Evening star., 1929-10-06


problems peculiar to each community
into consideration If constructive plar
correction Is to be carried out
Up to Physicians.
1T is up to the physicians themselves I"
DIR. Morgan says, Ito stay the trend to-
ward socialism and State medicine
which is being fostered by influences
outside the ranks of the daily practi-
TONERS II we desire to have the en-
lightened public conti91Me to turn to the
medical profession instead OF to the
cults or State medicine, 1t is necessary
that we prove to them that we are able
to render to them more efficient and
adequate personal service"
Much of the present difficulty, DR..
Morgan says, Is due to lack of under
standing by both physicians and public.
| The particular problem of diagnosis,
now being studied in Washington, he
says, demands on the part of the pub
lie a realization that, while the init ial
cost may seem excessive, medical costs
really are lessened. because the patient
| is not called upon to pay for useless ex-
perimental procedure.
/ The local committee is preparing to
pass the study over to the Medical So
ciety OF the District of Columbia, where
it will have an official status.
Views Are Outlined.
Outlining his views on the medical
cost problem. DR.. Morgan said:
The basis OF effective treatment must
rest upon correct diagnosis. The type
of treatment may vary with the in
dividual experience of the physician
| The study necessary to evolve a correct
! diagnosis must always be more or less
extensive and is often the ma jor part of
the cost OF cure of disease. There can
be no argument as to the basic neces-
sity OF starting any treatment from the
result Of the diagnostic endeavor.
| The development of the present
methods of arriving at a diagnosis has
been evolved through the single minded
purpose on the part of medical men to
render more efficient service to Their
patients. But the laity have come some
what TO recognize the difference be-
! tween knowledge based on profound
study OF the individual and a more su-
perficial method OF treating disease with
which in the past they were satisfied.
The public has not yet come fully
to recognize the immense amount OF
unremunerative thought, study and ex-
Fermentation which has been neces-
sary to develop the present-day ef-
nclency in the practice Of medicine
OF which it is reaping the benefits.
Necessary Increased Cost.
when the public fully understands
this phase OF the question they will
realize the necessary increased cost OF
making diagnosis and will see that
because OF the correctness OF the dag
nosiS the treatment will frequently be
of shorter duration. and therefore the
medical budget over period Of years
will be appreciably leSsened. AS a re-
suit the people will no longer be salts
fed with treatment based upon sub
jective symptoms alone.
Before the introduction of labora :
tory methods, when the making of a
diagnosis was wholly a bedside pro-
cedure. the cost to the patient was sell
dom more than for daily visit. or al
most a moderate consultation fee
With the assistance of the clinica
laboratory the physician is able tc
make an increasingly larger number o1
correct diagnoses and as an inevitable
result the cost to the patient Of thai
diagnosis is greaer.
Laboratories mean expensive equip
ment which has to be continually re-
newed. The technicians must pas.
through long course of highly techni'
cal training The laboratories have Il
be housed in convenient neighborhoods
hence high rentals must be paid. Pure
and high-priced chemicals must bt
used. In the case of X-ray laboratories
expensive apparatus must be provided
disqualification Item.
"An important element in the in
. creased cost of the treatment OF Hines:
is disqualification. With the develop
ment of modern methods for treating
; the sick disqualification is becoming
more necessary and advisable, because
domestic life has become more compl1
Gated and the domestic servant prop
lem more difficult In the moderr
home preparing and serving OF specla
diets and giving special forms O
treatmene is becoming increasingly diff
cult. so that the public has come II
realize that the bes course lies IN seek
ing relief in well-organized hospitals.
THE service of trained nurses Fa'
become necessary element in the care
of the patient. The salaries OF nurse!
have increased only in proportion to tn
increased cost of living, but because th'
hours of duty now are limited to elgh
or II out of "a more nurses are REQUIRED
and the nursing cost has increased.
"All of the elements that go toWarc
the running of a modern hospital have
steadily mounted in cost 1t is unavoid
able and inf1exible. and those seeking
hospital care must bsar large part O
the increased burden. 1t is not out D
proportion to the mounting costs o
other elements in general maintenance
and not out of proportion to the IN
creased earnings of the people at large
Derivation of Income.
Under the present methods of financ'
ing at most hospitals large part OF the
income is derived from private patients
1t follows that the rates for private
rooms are gradually increasing. On thu
other hand, the hospital services rem
dered them are limited largely to the
bed they occupy the food they eat ane
more or less inadequate nursing service
everything beyond this being an eXtrs
; charge. 1t appears to me an untall
division of financial responsibility thai
the major cost for daily maintenance
be derived from private patients.
II have growing conviction that ar
inadequate proportion of the enormous
annual total which is devoted to healtf
/ matters is spent for hospital main
| tenance. And even of the amount de-
! voted to hospitals too large proportion
) is expended on the physical development
, of the institution as compared to thai
which goes to meet the daily cost o1