Evening star., 1936-04-26


Esther Everett Lape, director OF the
foundation. describes the methods
and aims OF the medical inquiry in
the tolloUing article.
BY ESTHER EVERETT LAPE.
Written for the Associated Press.
n EDICAL men all over the
M country this Winter have
thought to the following in
ouiry made to them by the American
Foundation Studies in Government:
DO you believe radical change in
the present organization of medical
care in this country is indicated?
IF so, in what direction?
"If you do not believe radical
change is needed. what. if anything, in
the present set-up. do you think should
be revised? What evolutionary posi-
hilities would you streSs?"
The letter went to men who were
graduated 20 years or more ago-that
is. to the men that have been actually
doing or directing the medical work of
the country during the past genera
tion. The appeal is to experience.
The replies are full and frank, star
tlingly individual, thoughtful, detailed.
The writer's include undoubted leaders
of medical science throughout the
country, men so busy with the scien-
tifc aspects of medicine and the de-
mands of urgent practice that they
have little time for flyers in social
science.
Profession Answers Frankly.
Organized medicine, characteristic
cally, and very naturally. suspicious of
lay efforts in investigation and reform,
has been frank and unguarded in this
case. Several State medical journals
urged physicians to make considered
and "studious" replies.
The American Foundation has no
scheme of its own.
What the foundation does believe is
that the problem needs to be much
more accurately defined than it has
been before any of us can know what
solutions are in order and whether
and where and how the Government
comes into the picture. Referring to
the previous widespread public agi-
tation of the subject, our letter to the
medical men said:
"~ Our general feeling is that
perhaps more heat than light may
have been developed and that the es-
sential factors are still very much in
need of Qualification and of compre-
hensive and impartial presentation.
"% We are aware that for ap-
proximately 20 years past YOU have
probably been more concerned with
the exacting problems of medical
science than with social theories of
any nature. We know also, however,
that 20 years of medical practice in
a community must have resulted in
certain impressions, If not conclusions,
and We think crystallization Of the
experience of the qualified medical
men of the country is the most likely
source of illumination in any fair
attempt to clarity question that has
become unprofitably controversial"
Ask for Experienced Views.
Our letter proceeded to inquire:
80 Whether your years of ex-
perience have led you to feel that any
essential change in the present or
ganization of medical service is needed.
If you do think some essential
change is needed, in what direction
do you think it should be-in any
form of insurance, voluntary or COM
pulsory? In the greater participation
by the State in the provision of med
ical service to the people? In govern
fnent subsidies without government
administration? In the extension Of
the public health serviceS-and which
OF them-Federal, State, local or all
OF these? In an extension of COM
munity disqualification, group clinics,
public health nursing? In more di-
rect relation between medical science
as represented by the leading physi-
clans of the country and public
health administration? II you con-
slider it desirable or imperative that
the medical profession through the
medical societies should control stand
ards, public health appointments, ETC.,
how do you think that this end could
best be achieved?"
An advisory committee composed Of
many of the most prominent medical
men in the country is now being
formed, under the general chairman
ship of DR.. Truman G. Schnabel, the
medical member of our governing
committee. This Medical Advisory
Committee will act with the Amer
lean Foundation in presenting the re-
suit of this inquiry.
1t will contain no recommended
tions of ours. 1t will simply pic
ture the situation as our correspond
ents present it, and summarize their
proposals for solutions, which range
from broad general policies to de-
tailed methods for improving specific
aspects of medical practice or medi-
cal education.
All Angles Considered.
The concrete material now in hand,
In our judgment, puts the whole dis
cussion on broader base, diverts it
from slogans and prejudices and loose
ly defined terms such as "State medi-
cine" gives direction and depth to
what Is now shallow thinking-the