The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1932-03-11
(Official City, State and County
Newspaper
Foreign Representatives
SHALL, SPENCER, LEV1NGS
& BREWER
UncorporateO
CHICAGO NEW YORK BOSTON


Discussing the need for higher
standards of medical care, DR.. Louis
8. Reed, reporting to national COM
mittee which Is investigating this
subject, suggested that arrangements
should be made for closer cooperation
between the medical profession and
such secondary practitioners as mid
wives, chiropodists and optometrists.
It is asserted that these practition-
ers exist "in response to a demand
for services which physicians are
either unwilling or unable to perform
at equivalent fees" and hence play
a necessary and legitimate part in
medical care"
The committee, composed OF pub
lic-sparited physicians and leading
laymen. started out to find method
whereby the cost Of medical care to
Americas great middle class could
be reduced. They recognized that
the wealthy can afford to hire the
best of care and that the poor often
Get excellent care at free public
clinics. but that the middle class
person who would resent the idea of
charity too often finds himself pay
ing on the same basis as though he
were rich.
No definite answer to this problem
has yet been presented but the COM
mittee has made considerable prog
ress in smoking out the factors in
volved. AS a question pertinent to
the subject in hand it has investi-
gated the field of secondary practice
and has discovered the amazing fact
that nidwives attend nearly is per
cent of all births in the United
States. While licensed and carefully
supervised in some states, in other
states, though licensed, they are not
supervised; and in still other states
they are neither licensed nor super
vised.
More than 80 per cent Of all Amer
lean midwives are in the south. The
southern midwife, DR.. Reed found,
is usually colored and is often igno-
rant. unframed, dirty and supersti-
tious. The midwife in the north,
where unsupervised, was found to
possess similar weaknesses. Under
close supervision, however, such as
obtains in New Jersey, New York
city, Philadelphia and certain other
communities, these defects have been
remedied and midwives are found to
be capable of giving highly efficient
type OF maternity care.
Among the reasons advanced for
existence Of the midwife in America
are the following:
/. Prejudice OF many immigrant
groups, accustomed to the employ
1nent of midwife in their home
countries, against employing a male
doctor.
2. Scarcity Of physicians in some
sections.
;. Inability to pay physicians.
I. Distance from physicians. "A
trip Of 100 miles at a dollar a mile
plus the regular obstetric fee would
consume more than the entire cash
income of a family for a year in
many cases." said one health officer
in describing the situation in a
sparsely settled southwestern state.
A notable shift has occurred in the
attitude Of physicians toward the
midwife in the last two decades, DR.
Reed discovered. Because of closer
study Of the problems of obstetrical
care, large part of the medical pro-
tession has come to recognize that
for some time to come economic fac
tors make It inevitable that an ap.
prsciable proportion Of the births in
this country. particularly In rural
areas. will b attended by midwtves.
Consequently, greater emphasis Il
being placed on their training and
supervision.
Altogether there are $4,000 active
physicians and surgeons, $1,000 dem
tists ana 10000 trained nurses in
the United States. Their income Is
not given.
The survey discloses that there are
1900 midwives. earning $4,000, 900 q
yeer:: le9S chiropodists earning $l4.-
7760oo, ana 1905 optometrists with
a income Of $4,000 900. The latter
5tem includes the cost Of spectacles
1,1nislaed ~ them.
This reaches the grand total o!