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MEDICAL PROBLEM DEFINED

Public Authorities May be Expected to Take Over Private Practice.

Dr. Richard C. Cabot '89, of the Medical School, gave the fourth of the series of lectures on "The Social Problem and Its Remedies" yesterday afternoon. Dr. Cabot's subject was "The Problem in Medicine."

Three or four years ago Dr. Cabot had occasion to spend the night with a doctor in a small town in Vermont. He was informed that this man had nearly lost his practice because the efficient work of the state and local boards of health had prevented much sickness. The public side of the doctor's interest is driving out his private interest.

In 1892 boards of health existed, but the amount of their activities was not one-fiftieth of what it is today. The movement against tuberculosis is a striking example of the work that boards of health and hospitals are doing free of charge. All this free work threatens doctor's incomes and they feel it. More or less as a result of this the number of medical students in the country is decreasing.

Hospitals are a force that is tending to drive the physicians out of business. Many hospitals were originally founded as charitable institutions, but now anyone, rich or poor, may have the free use of a hospital. In this way patients who are able to pay a physician's fee, get free treatment and decrease the doctor's practice. Late in June, 1909, a circular was sent to the hospitals of Boston stating that, although the various hospitals had thousands of cases on June 17, not a doctor in the North or West End had a single case.

Factories are employing their own doctors and nurses, and insurance companies hire doctors and nurses to visit their policy holders and keep them in good health. These are also forces tending to take away the private practice of the physicians.

The work of preventing and curing disease is being shifted from the doctor's private office to the public hospital, but this public work is the line of progress. Health is of public importance, and in the future provision will be made for health as it is now made for education.

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