Medicine: Panel Doctors

In the dusty brick headquarters of the American Medical Association in Chicago there is a large office file on the subject of paternalism in medicine. President William Gerry Morgan of the Association has excerpts from that file in his fashionable offices on I Street, Washington. Some evenings he takes them to his home around the corner to study, or to his office at Georgetown University, where he lectures on diseases of the digestive tract.

The records show a gradual spread of institutional medicine in the U. S., of doctors working for hire—for clinics, insurance companies, factories, labor camps, government agencies. Especially does governmental interference with medicine annoy Dr. Morgan and his A. M. A. associates. They insist that the Government should abstain from conducting, controlling or subsidizing any form of medical treatment “excepting such service as is provided by the Army, Navy or Public Health Service, and that which is necessary for the control of communicable diseases, the treatment of mental diseases, the treatment of the indigent sick, and such other service as may be approved and administered under the direction of or by a local county medical society, and are not disapproved by the State medical society of which it [the county group] is a component part.”

In other words, the A. M. A. wishes to control the practice of medicine in the U. S. It wants each doctor to develop his own clientele through his own ability and personality. It wants patients to have the freedom to seek personally preferred medical attention. It does not want U. S. doctors regimented, as in England and Germany, where doctors are listed on panels like jurymen. In England some 39,000 doctors are so paneled. To each is allowed up to 1,000 of the population. The sick under the insurance plan must go to one of these doctors. He willy-nilly must attend to them, at a fixed sum from the government.

The English profession dislikes its situation as much as the U. S. profession dislikes its prospect. In the headquarters of the British Medical Association in Tavistock Square, London, there is a file similar to the A. M. A.’s file. Like Dr. Morgan, President A. H. Burgess of the B. M. A. has excerpts in his offices at Victoria University, Manchester, where he is professor of clinical surgery.

Dr. Burgess’ associates are a more compromising group than are Dr. Morgan’s. Last week, London despatches reported how they are dealing with their situation.

For the prevention of disease they would have the family physician educate and advise the public, school doctors educate children, public health authorities handle health propaganda and sanitary services.

For treatment, every individual would be involuntary contact with a general practitioner. The general man would guide the patient when necessary to a specialist or an institution.

For payment, the individual would pay all costs where at all possible. Some would pay the doctor for his house visits and have voluntary insurance to pay for hospital treatment. A third group would get their family doctor paid by national insurance, the hospital by voluntary insurance. To the very poor, all medical service would be free.

Wrote a colleague of Dr. Burgess to the American Medical Association: “… The scheme outlined has been brought forward because the British Medical Association regards this extension of medical socialism as inevitable and wants to be early in the field, so that the change shall be, as far as possible, on lines acceptable to the medical profession.”