Evening star., 1937-04-04
DOCTORS SURVEY
THEIR OWN FIELD
Admit Costs Too High.
Changing Concepts Are
Outlined.
~ ne Associated Press.

~ NE Associated Press.
NEW YORK. April 3.-The Ameri-
can Foundation, after l8 months OF
inquiry. made public today An ex-
haustive survey Of medicine in the
United States. with special emphasis
on the problem Of making adequate"
medical care available to large por-
ton OF the population now without it.
The report, titled American Medi-
eine-Expert Testimony Out of Court" :"
summarizes an extensive correspond
ence with leading doctors, surgeons
and specialists in every State, chiefly
those that have been In practice 20
years or more.
There was no queStionnaire. The
correspondents we're asked to COM
ment freely on all phases of the ques-
ton of whether they felt any change
was needed in the present system Of
medical care and, if So in what di-
ection.
The report makes no recommends
t4ons and sets forth no program Of
its own. The foundation, established
And endowed by the late Edward w.
Box, desired only to illuminate condi-
tions and present comprehensive
analysis of the entire structure Of
American medicine.
Economics Part of Problem.
The summary of the report, pre-
pared by Esther Everett Lape, men,
ber-in-charge of the foundation, says:
THE problem of medical care is bound
up with the social and economic prob
Iem as whole and can be accu-
rately analyzed only in this connec-
ton.
THE parties in interest are the
medical profession. the public and the
Government. and all three must
search together if the answer to the
problem of supplying adequate medi-
cal care to the whole of the popula-
t,on is found"
The report sets forth, in the views
q the correspondents, all OF the
alternatives to the present organiza-
ton Of medical care:
!. The status quo with some changes.
2. Thorough-going State medicine,
with Government doctors.
2. Compulsory insurance with three
eontributors-the Government, the
employer and the employe.
I. Various forms of voluntary insur-
ance, including hospital insurance.
s. Limited State medicine, integrated
with private practice.
Under the latter, the report con-
tains suggestions for the extension of
the public health services. tax funds
for hospitals, extension of facilities
for unsupported hospitals, Federal
funds for research as the basis alike
for preventive as well as curative medi-
cine and Federal department of
health.
Health Department Indicated.
"A Federal department of health" Il"
the summary says, is frequently pro-
posed as justified under the present
powers and degree of functioning of
the Federal Government in matters
OF health, and as imperative with the
proposed increases in this functioning
indicated by the present appropria-
lions OF the social security act, and
BY such proposals as Federal grants
sick"
The doctors letters show that they
know costs are too high for average
incomes and that there are many
groups and regions in the country
that certainly do not have adequate"
medical care. But even these things
seem to them secondary to the press
ing need to produce better medicine,
to find and train a constantly better
grade of men able to apply the re-
suits Of modern research to the cure
Of disease and, above all, to its eftec-
tive prevention.
The real new deal in medicine has
IN manner already taken place
owing nothing to legislation or social
planning. 1t has been going on for
q generation. 1t consists in the
phenomenal development of medical
science itself with consequent
changing conception of disease and
OF health. And with these changing
conceptions comes a change also in
the doctors function, a change in the
public's idea of health. and in the
nature OF the services of the doctor.
Change Still Incomplete.
The change in attitude is as yet
incomplete, on the part of both doc
tors and the public. There are still
doctors that insist that their field is
curative medicine" only; prevention
they would still relegate elsewhere. To
this dwindling group. the cure of dis
ease is still the dignifed function of q
liberal profession; while prevention
Is the anomalous activity of hybrid
type OF medical man grated onto
social worker. The public also comes
along only slowly in its recognition Of
. sharply changed emphasis. Those
that will willingly pay fee to have
. boil lanced will, still resist paying
for advice that might keep the boils
away.
Members OF medical school faculties
say that medical students veer away
from courses in preventive medicine,
although stirred to enthusiasm by the
clinical study Of rare and devastat-
ing disease
To fire the students Imagination
something more will be needed than
field trips to milk plants. sewage out
falls and filtration plants, and lee
lures on environmental sanitation and
communicable disease. The study of
health itself will have to find its true
place in the orthodox medical curric-
ulum before the world can be geared
to the vision of positive" health.
A number Of doctors clearly feel
that the resources of medical science
are now most insufficiently used for
the advancement of human produc-
ttvity and for enjoyment of life. Some
medical scientists Of notable achieve
n,ent writing in American Medicine,
betray disillusionment in the net re-
suit Of their labors, and in the mega
tive character Of much Of their work
Too much Of the doctors time and
energy at present go into the scientific
care Of the unfit, too little into In
creasing the competence and the pow
a OF the fit-or saving 1t from hazard.