Summary: Since the end of the draft in 1973, the military's direct medical care system has experienced a gap between the number of military physicians it has available and the number needed to provide medical care, seriously impairing the system's ability to meet peacetime medical needs efficiently and effectively. Hospital operations have been hampered by the lack of physicians as has the ability of active-duty members to obtain medical care.
The military service medical departments project substandard professional staffing levels past 1984, with no foreseeable increase in the supply of military physicians. Department of Defense (DOD) data showed widespread closings and reductions of medical services in fiscal year 1978 due to the shortage affecting all beneficiaries. GAO visited seven military hospitals and found services closing and reopening, depending on physician availability; patients sent elsewhere or moved long distances for specialized services; greater dependence on civilian services; longer waits by patients; occasional denial of services; and temporary assignments of physicians to short-handed nonmedical functions. GAO recognizes the physician shortage but sees additional reasons for the system's shortcomings, including shortages among other medical service personnel. GAO surveyed beneficiaries living within 30 miles of military hospitals and found that most families of retired members had tried to obtain medical care during an 8-month period; about one-third of them could not do so. GAO estimated that, in the survey period, 104,000 active-duty members and 157,000 retirees failed to obtain care. A follow-up questionnaire from GAO showed that most patients sought medical care elsewhere because of physician shortages or long waits for appointments; they compared civilian care favorably to that of military hospitals and experienced only slight difficulty in paying for these services.
