Official proceedings of the annual meeting: 1923

56

HEALTH

THE GROWTH OF THE SOCIAL POINT OF VIEW
THE GROWTH OF THE SOCIAL POINT OF VIEW IN THE
MEDICAL FIELD
William F. Snow, M.D., General Director, American Social Hygiene
Association, New York.
The growth of the social point of view in the medical field can be discussed or
interpreted only in the light of history and the present development of medicine and
surgery. Within the memory of many of our own parents living today, anesthetics,
without which surgery could not be practiced, came into use. The thinning ranks of
Civil War veterans, as they march on Memorial Day, are evidence of the short span
of time since men went to war with army physicians who knew nothing of modern
bacteriology and asepsis or of sanitation as it is carried on today by every city and
state in the nation. It was not until the present century, which is a way of saying
within the past fifteen or twenty years, that the profession of medicine became equipped
with its wonderful methods of scientific accuracy in diagnosis and treatment, in immunization, and other means of prevention of disease and the conservation of health.
The almost incredible rapidity with which knowledge requisite for the practice
of medicine has increased in the past fifty years, and the development of great hospital
and dispensary organizations in every center of population have inevitably absorbed
the attention and administrative skill of the best men in the field of medicine, and until
very recently there have been relatively few women practicing medicine. These
leaders have thus naturally devoted their efforts to intramural research and the individual treatment of patients. The students of medicine were most deeply impressed
with this phase of medicine, and on graduation began practice with ideals of the
highest service to each patient, but with no conception of any duty to the community or
the families and associates of their patients. From the date of receiving his license
the average successful physician has few contacts outside the immediate affairs of his
private patients, and these contacts are largely limited to his office or bedside visits
at which the important subject of discussion is the procedure in critical illnesses. One
can hardly find another large group of influential highly trained men and women who
have hitherto had less opportunity in their education, occupation, and daily lives to
know what advances have been made in the growth of the social point of view.
Other reasons why physicians have been slow to play their full part in social
work may be found in the spectacular development of public-health administration
and of the nursing profession. The latter has increasingly relieved the doctor from
the responsibilities for solving the social problems of his cases. With this opportunity
for release from the general advisory relationship of the old-time family physician, he
has buried himself in the technique of the specialities in medicine and surgery. This
partnership between nurses and doctors has been in many ways a great benefit to
patients in both private and institutional practice, but it has served to remove the
physician further from contact with the social aspects of his profession. Likewise the
transfer of responsibility for the control of communicable diseases from the physician
to the public health official and the equipment of the latter with administrative power,
laboratories, inspection services, and popular educational facilities has still further
convinced the physician that the public considers his duties to be limited primarily to
individuals who seek his advice and treatment.