1152 



possibility" that a substantial number of medical schools would have to 

 reduce the size of future entering classes and curtail innovative pro- 

 grams for the curriculum.^^^ 



Medical scientists and medical educators, traditionally cautious in 

 public pronouncements, reacted sharply to the Administration's budget 

 cuts for health and medical research. The New Yovk Times termed 

 their reaction "quite spectacular," and quoted the doctors expressing 

 such adjectives and epithets as: "unimaginative," "obtuse," "irrespon- 

 sible," "disastrous," "catastrophic," and "lunacy." ^^^ 



Some of the sharpest criticism of current health policies came from 

 Dr. Jesse L. Steinfeld, at present head of a department at Mayo Clinic 

 and for 3 years before that, the Surgeon General of the United 

 States, a post to which he was not reappointed and which remains 

 unfilled. Correspondent Richard L. Strout of the Christian Science 

 Monitor enumerated three facts in his article on Dr. Steinfeld: (1) 

 The shortage of 50,000 physicians in the United States; (2) the turn- 

 ing away of some 20,000 qualified American premedical students from 

 U.S. medical schools each year for lack of space; and (3) the hiring 

 of 40 percent of the interns in American hospitals from foreign coun- 

 tries, often to the disadvantage of the LDCs which produced and still 

 need them. A paradox like this, he said, had convinced Dr. Steinfeld, 

 in the doctor's words, that the "whole complex health-delivery appa- 

 ratus is out of control" and that the "health and medical apparatus 

 is in chaotic condition." ^^^ 



The shortage in American medical manpower has created a dis- 

 equilibrium in the supply and demand equation in this country, pro- 

 viding what Dr. Margulies termed "Almost unlimited opportunities 

 for the employment of foreign medical graduates." ^"^ The marginally 

 employed, superfluous Asian, African, and Latin American FMG is 

 irresistibly drawn to the possibility of wealth, social status, and Amer- 

 ican citizenship. 



Why the shortage of doctors in the United States ? Students of brain 

 drain emphasize that the great expansion of health services under 

 federally sponsored programs increased the demand for M.D.s. And 

 American medical schools could not supply the demand. (In 1956, the 

 United States produced 9,862 doctors; 11 years later the figure had in- 

 creased by less than 10 percent.) ^°^ Accordingly, U.S. medical institu- 



*<" In reporting the results of the AAMC survey of medical schools. Dr. Cooper said : 

 "In terms of undergraduate medical education, one third of the schools reporting Indicated 

 the strong possibility of having to reduce the sl^.e of future entering classes. For a con- 

 siderable number of schools, future Increases In flrst-year enrollments will not be possible. 

 And for a majority of the reporting schools, programs for curriculum Innovation may 

 have to be abandoned or curtailed." Statement by AAMC on the costs of medical care 

 and the role of tbe Federal Government, presented by John A. D. Cooper, M.D. before the 

 Consumer Economics Subcommmlttee of the Joint Economic Committee, May 15, 1973, p. 6. 



In citing the shortage of doctors to staff hospitals and Indicating the degree of depend- 

 ency on FMGs, Stevens and Vermeulen made this projection : "Presumably, then their 

 [i.e., American hospitals] demand for more foreign physicians will continue." (Stevens 

 and Vermeulen, op. clt., pp. 4—6.) 



For a discussion of the impact of cutbacks In federal funding on American medical 

 education, see Harold M. Schmeck, Jr., "Medical Educators Here Alarmed by Proposed 

 Slash In U.S. Funds," The New York Times, Apr. 25, 1973, p. 45. Nine medical educators 

 In the metropolitan New York area discussed this problem. They said that the cutlJack in 

 general research funds and training grant money, in the words of the Times, "would 

 retard the develooment of the ne^t generation of medical scientists." 



=»8 Harold M. Schmeck Jr., "Policy Shift: The Doctors See a Bad Prognosis," The New 

 York Times, May 27, 1973, n. 16E. 



»» Richard L'. Strout, "Health-Care 'Paradox' Blamed on U.S. Policy." The Chrtatian 

 Science Monitor, Sent. 12, 1973, p. 6. 



"""Margulies and Bloch, op. clt., p. x. 



»n Baldwin, op. clt., p. 370. 



