Evening star., 1937-10-17
STATE MEDICINE is SEEN
NH.O.L.C. HEALTHCLIN
Profession Alarmed at Threat of Posi-.
bility of Most of City's Residence Get.
ting Treatment ION the Line.'

PotoCiii VI uVlIlR from which 1t Is
very hard for any individual to escape.
The situation grows worse instead Of
better. Medical services continually
become more costly, because more ex-
tenslVe. Diseases almost unheard of
III years ago now constitute a heayv
economic burden. Expensive pro-
ceoures, largely developed in the last
TWO decades, have become part of the
routine OF medical practice. Home
lnerapy Is discouraged by the physi-
clans themselves. The fine old ira
oltlon OF household medicine is shat
tereo. There is more to be had. Folks
want and demand more. It costs
more. So the cost of adequate medical
care, according to present standards. is
very apt to be out of sight for the
average victim of a sickness <emer.
gency. 1t throws him for a big loss.
ne may be years getting out of debt.
IL Is not luxury which he can buv
OF leave alone. 1t is a grim. inescan.
ape necessity, matter of life and
death. oiAu
ANYTHING which will reduce the cost
OF tnis medical care and at the same
tiihe maintain its high quality is well
come to the public at large.
but no wonder Washington phvsi.
clans are alarmed. This thing threat
ems eventually to take away at 1east
nan their practice-possiblv nine
.eilths OF 1t. The doctor will be forced
10 go to work for the association as q
hlred hand, or find some other wav Of
making living. This prospect of
course, is not immediate. But il might
not be so far away.
What of it? The public is NOT IN
terested in the economic condition of
the practicing physician, except as
that economic condition contributes to
giving 1t what it wants. So far as it
is concerned the doctors can buv
themselves tin cups and dark glasses
and stand on the street corners sell.
ing shoe strings. if they can get police
permits. This is a -blooded way
to look at it-but for the economic
condition of the doctor as an indi-
vidual we care no more than for the
economic condition of the street car
conductor as an individual.
Is 1t Best?
The question comes as to what is
best for everybody concerned. Will
such a set-up as that of the Home
Owners Loan Corp. actually provide
cheaper medical service without low.
ering of quality? The almost uni
versal verdict of physicians is that it
will not, and, in the very nature of
things, cannot.
In the first place, medical practice is
far from standardized thing. by and
large. 1t is not susceptible to factory
methods. Every case is ideally an in
oividual problem. 1t is as much an
individual problem as writing a SON.
net or composing a piece of music.
There is, of course, certain founda-
ton of routine procedure. But this
accounts for very small percentage
OF medical services as whole.
Let us suppose that, for some
queer reason. hair cuts for everybody
once month were vitally essential
to the public welfare It might be a
flne idea to set up State hair-cutting
establishments because hair-cutting is
pretty much routine procedure
which one adequately trained man can
DO about as we'll as another. But
there is certain difference between a
nair cut and an operation for appendi-
cltis. The one is only a technique.
Ihe other is both technique and an
art. Just because man has mastered
a certain technique doesn't mean that
he has mastered the art of cutting out
appendices-or can be hired at so
much week for that purpose. There
Will be an inevitable tendency. say the
doctors, to treat each case as a mat
ter Of routine and not as an individual
problem. The hired doctor tends to
become a mechanic rather than an
artist. And the difference between
the two is often the difference between
lie and death, between curing and
killing.
How About Emergencies.
This does not mean that such a
clinic may not have an able and ade-
quate staff-even a staff of doctors
who care nothing whatsoever for their
own economic position, but only for
the alienation of human suffering.
Such set-up might not be impossible,
although little short of miracle. No
doctor can guarantee his results. If
he complies with the recognized rules
of practice he cannot be held to any
untability-except the econonic
one of his own declining business.
The present economic set-up of the
medical profession seems, at first
sight. rather cumbersome. It is a re-
suit of trial and error over many gen.
erations and some of the things that
seem most incongruous have been ar
rived at through process of evolu-
tion. One cannot dismiss them lightly
without examining carefully their his
tory. Washington probably has easily
more doctors than it needs most Of
the year. 1t does not have enough the
rest Of the year when epidemics are
abroad. What would happen if the
medical services of the city were con-
centrated into such a clinic? How
could it be adequately stated for
emergencies.
BY and large. the physician takes
from the rich and gives to the poor.
That Is, we suppose, he charges about
A.