DOCTORS' TASK

Evening Post, Volume XCIV, Issue 67, 17 September 1917, Page 8

DOCTORS' TASK

COMBIKG OUT THE FITS

SOME OF THE DIFFICULTIES

THE VALUE OF EXPERIENCE,

There being a certain amount of dis- ■ satisfaction 'throughout' the* country regarding* 'the'medidar examination of recruite, a Post reporter .waited upon the Director-General of Medical 1 Services today and requested him to' explain the difficulties the Medical Boards were labouring under, so that the public might be better able, to appreciate the position! The D.G.M.S., in reply, made the following statement: — '"MEDICAL SCIENCE NOT AN ;' '... EXACT ONE." , ; "The 'medical examination of-recruits," he said, /'is a much more difficult tack than , the average layman realises, andits complexity was not fully understood when men were first recruited for the Expeditionary Force. Most of the mcdi- | cal officers who were invited to undertake the examination had had no pre- | vious experience in work of the kind. .The result; was that they, were liable to | place different interpretations on the regulations, as to the standard required, and ao. men who should otherwise have been classed as fit were rejected. These errors have been, corrected as the medical officers have gained experience, but errors'unfortunately cannot be wholly eliminated, as with the despatch of further doctors to the front, others have to be'employed, and they have to'gain experience in their turn. The difficulties are inseparable from the conditions of the present war, which, because of its vastness, is making hitherto unheard-of demand^ on the medical services.

"The public, perhaps, will be better able to appreciate the position when reminded that medical science is not an exact one, and different medical men may have quite legitimately different opinions which they may place on certain suspected . disabilities. : Occasionally, also, the task of medical officers is accentuated by the. necessity of having to put through a large number of men within a given time, rendering thorough examination a matter of difficulty. As emphasising the fact that medical science is not an exact one, it may be mentioned that at a leading hospital at Home, attended, by eminent physicians, the results of post-mortem examinations during „ one year, disclosed somethig lik.e 10 per cent, of errors in the diagnosis made during the life time of the patients. iWhen-;that,.is .the 'case: with eminent physicians, one can more readily understand how.it 13 that young practitioners, unacquainted- with/..the physique required for soldiering, are liable.,tovary iii their estimates of the 3egree pf^'physical efficiehcyT,bf;"a particular.recruit;-1*: ' "RESULTS BECOMING MORE : SATISFACTORY^".'• ■

■■ "That was the position' in New- Zealand up to the appointment of the District Medical or Examining Boards, under the Military Service Act,; in November, 1916. It was, thenfidecided to lower the [Standard in.accordance with that fixed by the British War Office, and to examine all men called up, whether they;: had been .rejected"before under the previous standards or pot. The interpretations given to the new standard, however," were' not found satisfactory, and it-was resolved to tighten the regulations, which as regards previous examinations, complicated matters. Now, with the exhaustion of the First Division, the re-examination of likely men is proceeding 'tinder the supervision of the niosti experienced medical officers it is possible to get., . The present District Medical Boards are composed of men who have been busy practitioners of long standing and experience in New Zealand. 'Some of them have served in foreign campaigns. Endeavours have been made-tb secure uniformity in the interpretation, of % the instructions issued by conferences^ of the Medical Boards .operating.in the several districts and at Defence Headquarters, and by interchanging officers between the camp staffs and District Medical Boards. The task is one that requires time to settle, but the results are becoming more •satisfactory;■ With reference to the number of unfit" nien being sent to England, Brig.-General, Richardson, officer commanding Ne\v Zealand troops iii Great BriiaihV" writing'!'on 10th' July last, states i ' There has been a small percentage of unfit men arriving with each draft, the chief disability being over age,' but on, the whole I consider the percentage of unfit men arriving from New Zealand as very small indeed.' That answers th 6..' allegations.'.that ■'■' have been made • regarding ' the' large number of, unfit men who have been sent to Eng-' land. Dealing with a statement in the public press, that a medical man had said he-would'guarantee that when the 18th Reinforcements got to England, at least fifty of them would be rejected, for service in the field; General' Richardson writes: 'The Principal Medical Officer, Sling: Camp, states that as 1 regards, this Reinforcement, fourteen cases were not found sufficiently suitable for active service in France.' Altogether the constant practico of the District Medical Boards is producing increasing efficiency in the medical examination of recruits.

, "It js most desirable that men when coming forward in the ballot,.who have suffered from various complaints which I they consider might unfit theni for active j service, should get their family doctor ■to forward-under confidential cover his .certificate, with, reference to such disabilities direct to the group area officer concsrned; If this is done the certificates, will be.placed, before the) Medical Boarck when examining the recruits concerned. -.■■,.: , GRADUATED COURSE OF TRAIN- ... .; „ ■ ■./:.;..ING.. .... „, "It has been found in New. Zealand, as in ' Great' Britain, that owing to unfamiliari ty ■• with recruiting requirements a certain nujnber of' men possibly may have been found unfit who/nevertheless might bo fit for the Expeditionary Force at once or*l>e made fit after undergoing a short coarse of graduated training in the camps. These are the men who are now being called up for re-examination in the. revision of the First Division. Lest misunderstanding should'-still'-exist in this connection, it is as well to repeat that the standard ■ for such men is not being lowered in. any way, the standard required for them being the same as that for fit men posted to the Reinforcement drafts...'.The. graduated course of training fixed is the same as that laid down by the Army Council at Home for young -recruits,-'namely i those who go in at 18 years of age. ,Such men classed, as (Cl) and sent into the '01 Training Camp' at ■ Featherston will commence •wi^h short intervals, of the easier forms of physical training and with lectures at rest, and will perform mo duties to begin with ■beforebreakfast'/'Theywill be under the constant supervision of a specially-select-ed medical officer and an experienced physical'-.instructor, .a military officer, wh"d has lately arrived from : England, where he was employed'in similar preparatory training camps.- ;Thekroen. that lsv such as-are- considered, .fit, wiLl be posted-.-.to ...the ..;Reiriforcemeiit drafts at monthly intervals. . Those, who have not attained''the standard required-.will be kept on for a further period of training— it may be for a month or more—and as

they shape will >either be posted to a ■Reinforcement or discharged altogether, j Of course, where it is considered that there is no prospect, of a man being able to qualify for active service he will be at once .discharged, irrespective of whether he has been in camp a month or,not." THE FUTURE ASSURED. "The truth is that, having been unprepared for this war, we have had to make the best of. things as we have gone along. This has been done with the medical services to the extent that the future of the New Zealand Army-, as faT as the efficiency of this depai"tmenit is concerned, is now assured. This is guaranteed by the establishment of the Medical Officers' Training Corps at Otago University, which from now on will be turning out well-trained medical officers every year who will have a | thorough .knowledge of military medical requirements, both as regards the examination of recruits and organisation in the field and hospitals. These officers having, all been trained in the one school of thought, New Zealand is not likely to experience the same difficulties again j that have been troubling her during 1 the past three years."