Health and Private Doctors
by Daisy Lee Worthington Worcester
Co-Author, Volume 15 of the Federal Investigation of Women and
was the realization of Dr. Pomeroy's dream, a strongly centralized
administrative machinery, and a completely decentralized service,
reaching out to the most remote rural dwellers, and taking to
them modern medical and health service which many a city would
envy. The Los Angeles County Health Department has been a pride
of the American public-health movement as well as of socially
minded Californians. Professional men from all over the country
came to study its methods. Professional recognition of the executive
himself came in Dr. Pomeroy's present position as president of
the Western Branch of the American Public Health Association.
when I was in Los Angeles a few weeks ago, I found that curative
and emergency work in all but one of the health centers had come
to a dead stop. Many of the remaining services of the department,
well-baby clinics, vaccination against smallpox and immunization
against diphtheria, were under the fire of the organized doctors
who had succeeded in closing the clinics and the emergency hospitals.
The only one of these centers
where curative clinics still go on is in Alhambra, a city of about
thirty thousand. This health center was completed in 1930. Its
opening was celebrated by a fifty-page edition of the local daily
paper. Its work was developed by Dr. S. J. Stewart, a man who
brought to this small community seventeen years of experience
as superintendent of state institutions in Nebraska, captain in
the Medical Corps of the US Army during the World War in charge
of neuro-psychiatric work, staff physician of St. Elizabeth's
Hospital in Washington, D. C. Such, in general, has been the character
of the men whom Dr. Pomeroy has obtained to aid him in his work.
The Alhambra Health Center proudly displays the bronze plaque
which was awarded to it in 1931 by the US Chamber of Commerce,
for "Best Accomplishments in Health Conservation" of any city
in the United States with a population between 20,000 and 50,000.
center has not been closed because Dr. Stewart had the foresight
to have inserted into the contract between the city and the county
the provision that if ever the center ceased to be used for its
original purposes, all the buildings and equipment would revert
to the city of Alhambra. The community has demanded that the terms
of the contract be kept. More than forty thousand signatures have
gone into the supervisors (the health center serves an entire
population of more than 200,000), demanding that the center be
kept open. Dr. Harry Wilson, secretary of the Los Angeles County
Medical Association, says that it is only a matter of weeks until
it will be closed, as the doctors in the community will refuse
to serve on its staff. The same opinion was expressed by Dr. Phoebus
Berman of the Los Angeles County Hospital, medical director of
the newly developed "San Fernando Plan," which the doctors have
substituted for the healtn-center program. On the other hand,
Dr. Stewart, in company with prominent citizens of Alhambra, says
that the center will remain open, though the supervisors must
hire a staff of physicians to be placed on the county payroll,
even as Dr. Stewart himself is.
community's pride in its enterprise is justified. The building
itself is beautiful: white brick, with red-tiled roof, set back
in the midst of green lawns and waving palms, its architecture
a combination of early California and Monterey types. The equipment
includes x-ray for the diagnosis of tuberculosis, hydrotherapy
for the treatment of infantile paralysis, appliances for orthopedics,
the most modern apparatus for dentistry, everything needful for
the diagnosis and treatment of venereal disease.
the day of my first visit, despite the rush of work going busily
forward, the atmosphere within was that of quiet efficiency. Dr.
Stewart was going about among the patients, greeting many of them
by name, making friendly inquiries of those who were waiting for
treatment, while the white-clad nurses moved about with all the
orderly precision characteristic of the best modern hospital.
In the emergency hospital, a young girl had just been brought
in from the highschool with a broken leg which was being placed
in a plaster cast. A group of mothers were watching their babies'
weights and measurements at a wellbaby conference. A number of
people were waiting to be interviewed by the friendly social-service
worker. There was an entire absence of the condensed depression
which so oftert marks public clinics, and a combination of dignity,
graciousness and efficiency which I have not seen paralleled,
even in the offices of private physicians.
This is the kind of health service
which Los Angeles County has discarded because some of her doctors
were hungry. There is no doubt about the cause. It came into the
conversation of more than a score of people with whom I talked,
representing widely different viewpoints. It was stressed by Dr.
Harry Wilson, secretary of the Los Angeles County Medical Association;
by Dr. Phoebus Berman, medical director of the County Hospital
and of the new San Fernando Plan, by Arthur J. Will, deputy superintendent
of Public Charities in charge of institutions; by Mary Stanton,
secretary of the Health Division of the Los Angeles Council of
Social Agencies, and by all members of the County Health Department
with whom I talked. The entire story of the recent developments
was the same in all essential details, no matter who related it.
A few years ago, many physicians
were enthusiastic members of the volunteer staffs of the health
centers. But as the lean vears continued, their private practices
began to fall off, at first slightly, expectedly, then ominously.
This was the situation in almost every section of the country,
but in Los Angeles it had special significance because the health
centers were there to deal with the other side of the dilemma
which the doctors were facing. The dinics of these centers became
crowded with patients. The doctors began to see some of their
former private patiedts among them. Many of them had automobiles;
some of them were still well dressed.
were those who had once held good positions; those whose savings
had been swept away by bank failures or were frozen in Building
and Loan Associations. By 1932, when the doctors began to complain,
many patients who had been living on savings that had not been
lost, were reduced to complete dependency. They were swelling
the mlmbers of the curative clinics. Most of them felt that they
had a right to be there. They had built and supported these health
centers in their days of plenty.