DOCTORS AND DOLLARS
Warbasse, Dr. James Peter
Doctors and Dollars By DR. JAMES PETER WAR BASSE HOW'S business?" is a common salutation among the doctors in the town near my home. Business is improved by unnecessary operations and by the...
...Carlton E. Wertz declared: "It cannot be said and it must not be said that the dollar sign is ever permitted to stand between the ailing patient and good- medical care...
...The AMA could have helped prevent political socialization by promoting cooperative medicine—the cooperative organization of patients and prospective patients...
...A larger number unite to own their own hospital, clinic, laboratories, and drug supply, and to employ full-time salaried doctors...
...In The Hague in Holland 125,000 people are organized into a consumer cooperative health society employing a staff of 35 superior doctors with salaries better than the average incomes of Holland physicians...
...It was built at the height of the depression following 1929 without Government aid...
...they are decent and considerate...
...At the same time they boast of its accomplishments and claim them as their own...
...He was editor of the New York State Journal of Medicine for three years and special editor of the American Journal of Surgery for 10 years...
...Klebs and Loeffler...
...Socialization of medicine can be political and compulsory or cooperative and voluntary...
...Surgical Treatment," a 3,000-page study, was his valedictory to his profeuion...
...The dangerous hospitals, to be found in every large city, where unnecessary operations and abortions are done, are owned and run by doctors...
...In New York City, where I practiced for 30 years, many a doctor I knew responded to the call of the sick with the question, "What is there in it for me...
...IV The non-political socialization of medicine is the socialization in which I believe, which I have advocated for more than 30 years, and which the organized doctors have opposed because of sheer ignorance...
...The whole gamut of conquered diseases, the increase in happiness and longevity, are no affair of the AMA pattern, prescribed by its board of trustees...
...These discoveries were made by research scientists working in institutional laboratories with salaries largely from political governments...
...Laymen can exercise "free choice of physicians...
...Non-political socialization now proving its effectiveness consists in the democratic organization of patients and prospective patients, upon a voluntary consumer cooperative basis, to prevent disease and to protect their health...
...Every form of medical practice except the competitive, individualistic system prevalent in the United States is derided and denounced...
...in 1884, discovered the bacterium that causes diphtheria...
...It has a membership of 1200 families...
...Caleb Smith, practicing in Bradford, Pa., reported in the August Atlantic Monthly that five of the 30 doctors he knows keep abreast of medical progress and do a good job...
...Here we have a conflict of interests...
...A still larger number of consumers, or a federation of health societies, solves the more difficult problems of hospitals for chronic diseases, sanitoria, and the less common specialties...
...Suppose we look at the latest authoritative claim—fresh from the lips of the newly elected president of the Medical Society of the State of New York...
...And here am I, a physician who looks with disfavor and dread upon every socializing tendency that makes for the expansion of governmental functions, and for the dependence of individuals upon the state, asking for honest treatment of the socialist threat...
...Business is improved by unnecessary operations and by the injection of water or some other placebo "which does the patient no harm and keeps her coming while she gets well...
...They represent not only an important business but a profession, an art, and a science...
...when thus organized, better than can the lone layman...
...Many other countries, including Japan, are developing this cooperative medical way...
...1, 1950, Dr...
...The few disreputable and low grade colleges are owned by doctors...
...These are not practitioners of competitive medicine, working for payment after the service is performed, but scientists who have no traffic with the salesmen of the drug houses, scientists with assured salaries which come more and more from the socializing process of political governments...
...and now the disease is rarely seen...
...The last doctors engaged in general practice to add new discoveries of significance to medicine were Edward Jenner (1749-1823), Robert Koch (1843-1910), and Joseph Lister (1827-1912...
...For years the spokesmen of organized medicine have insisted that the best results accrue when the doctor competes with his fellow practitioner for business, when he is paid not before but after he has rendered the service, and that to be placed on a salary basis in the service of his patients is a violation of good econJAMES PETER WARBASSE has been a leadioq member of the American medical profession and a crusader for cooper' atives for many years...
...People of affluence and influence are commonly found in favor of the conditions that gave them their advantages...
...This has now become a serious problem in a country where 38% of the people receive no medical aid in the event of incapacitating disease...
...For this reason, organized medicine opposed prepayment medical plans and bitterly fought cooperative organization of patients until public sentiment was so overwhelmingly against the doctors that they had to recant, and now half-heartedly go along with the progress of the times...
...A small number can employ a doctor with a salary part or full time...
...How are they occupied...
...The AMA is still fighting against the inevitable lay control of medical institutions...
...They are the most useful citizens in our communities— the flower of a confused civilization...
...Its work and its doctors are superior and the results of prevention and treatment contrast so advantageously with the neighboring doctors and hospitals that every effort is made by the AMA to destroy it...
...This society maintains a hospital, clinic, polyclinic, ambulances, drug stores where its medicines are made, and a staff of nurses and technicians...
...This statement is characteristic of the attitude of organized doctors toward society and the advancement of medical science...
...The president of one of the largest publishers of medical books in this country has told me that less than 15% of the practitioners can really be said to buy new medical books...
...These methods are in successful operation...
...Now these once common diseases are rare...
...The present price-profit system, promoting scarcity, keeps the number of doctors in the United States to less than one-half the number needed...
...Now all the good schools are owned, financed, and controlled by laymen...
...These two groups live by disaster...
...Medical colleges could, with some financial help, train more doctors, but the powerful AMA lobby has recently blocked the bill giving federal aid to medical schools...
...An increasing number of associations with model high grade hospitals are in operation from the state of Washington to Texas and across the northern states...
...It is unfair to propagandize an outmoded and declining way of practice as responsible for the progress of medicine and health...
...The cooperative Hospital at Elk City, Okla., is the pioneer...
...The general trend toward consumer control is a sign of medical progress, but it is progress promoted by the people, the public, and not the doctors...
...These societies have proved the falsity of the AMA contention that a doctor gives better service when his pay is withheld until after the service is rendered...
...I mention these facts to illustrate that medicine in the United States is a business first, and secondly a science, profession, and art...
...Sept...
...The theoretical objections to cooperative medicine which the AMA propagandizes are innocent of factual basis...
...No word in this article can be taken as a reflection upon those in the medical profession who are competent, who do cure diseases, prolong lives, and augment the efficiency and happiness of those who come under their ministrations...
...In his first presidential address, reported in the New York State Journal of Medicine...
...This board, which opposes social progress, is composed of doctors possessed of two qualifications: affluence and influence...
...The cooperatives in the United States are moving into this field despite the almost insurmountable hostile actions of the AMA...
...Should political socialization come with all its worst features, we shall have the AMA to thank...
...The doctors of the United States make their living from the 2 percent of the population who are sick...
...The biophysi-cists are now leading the way toward the solution of the cancer problem...
...The cooperative method is maintained also by the 98% who think they are well...
...Thanks are due to Eberth, who in 1880 discovered the typhoid bacillus, the cause of the disease...
...The crying need is not more money for doctors but more doctors for the people...
...The great and important hospitals are owned and controlled by laymen...
...the other 25 read little or no scientific material, do not make diagnoses but treat symptoms, and depend largely upon proprietary remedies...
...As a physician of many years' observation of medical practice, I resent the dishonesty of the AMA and its constituent branches in promoting propaganda to prevent the inevitable development of cooperative medicine...
...Just what could be expected of doctors practicing true to the standards of the American Medical Association...
...The result is that doctors are busy and prosperous as never before...
...I can remember when an old practitioner said to me, "I count on the typhoid cases among people returning from their vacations in the fall to carry me through the winter...
...omics and the best medical aims...
...This places them in the position similar to the undertaker...
...Laymen do not "meddle in medical affairs...
...This discovery was followed by the development of typhoid vaccine by Pfeiffer, Fraenkel, and others-bacteriologists financed by the German Government...
...A pamphlet entitled "Cooperatives and Medical Service," published by the Bureau of Medical Economics of the American Medical Association, so misrepresents cooperative medicine as to be a standing reproach to the AMA as well as a testimony to medical dishonesty...
...Once the medical schools in the United States were owned, financed, and controlled by doctors...
...Diphtheria was once the common dread of mothers—3,000 children died each year in New York City from this disease...
...The recent contributions of the general practitioner to these glorious accomplishments are, in my judgment, close to nothing...
...With the ownership and control of hospitals and of medical colleges passing out of the hands of doctors and into the hands of laymen-patients and prospective patients— the character of medical practice can continue to improve...
...The conquest of infections goes back to the bacteriologists and to government-employed health officers...
...There is no logical place for consumer organization to stop its development once started...
...They are sitting in their offices waiting for calamity to strike a human being...
...The drugs for the treatment of syphilis and the other new drugs —the sulfa compounds, penicillin, streptomycin, and the rest—were discovered by scientists in the fields of biology, bacteriology, chemistry, and even agronomy...
...He went on to say, "This magnificent record does not mean that we in the medical profession can sit back and bask in our own glorious achievements, that we can allow ourselves to slip unconsciously and dangerously into a self-complacent state of mind...
...He published more than 100 original monographs on surgical subjects during his 30 years as a surgeon, pioneered in the bacteriology of surgical diseases and the pathology of cancer, and wrote a number of medical books...
...It is not true that cooperatively organized people abuse the privilege of unlimited medical service...
...Experience is showing that the people cooperatively organized in health societies can run hospitals, laboratories and clinics, maintain facilities for examinations and the early detection and prevention of disease at costs below what the average family pays for medical service under the old competitive system...
...Dr...
...Roux and Behring developed the anti-toxin...
...the laymen administer the business, employ the doctors, and leave medical problems wholly with the medical profession...
...Doctoring is one of the best paying businesses in the country...
...It can go on to the training of its own doctors, technicians, and research scientists...
...Since then the discoveries have come from scientists in the laboratories of research, of medical colleges, and of hospitals—owned and controlled by laymen...
...After studying medicine at Co-lumbia University and the Universities of Goettingen and Vienna, he prac-ticed surgery in New York and at' tained distinction as surgeon, scientist, teacher, and author...
...Instead, they fought this natural method...
...This incomparable and rapid advance in medical progress," he said, "indicates most convincingly what can be done only under a system of free and unfettered medical practice...
...Wertz emphasized the acom-plishments of medicine—the reduction of death rate, the conquest of diphtheria, tuberculosis, typhoid fever, malaria, to mention a few...
...Their prosperity rises and falls with the amount of calamity...
...III While these events take place the organized doctors cry out against socialism...
...11 The interesting fact is that the progress of medicine, the conquest of diseases, and the lengthening of life have come about despite the individualistic, competetive methods of the doctors...
...Observers of medical problems agree that the majority of doctors in the United States occupied in competitive business not only do not advance in scientific thought and method after graduation, but deteriorate...
Vol. 14 • November 1950 • No. 11
