Official proceedings of the annual meeting: 1923

THE SOCIAL POINT OF VIEW IN THE MEDICAL FIELD-SNOW 57

All this, however, is only evidence of the physician's lack of understanding of
social needs and social-work methods. It does not justify the deduction that the
medical profession is opposed to participation in such work. The reverse is true. In
every great emergency, such as the Dayton Flood, the San Francisco Fire, or the
world war, and in local conditions wherever a physician has become interested as a
citizen in the public welfare, his social point of view has developed along with that of
this fellow-townsmen similarly interested.
More concrete evidence of this is found in the extent to which physicians have
served as health officers without pay, or as members of boards of health, and in innumerable other welfare bodies to which they have given most generously of their time and
money. The growth of free dispensary services, the later pay-clinic plan, and the
recent health-clinic idea, all of which thus far depend largely upon voluntary or small
honorarium service of physicians for their success, are additional evidences of the
increasing degree to which physicians are participating in social work. The most
encouraging new factor in growth of the social point of view in the medical field is the
rapid development of the periodic health-examination program. This principle has
long been practiced in dentistry and has of course been advocated by individuals, by
school, by health authorities, and by such agencies as the Life Extension Institute, but
only within the past year promises to become a national practice. Probably nothing
will contribute more rapidly to completing the social welfare education of the physician
than the success of this periodic health examination movement in which he must participate.
Other forces which are playing their part in leavening the conservatism and
individualistic ideas of physicians are the experiences so many of them had during the
war. Those who entered the army and navy learned that, important as is the treatment
of individual cases, the great thing in winning a war is to keep the largest possible number of men on the battle line the greatest number of days in the year. This they learned
could not be done by limiting their efforts to those who became ill or were wounded;
the big thing was to keep them well. What the army and navy medical officer learned
about prevention of disease and health conservation, the overworked physician who
was held at home learned in his community and through co-operation with his local
health official or by service with the United States Public Health Service. These
experiences have been supplemented by participation in the organized health and
welfare work of the American Red Cross and of other great philanthropic bodies. The
enlarged health programs of industrial organizations and of the insurance agencies,
notably the Metropolitan Life Insurance Company, have still further enlisted and
convinced the medical profession that the social aspects of its work must be given
adequate attention. It is no longer the theory of social work in relation to medical
practice which holds the physician back, but certain difficulties of administration and
practical application.
The national health insurance schemes adopted by various countries in the past
thirty years, notably the English Insurance Act against sickness and unemployment,
have shown how to do some things and how not to do many others in relation to correlating the medical and social forces. The physicians themselves are working out many
problems of co-operation among specialists, and costs of professional service, by their
experiments in group medical practice and hospital-center facilities. The United
States Public Health Service and industrial surgeons are doing much to demonstrate