The Birmingham age-herald., 1923-12-09
OUTLOOK IS GOODMEO|CA[ LICENSE FUR AUTO TRADE SCANDAL IS ACUTE.
Connecticut And Missouri Both Stirred By ReveIa-
 tionS About Doctors
By MORRIS FISHBEIN, M. D. Associate Editor Journal of the American Medical Association
 

Associate Editor Journal of the American
 Medical Association
 and
 NATAHN F. COLWELL, M D.
 Secretary of the Council on Medical Edu-
 cation and Hospital of the American
 Medical Association
 Copyright, 1923, in United States and Canada by the North American News ! paper Alliance for The Age Herald. All
 rights reserved)
 CHICAGO, Dec. 8.-Connecticut and Missouri have awakened. The news papers of New York and the New England states are demanding action. Legislatures and public officials throughout the country are holding innumerable conferences and giving are trying to justify themselves to the people for the licensing of in- competent physicians. The state Of Connecticut, which, for more than five years, has passed unnotlced the warnings of the Journal of the American Medical association that 1t was permitting an influx of poorly qualified and wholly unqualified phy- sicians, is taking stern and summary action. What about the situation in otker states? Was and is there no way In which such nauseating, pitt ifuI spectacle could be prevented?
 For many years tho information regarding these conditions has been freely available in the headquarters of the council of medical education of the American Medical association. Since 1900 the Journal of the Ameri- can Medical association has patient ly. earnestly and steadfastly called attention to the perils of the situa- tion. Some-indeed, most--states have needed the warning; others have permitted the cleaning up of American medical education to be made the opportunity for the un- principled to acquire political in- fluence and few paltry shekels, to the menace of the health and the lives of the people of their states To understand the situation properly we require brief Historical para graph. Let us see how the condi- tons were permitted to arise.
 Medical Education In America.
 Following the close of the Civil war the number of medical schools in the United States began to in- crease rapidly. If the truth is to be told the creation of many of these schools was the result of selfish interest 7on the part of the men con stituting their faculties.s There was money to be made by teaching stu dents. So the standardSof the medi- cal education in America became an offense in the sight of the honest able, far-seeing leaders of American medicine.
 In 1906 there were 162 medical col | leges in the United States-more than in all the rest of the world. In 1923 this number had been reduced to 80 In 1906 there were two medical col- leges with satisfactory entrance re- quirements-2 out of 162. In 1923 there were "A out of so with satis- factory entrance requirements. Today the standard of medical education Tn the United States is as high as that anywhere else in the world. In 1914 schools were required to demand of work before entrance and in 1918 they were requested to ask two years of preliminary college educat tion.
 The council on medical education looked over the field of medical knowledge which had Increased in the past 50 years more than in the previous 50 centuries. It saw that extended and complex course of study; that laboratories were neces- sary museums, dispensaries and hos pitals. 1t listed the minimum amount of such appurtenances requisite for a first class medical school and it said: Any school that will limit Its course ito men who are properly qualified to study medicine and that can provide these appurtenances is Class A medical school"
 Then it looked over number of other schools and it said: These tials of equipment and in minor ways and can be fixed up to meet the requirements and we will put them in Class B until they can meet the stipulations." And then it listed number of schools which refused to cooperate in requiring adequate standards. which refused to submit lists of students, which refused to or could not provide adequate equip ment, and it said: These schools Vill require complete reorganiza- tfon; they must come up to the standard" It put them in Class C.
 Now, it is important at this point to emphasize certain legal aspects of the situation. The council on medi- cal education of the American Medi- cal association has no legal powers. The council has no authority to go into a medical school and inspect. but it does so on the invitation of the authorities of the school. It can not compel the authorities of the school to submit lists of students and their qualfica ations to study medi- cine, out practically all of the medi- cal schools now submit such lists voluntarily. When they do not, other means are sometimes found of secur- ing lists of students. The bodies re- sponsibie for seeing to it that onl competent physicians are permitted to practice medicine are the state licensing boards in the various states. These bodies have legal powers: they are responsible to public officials and through them to the people or the stutes. Let us now see how they and the legislators who give them their power have fulfilled this trust. State Licensing Boards
 These boards are established by the Legislatures in the several states. Naturally the medical practice law in each state is intended to safeguard the public against incompetent and r untrained physicians. In most of the states it does. But unfortunately laws are passed after the medical practice act is established. which may have the effect of nullify.~g il. If there is such a thing as scientific medicine: if there are such diseases as smallpox, tuberculosis, typhoid fever and measles, which produce definite changes in the Shuman body. it stands to reason that every one who wants to treat human disease ought to be able to recognize the changes brought about by such dis ease, to diagnose them when pres ent, to know how to apply preven- tive measures to keep other people from getting them
 You would not call an umbrella mender to fix your 17-jewel watch; certainly every one who wants to treat sick people by any method of treatment ought to be willing Co come before an examining body and be examined as to his knowledge of these Fundamental things. Never theless the legislatures in various states have created, not one body in each of the states to pass on every man who wants to, practice medi- cine and treat the sick, but 96 sep arate and independent boards which control medical licensure in the AS states Alaska and the District of