Health and Private Doctors
by Daisy Lee Worthington Worcester
Co-Author, Volume 15 of the Federal Investigation of Women and
Dr. Pomeroy was one of the first
to recognize the plight of the doctors. In the annual report of
1932-33, there is a further statement of a policy that he had
long advocated: "We would recommend most heartily that the private
physicians who are donating their time in the clinics be paid
some remuneration for their services." At such a proposal, however,
a cry went up from the Medical Association, "State medicine!"
It was considered evidence that the health officer was aiming
only to build up a machine which would cut the ground from beneath
stand of the organized medical profession was cloaked in an appeal
to cut taxes and relieve the taxpayer of what was declared to
be an unwarrantable burden. As a matter of fact, the budget for
the year beginning 1932 had been cut nearly 40 percent from that
obtaining two years earlier, though treatment-clinic services
had doubled, and care in the venereal-disease clinic tripled.
It is estimated that the small taxpayer in the county with a $3000
home now pays about fifty-eight cents a year on his tax bill for
health-department service. As is later detailed, the change has
not brought a saving to the taxpayer.
1932, the opposition of the Los Angeles County Medical Association
was bulwarked by the added force of the Public Health League.
Composed at first of members of the medical profession, the organization
soon included dentists. and nurses, and then interested members
of the lay public, the abused taxpayers. Its guiding spirit is
Dr. Harry Wilson, secretary of the Los Angeles County Medical
Association, who frankly labels the County Health Department a
"colossal piece of state medicine." The organization has become
state-wide. It publishes a magazine called the Guardian which
blazons on its cover the several purposes of the organization.
protect public health by preservation of modern scientific medicine,
dentistry, and nursing, and to strive by legitimate publicity
to oppose all objectionable forms of socialized medicine.
protect the private physician, dentist, nurse and hospital from
unfair competition by those that are tax-supported or charitysupported.
many quarters the opinion is expressed that this uprising of the
medical profession was a result not only of the depression, but
of the reaction to the report of the Committee on the Costs of
Medical Care, with its advocacy of health insurance and group
clinics. A private group clinic in Los Angeles, the Ross-Loos
Clinic, comes in for scarcely less vituperative abuse than the
County Health Department.
At Santa Monica as elsewhere the health centers of the
County Health Department brought the poor the costly facilities
needed for scientific diagnosis and care
IN July 1932 the doctors were
successful in having the work of the curative clinics taken from
the Health Department and placed under the outpatient department
of the County Hospital, a part of the department of Public Charities.
Dr. Pomeroy's clinic directors, men with long and wide experience,
were replaced by internes from the County Hospital. The public-health
social workers were also replaced by those from the County Hospital.
As Arthur J. Will, deputy superintendent of charities, said, "Pomeroy's
social workers were trained under public-health standards; we
had to replace them with workers whose experience had been gained
under the Pauper Act; and you know, yourself, that there is a
in the summer of 1932, when savings had been exhausted, when the
relief budgets of the County Welfare Department had been cut almost
to the vanishing-point, and there was every reasonable expectation
that the number of people in need of free medical care would be
greatly increasedăthe order went out to cut down the admissions
to the clinic. The numbers were reduced. Some of those who were
eliminated came under the provisions of the Pauper Act which makes
eligible for poor relief only those who have been residents of
the state for three years and of the county for one. No one knows
what became of them.
step brought no relief for the doctors. No patients came back
a year later, a group of doctors from the San Fernando District
where the first health center had been established so proudly
seven years before, went to the county supervisors with a threat
and a "plan." The doctors had struck. They would not, could not,
continue to work for nothing. They would rather play ball or golf.
Their "plan" was to close up the clinic with all of its equipment,
modern to the last degree, and treat the patients in their offices
at a cost of fifty cents a visit with an additional charge for
bandages, x-ray, laboratory work, and so on, these last to be
provided at cost. Only those doctors were to participate who previously
had been giving their services to the clinics.
Some provision had to be made
for the care of the sick poor in the San Fernando Valley. The
supervisors agreed to the plan. It was adopted August 1, 1933,
for a ninety-day trial. At the end of the ninety-day period, the
supervisors ordered it to be put into effect in all the other
health centers of the county. Alhambra alone stood out against
the decree. Every other curative clinic and emergency hospital
under the County Department of Health was closed. Equipment worth
hundreds of thousands of dollars was left to rust and dust in
the closed-up rooms of the health centers.