Octobee 27, 1916] 



SCIENCE 



597 



free opportunities for training and the en- 

 tire taking over of medicine by govern- 

 mental mechanisms, solve these difficulties, 

 is a question which many are asking. 



It seems that it would be most easily pos- 

 sible to coordinate the different elements in 

 medicine in groups on a governmental, 

 rather than a corporation basis. 



It is necessary to provide each commun- 

 ity, no matter how remote, with a group of 

 trained medical men in which each special 

 field is covered and the work of each prop- 

 erly related to the others. 



The general practitioner and the family 

 doctor seem doomed to disappear. No 

 single individual can hope to keep abreast 

 of new knowledge in all branches. Such a 

 plan is for the best interests of the individ- 

 ual, the public and the doctor, and is in 

 line with the trend of the times, which 

 seeks to make of each citizen an expert in 

 an increasingly circumscribed field. An 

 agreement could easily be made whereby 

 each member of the group in turn could get 

 away to some of the continuation schools to 

 bring himself abreast of the latest advances 

 in his chosen work and carry back inspira- 

 tion to his colleagues. 



Whether this group system is a part of a 

 municipally or a state or a nationally con- 

 trolled mechanism can not be foreseen. 

 Whether it will evolve through a corpora- 

 tional or state health insurance can not be 

 foretold. Life insurance companies, rail- 

 way and mining corporations and other 

 similar organizations are drifting into 

 makeshift arrangements which have these 

 objects in view. In any event commercial 

 concerns are realizing a little of the huge 

 tax on the world of sickness, and the in- 

 creasing load which the well assume in 

 caring for the state dependents. 



If medical school inspection is such a 

 good thing, why should it not be extended 

 to embrace society as a whole ? 



As this group system develops, it will be 



found that all the members of a group so 

 constituted will not require the same train- 

 ing nor will some of the individuals re- 

 quire to be trained as long as certain 

 others. For instance, all might have the 

 same basic training, and employment could 

 be found under competent supervision for 

 those with the minimum training until 

 such time as they had opportunity to dem- 

 onstrate aptitudes. They could then be 

 returned for certain formal training to 

 graduate institutions so as to fit them for 

 the new line to which they aspire and for 

 which they have shown capacity. This 

 would be a sort of continuation school in 

 medicine whereby the original medical sci- 

 ence instruction in laboratory, in clinical 

 and in various public health phases could 

 all be related to each other and to practise. 



No one of us can see clearly the outcome. 

 He sees indications of a coming change and, 

 in many instances, instead of adapting and 

 preparing himself for such changes, re- 

 sents them. Here is an opportunity for 

 medical leadership. The public has been 

 aroused. We must not fail to rise to the 

 opportunity and meet the obligation. 



The abolition of sectarian ethics and the 

 adoption of one brand, based on the Golden 

 Rule, will cure many of the ills of human- 

 ity. In passing, we may ask ourselves why 

 we should have one standard of personal 

 ethics, another for professional and busi- 

 ness purposes and yet another for political 

 ends. Why, when owing to specialization, 

 each group becomes increasingly differen- 

 tiated from other groups of workers and 

 at the same time increasingly dependent 

 upon them, should the members of a group 

 so often stand by their fellows in that group 

 against the best interests of all the groups ? 

 That medical men have stood together, 

 quite often against the best interests of 

 other social groups, has estranged and in- 

 sulated them to such an extent that they 



