22

We could Cearn a great deal

from the British, who have
handled the recruiting of physi-
cians for the armed services
in a much more orderly way.

DOCTOR,
SHORTAGE
By MAXINE DAVIS
OUR doctor has gone to the Army. Your

Y neighbor's doctor left yesterday for duty in

tbe Na\-y- Your cbild suddenly leaves his
toys and goes to bed with a high temperature. Witb
nightmares of infantile paralysis, meningitis and
diphtheria whirling in your head, in a panic you
telephone all over town. It is tbree hours before a
doctor comes and diagnoses it as a little grippe.
And you are fortunate, for you live in a city. If you
lived on a farm in certain parts of this country,
you might wait for days.
We have a shortage of doctors, caused by the
war. This shortage is serious now, while we have no
unusual problems. It may be disastrous if we have
any epidemic this winter. "Epidemic" is tbe fear
that haunts the health authorities of every nation
in wartime. Even we laymen remember the influ-
enza epidemic of tbe last war, wben doctors were
few and overworked, when a hospital bed or a nurse
was almost impossible to find at any price or in the
most desperate need, and when more people died
of tbe disease than of enemy sbot and shell.
At that time, conditions were even worse than
they need have been because of the way in wbich
doctors were recruited for war duty. For medical
care has never been well distributed in tbe United
States. In some places—notably in some of the big
cities—there have always been too many doctors,
while in otbers, especially impoverisbed rural areas,
sometimes tbere has been no doctor at all. Yet doc-
tors were taken witbout regard for this inequity.
In tbis war, the Government and the medical
profession have taken this situation into considera-
tion. They planned from tbe outset to recruit doc-
tors In such fashion as to leave one general prac-
titioner for every 1500 civilians. That was a flne
program, but it has turned out, in practice, to be
only an admirable blueprint. The reason is that our
armed services demand a great many doctors, but Temperature: 103. Puiser rapid. Doctor Brown has gone to the Army. Doctor Hope is delivering
tbey do not draft them ; they ask tbem to volunteer. a baby. Doctor Jones is ill in the hospital from overwork. Doctor Ramsay's phone is busy.
In this policy resides the core of our troubles.
Let us examine the situation and see wbat has
actually happened. In June of 1940 the American and is expected to distribute doctors, dentists and
Medical Association began to register all doctors in ical officers at the present ratio of six and one half
doctors to 1000 men, almost half the doctors in this veterinarians equitably between the armed forces
the United States, and to classify them on a roster and the rest of us.
to be used if war should break out. A year ago we country will be in tbe armed services.
Although the Navy has not yet quit« exhausted When tbe Army needs, say, 5000 more doctors,
had 176,000 doctors in the whole country, but they it goes to Doctor Lahey and asks for them. Doctor
were not all practicing. Some were teaching, some its reservoir of reserve medical officers, doctors in
tbe Army and Navy reserve are automatically sub- Lahey and his assistants divide the number into
were old and retired, and some were selling bonds. quotas for each of the nine Army Service Com-
At the beginning of the war we had about 128,000 ject to call in wartime.
The Government did not tell the Army and Navy mands. The Procurement and Assignment Board
physicians engaged in the private practice of medi- in each of these areaa assigns appropriate percent-
cine. to go ahead and get doctors anyhow and anywhere.
It set up an organization called the Procurement ages of the required medical men to its state boards,
During this first year of war, the armed forces who, in turn, apportion them out to their county
asked for 42,000 doctors, and by October first most and Assignment Service, headed by Dr. Prank H.
Lahey, former president of the American Medical committees. The county committees, like the groupa
of the quota were already in uniform. If the Army in the higher reaches, comb their local medical-
and Navy expand in 1943 in accordance with their Association. The Procurement and Assignment
Service is under the War Manpower Commission society roster and select (Continu«/ onftjgo96)
announced program, and if they commission med-
 THE SATURDAY EVENING POST
96
The gasoline element would not ap-
pear to, amount to much—four tenths
of a gallon to 1000 feet—but the Pan-
handle Eastern last year handled be-
tween sixty-two and sixty-three billion
cubic feet of gas from the Kansas pool
and that in Texas, and produced from
that 25,000,000 gallons of gasoline—no
hay in any man's country.
Passing on through the pipe line,
the gas ia recompressed no fewer than
fifteen times between Kansas and De-
troit. But when it reaches the gates of
its destination city, it ia permitted to
expand until its pressure decreases to
From the kitchen.. about 100 pounds for household use,
since ordinary lines and equipment
[ARTIME calls women from could not handle the 500-pound pres-
sure of the transport line.
the home into the factory.
Even with frail fingers and Exploration is continuing in the
Hugoton field, although at present on
small strength they may work on a somewhat reduced scale, because of
heavy parts with a 'Budgit* Elec- the war and priorities. Although the
"sweet spots" have, of course, re-
tric Hoist to do the lifting. Thus
ceived the biggest play, wildcat wells
thousands of jobs are opened up
to women who must now do the
have been sunk all over the field, until
now the general outlines can be
grasped.
work of men.
'Budgit' Hoists are Proved territory stretches from
portable, electric hoists near Garden City, in Western Kansas,
almost to Sunray, Texas—130 miles
with lifting capacities of
250, 500, ioco and 2000 from north to south. It ranges up-
ward to forty miles from east to west.
lbs. They arc priced from Compare that with the proportions,
Í119UP. Hang up, plug say, of Massachusetts. The total area
in, and use. For complete of the field is approximately 2,540,000
information, write for
acres, and it takes in all or part of ten
Bulletin 348. big counties in three states.
Six years ago, gas engineers credited
z
z<
'BUDGIT' the then accepted 1,076,480 acres with
a potential reserve of fifteen trillion
cubic feet. Explorations since have
TfD, „t.
Hoists increased the acreage to more than
MANNING, MAXWELL & MOORE, INC. 2,500,000 acres. Testifying recently be-
MUSKEGON, MICHIGAN fore the Federal Power Commission in
Buildsri ai '5how-Bn.' Cranes, 'Budgir' ond 'lood Irfrir' Washington, Dr. Glenn G. Bartle, dean
Hoiili and other liliing (pociollios. Mokois ol Asticroll Gouge!, of the University of Kansas City, and
Honcock Valves. Consolidolsd Solalv and Relief Valvei and
consulting geologist for the Panhandle
Eastern, estimated the capacity of the
Blessed Relief field at about 9,300,000 cubic feet of
gaa to the acre. This ia conservative,
the range of other expert eatimates
from running from 8,000,000 to 10,500,000
feet. At Doctor Bartle's figure, the
strata forming domes, beneath which
oil or gas gathers and can he tapped by
wells. The Hugoton structure, however,
is a gigantic monocline—a single great
plane of rock, sloping gently upward
toward the west—which would never
in the world have trapped any gas
had it not been for a geologic accident
which closed off the upper end with a
sudden fault of impervious rocks and
shales. The gas thus can get no farther
upward toward the west, and it is
trapped on the lower side by the bot-
tom water.
Geologists got their first clue to the
presence of this structure from the be-
havior of the Cimarrón River, which
SYNONYM
By JESSIE FARNHAM
ORGETTING is a worry word,
F So I say "disremember";
Forgetting breathes finality,
Like an ashy ember.
Forgetting is a weary word.
Like leaves thnt dot November;
A brown and brittle rustling word.
So ! soy "disremember."
Forgetting is a teary word
That makes the heart a member
Of clans that clad lost dreams in black.
So I say "disremember."
Forgetting is a sorry word,
So I say "disremember,"
As though I had but stored a thought
For succor in December.
runs through Southwestern Kansas various
and Northern Oklahoma. The High limitless
Plains are fiat, but they have their made from
natural features, of which the Cimar- starts petroleum
rón is one. It is among the world's the road to chemical
most individualistic streams—a river extracted from salt,products.
Danmb» 12,1942
¡"of the Cimarrón and itß affluents gave
[the old-time scouts their first hunch
f as to the existence of the structural
I high in the country. To date, that
: structure is the biggest in the experi-
ence of the petroleum industry. Not a
dry hole has heen drilled within the
proved territory.
I The first great value of a field like
the Hugoton field is producing fuel.
Natural gas, which can be piped to dis-
tances almost as easily as electricity-
can be wired, has been called the per-
fect fuel because of its consistent quali-
ties and its ease of transportation. But
as a fuel resource, the Hugoton field
has hardly been touched. Its two
major and two minor pipe lines com-
pare with nine major and ten minor
pipe lines tapping the smaller Ama-
rillo field, which is a little older, and
therefore received the first play.
A few carbon-black plants have been
established, but it is generally agreed
carbon burning is wasteful, using less
than 3 per cent of the gas. The cattle-
minded people of the High Plains have
a homely simile: " Using gas for carbon
is like killing cattle for the glue in their
hoofs."
However, it is not likely that the
Hugoton field will wait long for de-
velopment. Its potentialities are too
great. The Kansas Industrial Develop-
ment Comniisaion recently completed
an intensive study of it. Dr. Roy
Cross, head of the Kansas City Testing
Laboratory, has called it "potentially
the cheapest fuel and cheapest power
resource in America."
Chemical analyses show that the
Hugoton gas is sweet gas—free from
sulphur compounds—and rich in ele-
ments which can be extracted and used
industrially. It has chemical com-
ponents which will make synthetic
rubber, synthetic alcohol, formalde-
hyde for making synthetic resins, and
plastics. Contiguous and ac-
cessible to the field is a practically
quantity of salt. Chlorine,
salt, ia the agent which
and natural gas on
Sodium,

TIRED EYES
MAKE THIS SIMPLE TEST TODAV
present reserves in the Hugoton field
reach the immense total of twenty-
three and one-half trillion feet —an
of paradoxes. It can be four inches the production of synthetic
wide one day and four miles wide the many organic reactions. rubber and
next. It rises in an extinct volcano—
is necessary for

utterly incomprehensible figure, but
enough gas to last, at the present rate
of withdrawal, for a couple of cen-
turies or ao.
EYES OVERWORKED? Just put two drops of The Hugoton field is huge because
Murine in each eye. Right away you fed it
start tocleanse and soothe your eyes.You get— it is a geologic freak. Most gas and
oil deposits are found in what geolo-
gists call anticlines—folds in the rock
Capulin Mountain, New Mexico—and These, however, are problems for the
has its mouth in a volcano that is by no chemicai engineers. The world's big-
means extinct—Tulsa, Oklahoma. gest bubble is there, insurance for long
The Cimarrón slashes a jagged val- into the future against gas shortages,
ley from the corner of Kansas north- ready to help in the job of welding
east until it passes Hugoton, then weapons for this war, or of turning the
suddenly makes almost a right angle wheels of industry for the reconstruc-
aoutheast into Oklahoma. This detour tion of the world after the war.

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men whom, presumably, the people of
the community can safely spare.
The local committee then advises
the physicians they select for the Army
to apply at once for their commi^ions.
All the committee can do is advise.
The doctor must volunteer his serv-
ices.
Theoretically there is no compul-
sion, and any doctor selected has the
right to appeal the committee's de-
cision, on the ground that he is essen-
tial in civilian life.
Actually, however, what haa hap-
pened is quite a different story. Many
doctors, fearing the inevitable loss of
their practice, did not volunteer when
advised to do so by their committees.
Consequently, the Army, desperate for
doctors, sent recruiting teams into
every state. Obviously, the recruiting
teams should not be cri&icized; after
DOCTOR SHORTAGE
(Continued from Page 22)
all, they were instructed to go out and
get the doctors. The Procurement and
Assignment Service wanted to move
more slowly, but it has no authority
and no jurisdiction.
The result has heen unfortunate.
Somehow, the original maldistribution
of doctors has become worse. New
York, always bountifully supplied with
medical care, has given, thus far, only
64 per cent of its quota, whereas many
doctor-poor Southern states have sent
more than 50 per cent more physicians
than were asked of them. Thus, while
you may have to find a new doctor if
you live in Manhattan, that's your
only problem. You'll still find a doctor
easily, and a good one. If an epidemic
comes. New York will be almost as
well provided for as any city can be in
the face of calamity. The reverse is
true in the South.
Moreover, the doctors who are left
behind are not always the most com-
petent. Take the town of B. It had
two doctors, one a conscientious and
well-trained man and the other a lazy,
indifferently educated one. The county
committee, concerned for its citizens,
offered the slovenly practitioner, but
the Army, quite naturally, insisted on
the best.
Or look at the situation in L, a
larger community. L had four doc-
tors—one a clever, hearty young man,
one an able but elderly phyaician, one
a practitioner suffering from a crip-
pling arthritis, and the fourth a notori-
ously chronic alcoholic. The young
doctor had to go to the Army. The in-'
valid and the drunkard cannot be re-
lied upon. The whole health of L de-
pends upon a man of sixty-six.
IConlinuad on ftige 98)

98
(Caniinued from Pogs 96)
Another condition, grave now and
potentially menacing, has arisen. In
more than 300 communities where
huge new war industries have been
established, the number of doctors
has not only been reduced but the
populations have increased astronomi-
cally. The Chamber of Commercé and
other agencies in, for instance, Mobile,
Alabama, are sending anxious tele-
graphed appeals for doctors to Wash-
ington. And trailer towns, without
established civic organizations to plead
for them, struggle somehow with life,
death and measles with perhaps one
doctor for ten or twenty thousand men,
women and children. Think what
would happen to our war production
should an epidemic smite.
Although 5 per cent of the doctors in
the United States are women, appar-
ently neither the Army nor tbe Navy
wants tbem very badly, though they
do, of course, have women doctors for
the Waacs and Waves.
Nor will the Army accept any of the
6000 alien doctors in the United States.
Theoretically, these foreign medicos
may be sent to communities over the
country which are suffering a shortage
of doctors. Actually, they don't move.
One reason is that they simply don''t
want to. Another is the matter of
license to practice. We have no uni-
form state laws, and a number of the
states refuse to let down the bars, even
for tbe war period.
The British handle their problem of
medical care with infinitely less hard-
ship to the people of Great Britain and
to the doctors themselves. They have
three years of war experience behind
them. They've made mistakes. Their
scheme has a good many holes in it.
Their situation is not always, for a
number of reasons, comparable to ours.
And their armed forces have not only
taken too many doctors to leave a
number adequate to insure the safety
of the civilians who are left but they
have also taken, in the opinion of the
medical profession, more than they
actually need. Tbe British forces have
4.75 doctors for 1000 men. However,
the British have learned by trial and
error, and we might do well to examine
their system—a system which I ex-
amined carefully on a recent trip to
England.
Compared to ours, it has four strong,
important features:
1. It is centralized, and not divided
between the government and the med-
ical profession.
2. It is compulsory. The British
learned in the first year of the war that
recruitment on a voluntary basis does
not work.
3. Its system of appeals is genuine,
sound and judicious.
4. It protects the practice and the
future of the doctor recruited for war
duty.
The British Medical Association pre-
pared for war long before its govern-
ment. By 1937 it had its roster of
almost every physician in Great
Britain well organized, and effective
six months before Munich.
How Britain's System Works
When war was declared, the govern-
ment made the British Medical Asso-
ciation its sole agent. When the army,
navy or air force needs doctors, it asks
the Central Medical War Committee
of the B. M. A. to obtain them.
The machinery is much the same as
our own. The B. M. A. has districted
the country, with local medical war
committees in each district. When the
THE SATURDAY EVENING POST D«Mmb«r 12, T942
army asks for 1000 doctors, the cen- be released if he is needed at home. If bank half the fees they receive for
tral committee assigns a quota to the other doctors in his community treating the warrior doctor's patienta
each. The Oxford committee, for ex- die, or become incapacitated, or leave, and to turn the funds over to him or his
ample, then comhs its roster for its he may appeal, on the same grounds heira. The doctor who stays at home
share, selects them, and advises each and in the same manner as for exemp- also agrees that after the war he will
of them that he is "provisionally tion, to return to his former practice. not serve any of the patients he has
selected." The local and central war commit- cared for in the absence of the warrior
This tentative drafting gives the tees of the B. M. A. are careful not to doctors for a period of one year. Thus
doctor the right of appeal. He may strip communities of doctors, nor do the doctor who has been away haa
appeal to his local committee, and if they skim the cream for the armed twelve months to reinstate himaclf
his appeal is denied, he has the right services. They try to divide them rea- with his former patients.
to appeal to the central committee. sonably in terms of quality. We have no such program in this
Both the local and central committees With proportionately fewer doctors country. Doctors close their offices,
go into the case thoroughly. They are in England than in the United States, often put their records and files in
concerned with one problem only: is the B. M. A. from the outset had to storage and resign themselv^ to a
the appellant doctor essential to the spread tbem even more thinly than new start under adverse conditions
welfare of the civilians he has been we planned to do. They concluded that when the war ends. Usually they have
serving? Civil need is the only cri- they must have one doctor for every worked hard to develop their practices,
terion. Any personal hardship such as 3000 people in the cities, and one for and it seems unfair to take them for
dependents the doctor must bring up every 2400 in the rural areas. They the Army without offering them some
before the regular draft board. have kept remarkably close, in prac- such security as the British have de-
British doctors often exercise their tice, to this ratio. They have also ar- vised. True, it is simpler in England,
right of appeal. Sit at a meeting of theranged the transfer of doctors from which has its health-insurance-panel
central committee at British Medical areas evacuated either because of bomb- doctors, and where physicians are in-
Association House in London. You will ings or because men and women have clined to work in teams or partnerships.
see a rectangle of long tables at which moved to the places where war fac- But some variation might be adapted
some of the most eminent of England's tories were located. The American Pro- to the American needs.
curement and Assignment Service is
scientists sit. All day long they hear
cases appealed from local committees. trying to do that too. "I
Lessons of War
Here is a doctor in the City of London, Women doctors are not all left for
where there are no private residences. civilians in England; the British use In Great Britain, the B. M. 1
He is medical oflicer for nine big in- and commission them in the regular also evolved schemes for- making
surance companies, and says frankly army as well as in the women'L auxili- reduced number of civilian doctora :
that anyone else could do his work. aries. The British are also making almost further. For instance, it has ruled •
However, he is also air-raid-protection maximum use of the 1250 refugee doc- the doctor shall work within a 'cert
doctor for the City, and therefore the tors in their country. The B. M. A. has radius only, and not overlap the ter
committee decides he cannot be given them temporary medical regis- tory covered by another phyaicis
spared. A doctor from Nottingham tration for the duration of the war, and This means, to be sure, that the patient
follows him. He is an assistant to an all those not too old or too ill or too is restricted in his choice of doctora.
older man, and claims his chief is overspecialized are serving the people But it saves the doctor's valuable time
feeble and cannot do without his help. of the country which gave them haven, in visiting bedridden folk, and it also
The committee concludes that his and doing their best to ease the situa- saves precious gasoline and rubber.
chief can get another assistant, and tion.
drafts him. A third physician is head We in the United States are suffering
of a big, and now understaffed, clinic in Neither they nor anyone else will a shortage of hospital beds and nurses
Wales. The committee is of the opinion steal the practice of the doctors who as well as of doctors—although we
that his patients need him more than have gone to war. The British "pro- have been miraculously healthy so far.
the army does. And so it goes. tection of practice" scheme is intelligent, Nurses are going into the services
wise and simple, and we would do well faster than we can train new ones.
Once the British Medical Associa- to adopt it here. When the English Congestion in defense areas, combined
tion decides the doctor must go to war, doctor goes to war, he leaves his rec- with the fact that people are making
he is compelled to go. However —and ords and his patients with one or sev- more money and therefore want to go
this is a wise provision —he may later eral of his colleagues. They agree to to the hospital when they are ii!,
accounts for the crowding of hospitals.
And it is bad. In Washington, D. C,
the hospitals are considering sending
uncomplicated obstetrical cases home
the day after delivery.
The British have had the same sort
of shortage. They have solved it, for
the moment. At the beginning of the
war they had set up a great many
emergency hospitals to take care of
their military wounded and the civil-
ian casualties from air raids. Aa they
have thus far had fewer wounded from
either cause than they had anticipated,
they are making other use of the beds.
In Scotland, for instance, the doctors
are taking this respite to treat all
chronic cases. A man with a hernia, for
example, which has not yet strangu-
lated and which could not be consid-
ered urgent, might have waited months
for a hospital bed. Today he can go to
one of the Scottish emergency hos-
pitals for care. Should the situation
change, should intensified air raids or
a second front increase the number of
casualties, these hospitals would have
to be put back to their original pro-
posed use. In the meantime they re-
lieve strains on the regular hospital
® and nursing services.
Altogether, the British system is
fairly satisfactory. It was neither com-
plete nor effective when it wasfirstput
into operation. It is far from perfect
now; the B. M. A. is still making
studies and recommending changes.
It has not yet had to face any severe
tests, for, with the exception of an in-
® crease in tuberculosis, the British have
e been unusually healthy during this war.