Helping Out the Doctor

Two years ago, Dr. William Henry was ready to succumb to his annual urge and quit his general practice in rural Twisp, Wash. (pop. 750). As the only full-time physician in a 500-sq.-mi. area, Henry was so overworked that he seldom read a medical journal and never had a vacation. But last year the doctor got expert help from Carl Chillquist, a former Army medic. As Henry's paraprofessional aide, Chillquist enabled the doctor to see many more patients, skim those journals, and even get away for skiing and fishing. In recent years, Twisp itself has never had better medical care.

What brought Henry and Chillquist together was Medex, a unique program that recruits former military medics to work as doctors' helpers. The program, which takes its name from the French medecin extension (extension of the physician), was conceived in 1968 by Dr. Richard Smith, a professor of health services at the University of Washington. Smith had surveyed his state and found a serious imbalance between urban and rural medical services. While the Seattle area had one doctor for every 506 patients, the ratio in some rural areas stood at 1 to 5,000. "We found doctors who were working 14 to 16 hours a day," said Smith. "Some hadn't had a vacation in seven years. One town that had had five doctors was down to two, and one of those was talking about leaving."

Wasted Years. Smith turned to a previously untapped manpower pool: the medical corpsmen who administer emergency care and assist physicians throughout the military services. "The armed forces spend up to $25,000 for training each corpsman," he explained. "A corpsman may have from 600 to 2,000 hours of formal medical training and up to 20 years of experience. Yet, after his discharge, he can rarely find a related health job in civilian life."

In 1969, Smith and his medical school launched the first Medex demonstration program with 15 former medical corpsmen. Paid by the Government, the men got three months' training that emphasized skills missing from their military experience, such as pediatrics and geriatrics. The trainees were then paired with general practitioners for year-long preceptorships, after which they were hired by the doctors for salaries ranging from $8,000 to $12,000.

Battlefield Credentials. Wearing blue coats to distinguish themselves from physicians, the Washington State Medex men take patients' histories, help give physical examinations, suture minor lacerations, apply and remove casts. In a recent survey of the results, eight doctors reported that last year they were able to treat 25,000 more patients than in 1969--an increase of 40%-50%.

Dr. Wil Gamon, who practices in Cheney (pop. 6,407), has nothing but praise for Medex Robert Woodruff, a former Army medic who helps him provide medical care at Eastern Washington State College. "He has good rapport with the students, who come back often and ask for him," says Gamon. Patients are equally impressed with the work of ex-Navy Corpsman Ronald Graves, a veteran of Marine combat in Viet Nam, who now works with Dr. Marshall Thompson in Davenport. Says one middle-aged patient: "If he's good enough to take care of our boys on the battlefield, he's good enough for me."

Other doctors will soon take advantage of the corpsmen's competence. Next month, trainees from Dartmouth Medical School's Medex program will begin preceptorships with general practitioners in New England. From Alabama to California, similar programs may put former military medics to work in a total of 14 states before the end of the year. Recruits are hardly lacking. The armed forces expect to discharge about 35,000 trained medical specialists this year. So far, 6,000 ex-medics have sought to put their training to use by enlisting in Medex.

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