THE TROUBLED CALLING

A general over-view of the state of medicine, its practice, practitioners and patients in the United States provides the springboard for stand-taking and the substance for reform. The author sees medicine today as the victim of its own success in keeping people alive longer; whereas in 1900 there was one doctor for every 500 people, today there is one for every 1100 with the prospectus in 1975 one per 1500. The physician himself is caught in the position of bringing into balance his function as a dedicated humanist on the one hand and a breadwinner on the other. Hospitals are at the focus of conflict; voluntary health insurance does nothing to abet the situation with its emphasis on hospital rather than ambulatory care. What of the position of U.S. medicine in world ranks? What of general practice (the discipline which covers the widest area receives the shortest period of preparation) and specialization? Of research? of the use and abuse of drugs? of postgraduate education? of private and public medicine? of current physician stand-patism? Mr. Greenberg examines these elements in the body medical and makes his own diagnosis; he prescribes group practice allied with comprehensive voluntary insurance as the curative. This offers the sort of call to clean house that the profession will have to do if it is to answer the country's needs and remain without the structures of socialized medicine.