Medical Reservists Sent to Gulf Are Hit by Financial Hardships : Economics: Earnings plummet and practices at home are threatened. Some suggest the possibility of resignation after the war to ensure they won’t be deployed again.

Dr. Susan Briggs is a 47-year-old surgeon and Harvard Medical School associate professor who runs a burn unit at a high-powered Boston hospital. Two days before Christmas, she was given five days to pack up her life and report for active duty in the U.S. Army Reserve.

Since then, Briggs has had to lay off most of her private office staff. She has referred her patients to other doctors. Facing a 50% pay cut, she says she is using a home-equity loan intended for her three children’s college bills to cover expenses for uniforms and office rent.

“I do think there’s going to be a large number of people leaving the Reserve who didn’t appreciate what it would be like if they got called up,” Briggs said at an Army hospital here this week. “The greatest thing that will impact on the medical reservists staying in is how much of a financial loss they take.”

A hefty 80% of the U.S. military’s medical manpower resides in the Reserves--the thousands of physicians, nurses, technicians, ambulance drivers and others who in peacetime devote one weekend a month and two weeks a year to being ready to back up the armed forces in the event of war.

Now the Persian Gulf War has necessitated the largest Reserve call-up in history, including tens of thousands of medical reservists, scattered throughout the world and placed under extraordinary stress with few familiar sources of support.

Some of the hardships they are facing are illustrated strikingly by physicians, a group not known for eliciting much public sympathy, but nevertheless badly needed by the military in wartime for their expertise in fields such as trauma and burn care.

For some physicians, the call-up threatens to decimate their practices. Their earnings have plummeted while many of their expenses are unchanged. Doctors in high-risk specialties, such as orthopedic surgery, still face malpractice insurance premiums in the range of $50,000 a year.

What’s more, their military call-up comes at a particularly bad time, some reservists say; the economy is weak and the health-care industry is suffering. Unlike some businesses, hospitals have been unable to make up or narrow the gap between their employees’ civilian and military pay.

“When we get back, there’s a feeling that probably a lot of people will resign because they don’t want to run the risk of being deployed again,” said Lt. Col. Darleen Meservy, a chief nurse in the Army Reserve who in civilian life runs a program in occupational health nursing at the University of Utah in Salt Lake City.

“It’s really hard to say how many people will consider getting out of the unit,” said Meservy, whose responsibilities include trying to keep her Reserve unit intact. “That depends on how meaningful an experience they have, if their expertise and knowledge are utilized.”

Despite their own difficulties, however, few medical reservists sympathize with those who have refused to go, such as Dr. Yolanda Huet-Vaughn, 39, who surrendered to military authorities in Kansas City last Saturday after deserting her Reserve unit to protest the war.

“I think it’s totally wrong,” said Briggs. “I think it’s like using someone else’s money. Particularly as a physician, you shouldn’t have taken the money from the Army Reserve program. Or you should have made your decision beforehand to apply for conscientious objector status.”

“No one twisted my arm to be here,” said Dr. Robert Jones, 43, a family practitioner from Utah who has left behind his wife and six children to work in the hospital in Frankfurt. “We’re an all-volunteer force. If there’s anyone to blame, I’ll blame (Iraqi President) Saddam (Hussein). He’s the turkey that got us here.”

There are numerous reasons why they became medical reservists. Many joined after a stint of active duty. Some like the extra pay from their regular training, some want the pension, and others want the continuing education credit. Many say they are patriotic; they like the life.

Take Dr. Craig Silverton, 38, an orthopedic surgeon who was working in an emergency room in Coldwater, Mich., in 1980 when, out of a sense of adventure and duty, he joined the Air Force Reserve to be trained in para-rescue--retrieving air crew members downed behind enemy lines.

The Air Force put Silverton through a year of full-time schooling, enough hair-raising courses for a doctorate in survival. He became a medical adviser in para-rescue, finished a residency in orthopedic surgery, then went on active duty in special operations.

In late 1989, Silverton broke an ankle in a parachute jump, then performed surgery, on crutches, on men wounded in the invasion of Panama. When the buildup in the Persian Gulf began, he had returned to the Reserve and was working as an orthopedic surgeon in a county hospital in Stockton, Calif.

He packed up his life one more time.

“I had a girlfriend,” he mused recently. “But I didn’t like her that much anyway.”

He moved out of his apartment, stored his possessions, arrived in Germany on Jan. 18 and went to work at the Air Force hospital in Wiesbaden.

Now Silverton lives in a military transient hotel for $27.50 a night. His salary is about one-third of what he was making at home. He could be here for two months or two years, he figures. And short of Saudi Arabia, there’s nowhere he would rather be.

“Everybody has priorities in their life,” said Silverton, a sinewy man exuding taut intensity. “At this point, supporting the country and the (hospital) commander is the No. 1 priority, not how much I make.”

And there’s the lifestyle.

“I get bored with monotonous type of things,” he said. “And once I got a taste of the exciting things--especially the time in Ft. Bragg, jumping out of an airplane at night in free fall at a classified altitude was a little bit exciting--I found myself starting to enjoy it.”

Of the medical reservists activated since last summer, 11,000 are with the Air Force and National Guard, 8,200 with the Navy and many more with the Army. About 3,500 of the activated Army medical reservists are in Germany indefinitely.

Those reservists in Germany have been dispersed to dozens of sites, from large Army medical centers to small dental clinics and veterinary detachments that inspect military food. Their mission is to fill the gaps left by military regulars who have been sent to Saudi Arabia.

Most were placed on alert a few weeks before they left home. When their orders finally arrived, they had just a day or two to prepare. They spent their last hours canceling plans, organizing wills, tying up loose ends. Their lives were reduced to two duffels and a carry-on bag.

Nancy and Joseph Seremet, a nurse and a social worker from Plano, Tex., flew his 73-year-old mother in from Massachusetts to live with their two teen-age children. Then they stayed up all night writing to creditors to put a hold on all payments on the debt on their two houses, cars and credit cards.

Frank Medina, a Dallas fire captain and medical reservist, says the only way he can afford the $15,000-a-year cut in pay is with the help of a federal law that holds activated reservists’ interest rates at 6%.

Jones, the Utah physician, encountered major difficulties. Two of the four doctors in his town of Springville have been called up. Faced with few options, Jones turned over his 3,200 patients to the two remaining doctors. Preventive medicine, according to Jones, is falling by the boards.

Meanwhile, another doctor agreed to take over Jones’ clinical duties as chief physician for the Utah Department of Corrections. Then he backed out the day before Jones was to leave. Jones managed to find a replacement--as he tells it, by begging and promising the man a permanent job.

But Jones’ leave of absence from the state ended the dental benefits used by his wife and children. (His wife has since taken a job.) And Jones has had to place on indefinite hold the loan payments on the building and equipment he bought when he opened his Springville office 2 1/2 years ago.

“If I’m gone six months, I figure it will take 2 1/2 to 3 years to recoup, to build the practice back up and pay back the debts incurred while I’m on active duty,” Jones said.

But as a small-town doctor, known in the community, he figures he may be better off than most.

These days, many of the medical reservists in Germany are waiting. Hospitals are overstaffed and underemployed, their normal caseloads deliberately diminished to accommodate combat casualties if and when a ground war begins.

Medina, a former Army musician, plays his bugle to fend off boredom. Silverton is on call several days a week to stay busy. Darleen Meservy travels around Germany visiting far-flung members of her unit, doing her best to keep up morale.

“The most serious problems I perceive are related to finances . . . and stress within the family from hurriedly removing one or both parents,” she said. Asked how the unit command might help out, one reservist wrote on a recent survey, “Could you please activate my 15-year-old sons?”

Briggs, the Boston surgeon, is one of many who believe that the country will have to take steps to reduce the financial disincentive to doctors and other medical professionals to remain in the Reserves. Without changes, they say they fear many will leave when the war ends.

“I think most of us, we’re happy to be able to do our part,” said Briggs, who joined the Reserve two years ago after working as a civilian in medical evacuations from El Salvador and Armenia and in treating victims of a gas explosion in the Soviet Union.

“We hope it won’t be at a horrendous financial loss,” she added.

“I think the length of the call-up and the ability to plan ahead will be major factors. It would help if we knew how long we were going to be out. But nobody really knows that.”