TREASURY DEPARTMENT

PUBLIC HEALTH SERVICE

 

IN REPLYING
ADDRESS THE SURGEON GENERAL WASHINGTON
U. S. PUBLIC HEALTH SERVICE . January 6, 1986.
AND REFER TO ,
rersonal

Medical Ufficer in Charge,
United States Narcotic farm,
Lexington, Kentucky.

v

Dear Dr. Kolb:

Your note of January &, 1936, enclosing therewith a
communication from Passed assistant Dental Surgeon Miller has
been received and read with interest. it is noted that Dr. Miller
recommends that the dental consultant be placed on a salary. When
it was represented to us by the Dental Section that it would be
desirable to appoint Dr. Walz, it was our understanding that he
would be willing to accept the consulting position at the nominal
salary of yl.00 per year. ©

When the cost of the nercotic farm is considered by
those outside the Public Health Service, there is an automatic
comparison made between the cost of operating Lexington and the
cost of operating State hospitals for the insane and prisons.
Naturally, we have met such comparisons by the statement that
the Narcotic Farm was a new departure on the part of the Govern-
ment to make a contribution to the solution of this narcotic drug
situation, to which hospitals for the insane and correctional in-
stitutions have made no contributions, and that naturally the
Narcotic Farm is a high type sanitorium to meet special needs for
special cases. It is apparent in the operation of a public insti-
tution, such as thet at Lexington, that it would be desirable to
have a group of visiting consultents to represent the best available
personnel in the community in order that they might stand between
the Government and the community with reference to the best type
of care which could be afforded cases admitted there. On the other
hend, the use of a visiting consultant who is competent may act as
a stimulus to the resident staff for acquisition of new knowledge
on the application of the best form of treatment.

Quite aside from these considerations, it is not possible
or feasible for the Federal Government to reimburse a visiting con-
sultant in anything like approaching the amount which he would re-
ceive in private consultations. ‘the major compensation of such
@ =a C

consultations would, therefore, consist of the opportunity of
studying rare and unusual situations, thus broadening the scope
of their professional opportunities, and also the dignity and
honor which comes with the identification with an institution

. such as yours.

On the other hand, if the honorarium afforded visiting
consultants assumes the flavor of a salary, there is opportunity
presented at a subsequent date when changes of personnel occur,
for influential people to attempt to use such honorerium, not in
terms of professional assistance, but rather as a sinecure to pay
obligations of alternating political parties.

I grant you that it would be desirable to appoint Dr.
Walz as a consultant with such income as would permit him to defray
his expenses, such as transportation, gasoline and oil, and items
of like character. Perhaps an honorarium of $25 per month or {300
per year would be such as we could consider. ‘The recommendation
covering this matter would, necessarily, be left to you.

However, the Public Health Service must anticipate its
financial needs a year in advance, and no provision has been made
in the budget set up to accommodate this increase in salary. It
will mean that next year our budget for personnel, which is always
segregated by individual positions might not meet with the approval
of the Budget Bureau. We have already registered a complaint

against the Budget Bureau for the reduction in our estimates for

the operation of Lexington, and it would hardly be consistent for
us to recommend to the Secretary an increase in salary for the
Consultant Dental Surgeon at this particular time. I am wondering
if it would not be better to wait until experiences actually demon-
strate the need for an increase in salary, perhaps, near “ae close
of the present fiscal year.

Sincerely yours,

Ue

Assistant Surgeon Geh¢ral,
Division of Mental Hygiene.

 

wLT/GM