Medicine: Physicians, Inc.

Physicians are organization men as well as healers, and last week the American Medical Association packed some 12,000 of its 170,000 members into Atlantic City, N.J. for its 108th annual meeting. Most distinguished of the 15,000 guests—mostly wives, nurses, medical students, vendors of drugs—was President (and grateful, well-recovered Patient) Dwight D. Eisenhower, who used the annual-dinner dais as a plate for another swing against inflation (see NATIONAL AFFAIRS).

Ike gave the doctors the needle: “The medical profession, as much as any other, has a vital interest in preventing inflation. Certainly it wants to provide its services for a fee within the range of what people can reasonably pay. If the time ever comes when larger numbers of our citizens turn primarily to the Government for assistance in what ought to be and to remain a private arrangement between doctor and patient, then we shall all have suffered a tremendous loss.”

Do It Yourself. The audience of 5,000 was delighted with Ike’s reaffirmed opposition to socialized medicine. But privately, many doctors questioned the need for his emphasis on keeping their fees down. Fact is, until recently, medical and surgical fees have lagged, while living costs as a whole have soared 108.6% in the last two decades. And as Ike noted, the A.M.A. is urging members to cut their fees for oldsters on retirement income shrunken by inflation.

On retirement income for its own. the A.M.A. hewed to its traditional individual-enterprise line. Though majorities of physicians polled in several states have voted in favor of bringing doctors under compulsory social security coverage, the House of Delegates voted down a Pennsylvania resolution favoring it. Main argument: doctors who kept on practicing after the age of 65 could not collect benefits until they quit, or until 72; doctors should be able to make better personal plans for retirement.

Which Way Freedom? What had been expected to be an explosive issue fizzled deceptively. Climaxing 3½ years of study, a 15-man commission headed by North Dakota’s Dr. Leonard W. Larson, chairman of the board of trustees, recommended last December that the A.M.A. relax its opposition to the practice of medicine by closed panels and groups.* Instead, it should concentrate on the quality of the care given, and the patient’s freedom to choose between an independent physician and a panel. Surprisingly, the House of Delegates approved the Larson report last week with no debate.

But if this changed the A.M.A.’s public posture, it did not change the minds of some A.M.A. bigwigs. Los Angeles’ Dr. E. Vincent Askey, newly chosen presidentelect (to take office in 1960, succeeding Florida’s Dr. Louis M. Orr), insisted after the vote that just as inviolable as the patient’s right to choose his physician is his right to reject one. To Dr. Askey, the freedom to choose a closed panel is no freedom at all.

* Biggest examples (out of hundreds in the U.S.): the Health Insurance Plan of Greater New York (552,000 subscribers); the Kaiser Foundation Health Plan (650,000); the United Mine Workers of America (1,000,000).