Medicine: The Plight of the U.S. Patient

(10 of 11)

from now, will be supplying much of that care as interns and residents. Across the continent, New York's Cherkasky declares, there is now "a substantial number of medical stu dents who don't put economics above everything else. These young people want to find in their profession a social commitment as well as a decent living. These kids are marvelous. They're even beginning to force changes in the curriculum.

They don't think that molecular biology is more important than people."

Family Medicine Men

Another promising development was announced last week in Chicago. For years the American Academy of Gen eral Practice has been campaigning to have its branch of the profession rec ognized as a specialty — despite the con tradiction in terms. Now, after many commissions and conferences, the A.M.A.'s Council on Medical Education and the Advisory Board for Medical Specialties have granted the G.P.'s plea and agreed to let the generalist become a specialist in "family medicine." The A.A.G.P.'s president, Chicagoan Dr.

Maynard Shapiro, made it clear that no G.P. will get the exalted rank with out earning it. There will be no grand father clause for automatic certification of present members. Each G.P. will have to put in at least 300 hours of ac credited postgraduate study to earn it.

Said Shapiro: "The new family phy sician will be a family counselor in sick ness and in health. He'll be trained in both the art and science of medicine.

He'll have training in psychiatry, psy chology, sociology, cultural anthropol ogy and economics in order to deal with lems." all Added aspects of Shapiro: the the patient's family med prob icine man will bring back "the com passion of the oldtime family doctor."

Doctors are given to claiming that medicine is both an art and a science.

The fact is that until a half-century ago it was virtually all art with scarce ly a modicum of science. Recently it has become virtually all science, and whatever art remains has often been ob scured by materialism and poor orga nization. Today not only disgruntled pa tients but also a growing body of opin ion makers and activists in public life and in medicine itself recognize its short comings — and know that they can be remedied. It will take time for the emer gence of a better-organized system for the delivery of medical care. It will take even more time for the new types of family physicians and medical grad uates to make their mark on the na tionwide practice of medicine. When they do, U.S. medicine may yet, in fact as well as in cliche, become the world's best.

-In an average year, patients bring 150 complaints of fee gouging against the 7,200 members of the New York County (Manhattan) Medical Society, and 25% of them win remission or reduction of the fee. -Only 31 states reported revocation of license proceedings for 1967. These states had 469 cases in which 208 licenses were revoked. No fewer than 148 revocations were for nonpayment of license fees. Violation of the narcotics laws, including self-addiction, with 13 cases, and abortion, with ten cases, were the only causes relating to medical practice. -About 5,100 of them are operated as nonprofit institutions and awkwardly called "voluntary"; the rest, concentrated in California, New