European Stars And Stripes (Newspaper) - January 21, 1986, Darmstadt, Hesse                                Page b the stars and stripes tuesday. January 21.1986 military Medicine of the front or. Capt Andrew Pele Raon examines Volta Dawaon in the Kingon Germany. Army clinic. Us Emu m out own nighttime care inadequate army wants to Cut clinic hours  medical writers events medical come officials want o scale Back he operating hours of Many army health clinics in Europe id avoid Milting promises the army can t keep. Many of the clinks have been open 24 hours a Day pulling ill East tin implicit commitment for emergency care around the clock. But they Don t always have the doctors nurses medics and resources after hours necessary to ensure Quality care. At the same time often Down the Street is a fully equipped and sniffed civilian Hospital thai could provide emergency treatment to american  and their families. The Issue is so sensitive and emotional Lylial 7th medical come officials prefer to talk in terms of changes in clinic care not closures of clinics after Normal Rulyn ours. The reason is that Many commanders soldiers Anil Fin Lily members have opposed plans w restrict hours believing Itai medical care is being 1a a away from them. But the medic at service stuns by criticism in the Stales that it has not always ensured Quality care says it must reduce hours a the dimes in order to reduce risks to patients. Otherwise medics working atone at night May make errors. Furthermore the Lime if lakes 10 Transfer an Emer gency Case from a clinic without resources to a local or american Hospital might make the difference Between life and death. Brig. Gen. Bill b. La few 7ih medical come Deputy commander says a proposal to restrict hours at sonic clinics b Progress. We re not taking things away said la Flor who chaired a Comini Ilsc on the clinics. This is Ilie Way it has to be. We be been asking some of our health care providers to provide care beyond their  it does t make sense said maj. Gen. Frank of cd Fard jr., 7th medical come commander to bypass u beautifully equipped German emergency room for somebody who s having cheat pains. And go to one of our Small clinics in the Middle of the  the 7th medical come began studying clinic operations last february under then commander i. Gin. Quinn Becker. In an interview in Washington where he n now army surgeon general Becker said he could not justify spending the Money necessary to up Grade All the clinics to the level required for Quality round the clock emergency cure in areas where there arc sophisticated civilian trauma centers. "1 would like Persona Ify to give everybody Over tiling they d like to have but 1 have to be cognizant that we re spending taxpayers  Becker said. The joint commission on accreditation of hospitals has four classifications for emergency rooms. The Wal Ter Reed army medical Center for example is level. One the lop. The hospitals at Frankfurt and 1-Anav Tull arc level two with doctors nurses and medics an hand As welf is Access to while Blond and certain Emer gency equipment 7th medical come officials said a level three emergency room requires a doctor to be on cell a registered nurse to to present and Access to whole blood As Well As the presence of emergency equip ment. Level four requires a doctor to be available with in 30 minutes. Arm medical officials in Europe say a clinic must have at least tour doctors before it can think about operating 24 hours. And o meet level three Stan Dards for All 65 clinics would require 950 More doctors nurses and medics. We can t keep a doctor there 24 hours u Day seven Days a Waceli Lydford said. Thai s cruel and unusual punishment officials of 7th medical come army hospitals and Mill try clinics have been trying to sell the plan in talks to Community leaders unit commanders and families. They credited the support of lop military leaders in some communities with the acceptance of Pesiri Clad hours. In some cases changes were Mude because of Community suggestions and new evening or weekend hours were added to improve clinic accessibility to sol Diers and their families. Seventh medical come officials plan to Brief top officials of the . Army Europe this week. They Hope to get Usa eur commander Gen. Glenn k. Otis s Blessing act the proposal in july oils directed unit commanders with medical personnel to share them with medical and denial clinics partly because of staff shortages lie noted in his Mes Sage that it May he necessary to eliminate some mis Sions consolidate or close facilities or modify operating  the 7lh medical come study cowered All 65 army clinics in Europe. Although most Are in Germany some Are in Belgium the Netherlands Italy and Turkey. Thirty seven of the clinics were operating 24 hours a Day. Under the proposal Only 11 clinics would continue 24-hour operations.  clinics would reduce from round the clock operations to Norma duty hours. The clinics also could hold limited evening or weekend sicken ii. Three clinics would be consolidated with nearby larger clinics or hospitals and two would be transferred o the air Force. The army Wool seek bids from private corporations to operate Tuo of the clinics four of the 65 clinics Are actually nid stations that were going to be taken Over by the 7th medical come but the proposal recommends that they remain Aid stations and not become clinics. Seventh medical come officials declined to identify the clinics involved until the proposal is approved some of the clinics such As Kiti Ingen and Karlsruhe in Germany began cutting Back their hour of str the study began when clinics Are closed during the night people with emergency medical problems have the of lion of going to the local civilian Hospital or nearest . Military Hospital. For non emergencies they can wait until morning and go to. The clinic. In Turkey however the plan would be to evacuate the emergency patient by air to he nearest . Mili tary Hospital. Under the proposal ambulance service would be provided generally by local civilian organizations the army would pay for the ambulance. The local civilian doctor would evaluate a patient s condition to determine if emergency care is. Required or if the person could wait until morning to Sec an Ameri can doctor at the army clinic in n lire threatening emergency local medical personnel would stabilize the person and either provide further treatment it Send him to lie nearest american Hospital. Language should not be a problem for americana seeking treatment officials said. In Germany for exam ple All an american would have to do when arriving at the Hospital is say doctor and he would be taken to the German doctor on duly. The doctor would be Able to speak English. Care for soldiers at civilian Hospi tals would be paid by the army because military medical care was not available. However when family members go to civilian Doc tors they Are covered by champs the civilian health and medical program of the uniformed serv ice which requires the person to pay an annual deductible charge and a share of the Cost. Seventh medical come officials would like the array to contract for after hours emergency care with local hospitals so family members would not have la pay. By it is not known if Money is available. In areas where the clinics already arc elated Al night Community and medical officials have supplied residents with emergency phone numbers for i lie German Hospi Tal and ambulance and maps to the nearest German and american hospitals. Some military officials believe dissension Over limited hours will die As current residents get used to the changes and As new people move in. Capt. Bari canker Deputy sub Community com Mander of  where the sea medial detachment Hiss closed ils doors at nigh and on weekends talked about the elation aspect fears May still be there but they won t be when new blood replaces the old blood Cariker said. New people won t know How it was when the dispensary was open 24 hours