Evening star., 1932-11-29

1nQlpfQu&l lees iof tflUSt WHO prefer tflal
method 1t Is proposed that such in
to compensate for wage losses due to
illness be kept entirely distinct from
payments for medical services.
Educational Recommendations.
The following recommendations are
made in the field of professional educa-
ton:
That more attention be given to
training In preventive medicine: that
more effective efforts be made to pro-
vide trained health officers; that "spe-
cialties in medical practice" be re-
strieted to those specially qualified ac-
cording to some objective standard. and
that post graduate educational oppor-
tunities be increased
Il also was recommended that the
professional education of dentists and
pharmacists be considerably broadened.
Some members of the committee. it is
noted in the report. held that the dent
ist should be required to have the full
training af a physician with dentistry
Itself specially" Much of the rou-
tine work of the dental Office would be
left 10 non-p-ofessional but highly
trained assistants. A broader and more
thorough training is proposed for reg
istered nurses, with the provision of less
thoroughly trained and lower paid
nursing aides and attendants.
Made Extensive Survey.
The COMMITTEES made an extensive
survey Of the medical situation through
out the country, following numerous
complaints that while the need was in
creasing, the cost of adequate medical
service was too great for the average
family. AS result of this survey il
was found:
That people need substantially
larger volume OF scientific medical serv-
ice than they now utilize. This is par
ticularly true. it was found, for persons
with small incomes. In spite of the
large amount of free work done by hos
pitals, clinics and individual practi-
tioners, and in spite of the sliding scale
OF fees by which most physicians try
to regulate their charges TO the pocket
books Of their patients, it wes found
that approximately one-half of the in
dividuais in the low-ineome groups re-
ceive no medical or dental attention of
any kind.
That public health service be extend
ed to a far greater percentage of the
people. particularly in rural areas and
that there be a geographical distribu-
tion of practitioners more in accord
with the actual needs of the people
instead of concentration of doctors in
cities.
Pee Splitting" Is Hit.
That fee splitting" be discontinued
and that some means be found to equal
ize the incomes of specialists and gen.
eral practitioners.
That there is need for reduction of
yryo CT IN, liwonf3A,.r ~,
the money spent for unnecessary medi |
cation, on services of "eultists" and |
wastes due to idle time of doctors. un-
used hospital accommodations and the
high overhead of private medical and
dental practice.
That there is need for some plan
whereby the unequal and sometimes
crushing burden Of medical expenses
can be distributed.
'The prevailing methods of pufchas-
ing medical care" it Is stated, lead to
unwise and undirected expenditures, to
unequal and unpredictable financial
to neglect Of health and of illness, and
often to ineQuable remuneration for |
practitioners"
Cost Put at SEQ to $40 Yearly.
It is estimated that proper medical
care for an individual can be provided, |
year after year, for from $40 to $40. |
This 1t Is stated, could be met by
monthly or weekly payments with such |
an organization as the proposed COM
munity medical center.
The committee was created In 1897 |
with Secretary Wilbur as chairman, |
and has made 26 faet-fnding studies, |
It was supported by eight foundations
and two other organizations, Supple |
mentary studies We're made for 1t by |
the American Medical Association, the |
American Dental Association and by
several institutions. The committee |
was made up Of "a physicians, II per- |
sons engaged in other forms of medical |
and public health work and 13
economists.
Two minority reports were filed The |
most significant of these was offered
headed by Dr. A. c. Christie, promi-
nent Washington physician. DR.. Chris
tie and his associates Of the minority
group characterize the so-called medical
centers as IAN idealistic plan based
solely upon theory"
Held 'Mass Production"
"There is nothing in experience to
show that 1t is a workable scheme" they
continue, "or that it would not contain
evils Of its own which would be worse
than it is supposed TO alleviate. 1t is
the adoption by medicine Of the tech
nique of big business; that is, mass pro-
duction. The profession Of medicine is
a personal service, and cannot adopt
mass production methods without
changing its character. Medicine has
rejected the idea as being destructive
OF the social values developed by pro-
fesSional traditions.
The medical center plan would es-
tabiish medical hierarchy in each
community to dictate who might prac-
tice medicine there 1t would add to
the evils Of medical dictatorship those
Of new bureau in the local govern
ment. with its attendant costs"
This minority group offered six rec
concentrations of their own, the chief
of which is:
The minority recommends that Gov
eminent competition in the practice Of
medicine be discontinued, and that its
activities be restricted to the care of
the INDECENT and of those patients with
diseases which can be cared for only in
Government institutions to the pro-
motion OF public health; to the support
Of ms5ical departments in the Govern
ment services which cannot, because OF
their nature or location. be served by
the general medical profession, and to
the care of veterans suffering from bona
fide service connected disabilities and
diseases, except in the case Of tuber-
cu,csis and nervous and mental dis
eaE-r
This group recommended that Gov
ernnent care Of the INDECENT be ex-
pended with the ultimate object Of
relieving the medical profession Of this
burden. and that united efforts be made
to restore the general practitioner to
the central place In medical practice
DR.. Edgar Sydenstricker, statistician
of the United States Public Health
Service here, refused to sign the report
of the committee, of which he was
member, on the grounds that the
recommendations do not. in my opinion