purchases,
compounds, and dispenses, and the patient or nurse administers. I discovered
the wartime military system differed. As a pharmacist I was baffled and
intrigued.
My research eventually inspired On Distant Shores, which follows Army pharmacist Tech. Sgt. John "Hutch" Hutchinson and flight nurse Lt. Georgie Taylor through Sicily and Italy.
First we looked at the role of the pharmacist inthe 1940s, then we took a visit to the local drug store and how its role changed during the war, and
today I’ll review the rather shocking role—or lack thereof—of pharmacy and
pharmacists in the US military.
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Army technical manual TM 8-233
Methods for Pharmacy Technicians
October 13, 1941 |
Drug
Distribution in the Military
In the US Army and Navy,
outpatient prescriptions were filled at base or unit dispensaries, while
inpatient orders were filled at hospital pharmacies. Both dispensaries and
pharmacies were staffed by enlisted personnel—pharmacy technicians in the Army
and pharmacist’s mates in the Navy—under the control of physicians. In 1936,
the pre-war Army had forty graduate pharmacists serving as enlisted
technicians.
Pharmacy technicians did not need
any previous health care background or education. They went through a
three-month program based on practical training rather than scientific
understanding.
Medical
Administrative Corps
For decades, pharmacy
organizations had lobbied for a Pharmacy Corps with commissioned pharmacists.
Indeed, most nations had similar corps. However, the US Army Medical Department
thought of pharmacists in a condescending manner as
businessmen rather than professionals, and they saw their drug distribution
system as adequate.
The Medical Administrative Corps
was formed in 1920 as a compromise. The MAC was responsible for administrative
duties within the Medical Department, including medication procurement and
distribution. In 1936, the MAC was permitted to commission sixteen pharmacists,
with future appointments in the MAC restricted to graduate pharmacists.
The number of officers in the MAC
increased during the war. In 1943 six hundred graduate pharmacists served as
MAC officers—but none of them served as pharmacists.
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| Pharmacist at the US 8th Evacuation Hospital, Teano, Italy, March 1944 |
Options for
Pharmacists
Since most draft-age pharmacists
had four-year bachelor’s degrees, they were eligible to serve as officers.
While physicians, nurses, dentists, and veterinarians were commissioned as
officers and placed in appropriate positions, no such option was available
for pharmacists.
Upon enlistment, pharmacists
could apply for the Army Officer Candidate School, but upon graduation, they
could be assigned anywhere. Pharmacists served as infantry officers, artillery
officers, and in many other divisions. Even if they happened to be assigned to
the MAC, as noted above, they did not practice their profession.
If a pharmacist wanted to compound
and dispense medications, his only option was to serve as an enlisted
technician, with pay and privileges far below that of an officer.
Fight for a
Pharmacy Corps
The American Pharmaceutical
Association (APhA) renewed the legislative battle for a commissioned Pharmacy
Corps. The Surgeon General’s office argued that “Army pharmacy was simpler than civilian practice. The department’s
three-month pharmacy technician course was sufficient preparation. There was
little compounding. Since medications were furnished in tablet form, ‘any intelligent
boy can read the label’” (1).
These arguments did not sit well with pharmacists—or with the
general public. Dr. Evert Kendig of the APhA argued that “Army pharmacy
technicians were given responsibility beyond that legally permissible in
civilian life even as the Army misused its professional pharmacists” (1).
Several incidents were reported of prescriptions improperly filled by
technicians and of blatant physician prescribing errors that would have been
caught by a pharmacist. Public opinion tipped the scale, and on July 12, 1943,
President Roosevelt signed legislation authorizing the formation of the
Pharmacy Corps.
Pharmacy Corps
The Pharmacy Corps was authorized
to commission seventy-two pharmacists. However, the military moved slowly. In
January 1944, after receiving 900 applications and conducting two-day written
examinations, physical examinations, and interviews, twelve officers were
commissioned. By January 1945, the Pharmacy Corps had only commissioned
eighteen pharmacists. The other officers’ slots were filled by former MAC
officers.
The drug distribution system did
not change by the end of the war, but the formation of the Pharmacy Corps laid
the groundwork for post-war reforms.
Resources:
2.
Worthen,
Dennis B. Pharmacy in World War II.
New York: Pharmaceutical Products Press, 2004.
Labels: pharmacists, pharmacy, Pharmacy Corps, pharmacy in WWII, World War II
