Evening star., 1923-12-19
La,os to License Physicians
Vary Greatly Between States
Political Considerations IN Several Jeop.
ardise Health and Liues of People,
Medical Writer'S Declare.

BY NORRIS FIsHBEIN. NJ. ID.
Associate Editor. journal OF Ameri-
eau Medical Association.
AND NATHAN =. C0LWELL, NJ. D..
Secretary, Council on Medical Educa-
tion and Hospitals of American
Medical Association.
Connecticut and Missouri have awah-
ened. The newspapers Of New York
and the New England states are de-
manding action. Legislatures and
public officials throughout the coun-
try are holding innumerable confer
ences and giving frenzied interviews
in which they are trying to justify
themselves to the people for the
licensing OF incompetent physicians.
The state Of Connecticut, which for
more than five years has passed Tn
noticed the warnings Of the Journal
OF the American Medical Association
that it was permitting an influx OF
poorly qualified and wholly unqualified
physicians. is taking stern and sum-
mary action. What about the situa-
tion in other states? Is there no way
in which such u plt!ful spectacle can
be prevented!
For many years the information re-
g'arding these conditions has been
freely available in the Headquarters
OF the council on 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 warming: others have per
initted the cleaning UP. of American
medical education to be made the
opportunity for the unprincipled to
acquire political influence and few
paltry dollars to the menace CT the
health and the lives OF The peoIde of
their states. To understand the situ-
alton properly and see how the con-
ditiops were permitted to arise his
tortcal paragraph is required.
Medical Education in America.
Following the close of the civil war
the number of medical schools in the
United states began to increase rap
creation OF many of these schools
was the result of selfish interest
on the part OF the men constituting
their faculties There was money to
be made by teaching students. SO
the standard of medical education in
America became an offenBe in the
sight of the honest, able farseeing
leaders Of American medicine.
In 1905 there were 1872 medical COL
leges in the United States-more
than in all the rest Of the world. In
1928 this number had been reduced
10 eighty. In 1906 there were two
medical colleges with satisfactory
entrance reQuirements-two out Of
1872. In 1928 there were seventy four
out OF eighty with satisfactory en-
standard of medical education in the
United States is as high az that
anywhere else in the world. In 1914
SCHOOLS were required to demand Of
their students one year of college
work before entrance and in 1918
they were requested to ask two years
OF preliminary college education.
The council on medical education
knowledge. which had increased in
the past fifty years more than in the
previous fifty centuries. 1t saw that
proper medical teaching required an
extended and complex course of study:
that laboratories were necessary. mu-
Seums. dispensaries and hospitals. 1t
listed the minimum amount OF such
sppurtenances requisite for a first
class medical school. and it said:
Any school that will limit its course
20 men who are properly qualified to
study medicine and that can provide
these appurtenances in a class A
medical school"
Then 1t looked over a number of
other schools and IL said: These
schools lack only in certain essen
tials Of equipment and in minor ways
and can be fixed up TO meet the re-
quirements. and we will put them in
class B until they can meet the stipu-
lations." And then it listed num-
Der of schools which refused to CO.
operate In requiring adequate stand
ards. which refused to submit lists of
students, which refused to or could
not provide adequate equipment. and
il said: These schools will require
complete reorRanization; they must
come I'D the standard 1t Dut
them in class G..
Now it Is important at this point
10 emphasize certain legal aspects
ical education of the American Med
ical 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
compel the authorities of the school |
10 submit lists Of students and their |
qualifications TO study medicine. but |
practically. all of the medical schools
now submit such lists voluntarily. |
When they do not, other means are |
sometimes found for securing lists Of |
students. The bodies Responsible for |
seeing to It that only competent ply
sicians are permitted to practice med |
icine are the state licensing boards. !,
These bodies have legal powers; they |
are responsible to public officials and !
through them to the people ot the |
states.
State Licensing Boards.
These boards are established by the |
legislatures In the several states. Nat |
urally the medical practice law in |
each state Is intended to safeguard !
the public against incompetent and |
unframed physicians In most Of the !
states IL does. But, unfortunately, !
laws are passed after the medical |
practice act is established, which |
may. have the effect of multiplying 1t.
II there is such thing as scientific
medicine; II there are such diseases
as smallpox. tuberculosis, typhoid
fever and measles, which produce ,
definite changes in the human body,
it stands to reason that every one
who wants to treat human disease
ought to be able to recognize the
ease. to diagnose them when pres
ent. 20 know how to apply preventive
measures to keep other people from
getting them.
Legislatures in various states have
created not one body In each Of the
states to pass on every man who
wants to practice medicine and. treat
Independent boards which control
medical iicensure in the forty-eight
states. Alaska and the District of
Columbia In some states there are
actually five or six different boards,
created by as many independent med
ical practice acts and outlining as
many different standards of educa-
tional qualifications.
Out of the confused mass Of legal
stipulations which has been described
comes the present scandal In this
welter Of loophole legislation the pub
lie interest has been disregarded.
This 1t is that has permitted such in