The future of medicine / by Sir James Mackenzie.

  • James Mackenzie
Date:
1919
Catalogue details

Licence: In copyright

Credit: The future of medicine / by Sir James Mackenzie. Source: Wellcome Collection.

    6/262
    FOR ALL. THE STATE AND THE DOCTORS. LESSONS OF THE WAR, (Bv Our Medical Correspondent.) The announcement inatle by our I'arlia- i inentBTj' Corrosponcient on iSaturda.y that j j Dr. Addison proposes ' to introduce a great ' measure dealing itli the medical services u ill not surprise those who have been following the trend of events which culminated in the Ministry of Health Bill. Jt is, indeed, no secret ! that changes in the methods of medical prac¬ tice in this country have become necessary. ■ Medical men are aware of ibis and various pro¬ fessional bodies have been discussing the subject ' during the last few months. Moreover, as lias been announced in The Times, conferences with public departments have taken place. The somewhat self-conscious Royal Colleges have been ready to meet more mundane bodies like the British Medical I Association in earnest consideration of the future. The ranks of the profession have slowly been closing, j The reason for this closing of the ranks is cer¬ tainly a fear that the Government may seek to ; exploit professional interests, and it is almost in- I conceivable that any other thing could have ; produced the lying down together of lambs ; and lions which w^e have recently witnessed. : It has been to the int-erest of the Govemnient to give these doctors a careful hearing. But the doctors themselves must have detected in the negotiations I somewhat altered tone from that of the humble j appeals made when the Insurance Act was commg into force. The truth is that Dr. Addison is in a very strong position. The medical profession is not. NEW METHODS CALLED FOR. The war taught the public the value of so-called “team work” and the need of applied science in medical treatment. The public are now asking for greater hospital accommodation, for expert examiners, for early treatment, for prevention, and so on. The i'Old methods of practice are falling into disfavour ' because they are seen to be vra-steful and often ^ inefficient. Again, a large body cd doctors exists in the country which has learned in the Army the methods of “team vrork ” and the need for pre* ,xventive measures. These doctors arc in very many ‘instances looking for work. Many of them have, thanks to their war service, lost their practices. Most of them are anxious to take up salaried work i on somid scientific lines. Consequently it whll be'found unusually difficult , to organize a doctors’ strike against Si reorganization of medical practice. Dr, Addison will hold a strong hand in the shape of the Army doctors. He will possibly, in the last event, be able to defy the strikers altogether. It is this certainty which, no doubt, is hurrying on the Government measure, for after a I time, if nothing is done, these Army doctors will be I. reabsorbed into practice and will in the nature of things cease to be available for national schemes. Dr, Addison is evidently determined not to miss his tide. ' We may, therefore, expect that when the Bill > comes it will be of a somewhat advanced kind. It is unlikely that it will amount to what is usually understood by a whole-time State Medical Service because the Government has no wash to arouse the general practitioners of the country to opposition. On the other hand we do not anticipate a mere extension of the panel system, because that system has failed and the Government is in a strong enough position to face the fact. There seems to be reason to think that there may be provided a system of health centres throughout the coimtry with hospital and out-door accommodation, possibly on the lines suggested by Sir Bertrand Dawson. It will, in this event be open to every doctor to associate himself with the centre nearest to him. At the centre team w'ork w'ill be possible and patients will be able to secure special advice and attention. The doctor may, or may not, be paid on a capitation fee basis for ea.ch citizen on his list. ' It is to be hoped that the whole nation will be ihcluded in the scheme, for disease is no respecter of persons? and one “typhoid carrier” outside of a health scheme might easily infect all those inside of it. But no doubt those who care to pay fees will be able to employ any doctnr they choose. Thus each doctor may be in part a State servant and in part a i^rivate practitioner.