DOCTOR'S DILEMMA

The recent internal strife, followed by an open break in the ranks of organized medicine as represented by the American Medical Association, has focussed public attention sharply on the rising costs of hospital care for the medically indigent. A large section of our population depend for their medical care on the free clinics which the majority of metropolitan hospitals run. As a result of the increasing specialization in medicine the expense of operating these clinics has doubled. The small group of doctors who precipitated the rift felt that the present policies of the Association would never solve the problem of financing the future work of the clinics.

The growing importance of clinical research in the advance towards a deeper understanding of the human body is unquestioned. During the past half century every major contribution to medicine has come from them. They can tap the best in equipment and men, and are proving the most adequate method of succoring the urban population that can pay little or nothing for medical care. The problem now before the medical profession is how to finance care for the poor in the clinics and continue their research activities.

Public funds are necessary for maintaining high clinical standards, and the least burdensome method of obtaining these is a small general health tax, such as is in use abroad. But this involves the question of socialized medicine, a radical specter that haunts the dreams of the small but intrenched group controlling the policies of the American Medical Association. These policies are those which were adequate half a century ago, before the population had mushroomed and the physician in private practice could fulfill its needs. They have consistently opposed the development of systems of medical care which threaten to minimize the importance of the old doctor-patient relationship, but which would provide better care for a greater number. The comparatively high standards of health in our cities, with people working under poor industrial conditions, is evidence that institutionalized medicine is the best method of caring for them. Legislation which would provide funds for the continuance of a system that functions on the whole successfully is essentially conservative.