Country Care

Although a modern country doctor makes his calls in an automobile, 55,000,000 U. S. rural dwellers are still getting horse-&-buggy medical care. To gather facts on this problem, the staff of Mary Imogene Bassett Hospital in Cooperstown, N. Y., under the direction of Physician-in-Chief George Miner Mackenzie, last autumn held a conference of country doctors and public-health experts. Last week the papers of the Cooperstown Conference were published in a well-documented handbook, containing the most complete information on U. S. rural medicine to date.* Significant facts:

> Most dangerous of all occupations is farming, according to Dr. John Howard Powers of the Bassett Hospital. Highest number of occupational deaths throughout the U. S. occurs among agricultural workers. But what hurts the farmers most often is not a reaper or a pitchfork, but a reckless motorist hurtling through country lanes.

> When the U. S. Public Health Service recently surveyed the health needs of 22,-000,000 rural dwellers in 1,340 scattered counties, it found that 55% of the counties, with a total population of 8,000,000, had no hospitals. Most of the hospitals in the remaining 45% were small, ill-equipped, seldom used. Greatest hospital need is in rural areas of the 14 Southern States, which have an average of one general hospital bed for every 1,000 citizens. (General U. S. average: 3.3 beds per 1,000.)

> One reason why U. S. rural dwellers get poorer medical care than their city cousins is the backwardness of the average country doctor, who does little to keep up with the rapid progress of medicine. Alert young physicians no longer settle in the country, and, according to Associate Professor of Medicine John Barlow Youmans of Tennessee's Vanderbilt University, 10% to 20% of country doctors "will not take postgraduate training on their own initiative, even when opportunities are available."

> A bigger reason: in a good year, an average country doctor covering a wide territory may collect $5,000 in one-and two-dollar fees. But, said vigorous Dr. Lloyd C. Warren of Franklin, N. Y., 40% of this gross income must be spent for transportation and medical supplies. So the doctor's average net income is seldom more than $3,000. "Obstetrical cases," said Dr. Warren, "are about 50% loss. Automobile accidents . . . are about 100% charity . . . and the boys with venereal disease never come back to pay."

* RURAL MEDICINE--Charles C. Thomas ($3.50).

This file is automatically generated by a robot program, so reader's discretion is required.