Koop Seeks Health Corps 'Uniformity'

WASHINGTON—Surgeon General C. Everett Koop's plan to "revitalize" the Public Health Service's commissioned corps has drawn the fire of researchers at the National Institutes of Health and the Centers for Disease Control. And the outcome of a May 18 NIH meeting designed to soothe them is not clear. "It looks like some of you came loaded for bear and weren't sure I was a bunny, so you shot anyway," Koop said following a series of pointed questions from the audience. Putting members back into uniform is the first step in Koop's plan to shape up the corps. In an April 6 memo to all 5,400 corps members, Koop ordered that "effective May 1, 1987, you are directed to own and wear the appropriate uniform" every day. Corps members had been required to wear the uniform once a week, but the rule was often ignored. (About half the corps members at the NIH meeting were in uniform.) Koop's memo also warned of more frequent transfers and a tighter system for reviewing promotions. After the meeting, NIH Director James B. Wyngaarden said that rules regarding uniforms would be forthcoming, but he would not say when. "We were given assurances that there was flexibility," he said. "We'll have to see what is the best deal we can get," he added. PHS clinicians and researchers work at various federal health agencies, including 750 at NIH and 588 at CDC. They also staff the Indian Health Service, community health care facilities, and health programs for migrant workers. The commissioned corps, patterned on the Army's commissioned officer corps, is the elite of the PHS. Following a meeting with CDC corps members in late April, Koop decided to allow the head of each agency within the service to set uniform requirements for its own members. The resulting decisions vary widely. (see bottom) Some 14 work groups are now establishing personnel procedures for implementing Koop's plan. "It is no little hubris for Dr. Koop, in his infinite wisdom, to think he can improve research by making corps members wear uniforms and insisting they move around, perhaps to the Indian Health Service," said Joseph E. Rail, NIH deputy director for intramural research, several days before the meeting. "It shows a total ignorance of how modem biomedical research is done." One virus researcher at the NIH meeting, dressed in blue jeans, sneakers and a work shirt, said that. the general feeling among corps members was "dismay." The uniform requirement is especially galling, he said. "I work with lab animals all day and they're scared enough as it is. A uniform won't help things." But a scientist from the National Institute on Aging, resplendent in summer whites, said the uniforms were "no big deal." The PHS uniform, with its short sleeves, open collar and no tie, is even an advantage in summer, he said. History of Criticism The corps was established as an elite, mobile group that could respond quickly to public health emergencies. Critics, including Koop, have said that the current corps has strayed too far from that ideal and that morale is suffering. But many scientists disagree. Koop has said his proposed changes are needed because the corps is the "object of criticism and, at times, ridicule. Serious doubt has been voiced, some warranted, about the corps' effectiveness as a uniformed service." Koop told corps members that "without some major intervention.. . we would see [the corps] demise within a decade." Much of that criticism has come from the Office of Management and Budget, which for years has sought to reform the personnel policies of the Public Health Service. As a uniformed service, corps members receive pay and benefits equivalent to those for military personnel; physicians receive pay bonuses. Critics have charged that the corps is top-heavy with senior officers whose duties do not always justify the extra pay. Beyond the symbolism of uniforms is the real issue of transfers. Several speakers told Koop that a system of military-like transfers could ruin a good clinical research program and waste 10-15 years of work. "It is ludicrous to think that any good personnel program would assign an individual to an inappropriate job," responded Assistant Surgeon General Edward Martin. "Any moves in or out of NIH will have the concurrence of the director." But Martin's are not the final words on the subject. "You know how easy it is to put pressure on an institute director?" scoffed one scientist. Byrne is on the staff of The Scientist. If It's Tuesday... The new uniform requirements for PHS commissioned corps personnel, are anything but uniform. Here's the rundown. CDC and NIH. Only on Wednesdays. CDC said it will enforce the rule beginning July 1. The enforcement date for NIH has not been set. Health Resources Services Administration. Monday through Friday. Food and Drug Administration. Wednesdays plus one other day each week, chosen by the individual. Alcohol, Drug Abuse and Mental Health Administration Three days a week, chosen by the individual. The uniforms resemble those of the U.S. Navy and are purchased through Navy uniform stores. A full dress uniform costs about $250. Corps members must own both summer whites and dress blues.

Koop Seeks Health Corps 'Uniformity'

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