Health and Private Doctors
by Daisy Lee Worthington Worcester
Co-Author, Volume 15 of the Federal Investigation of Women and
I tried to get an expression of opinion from
some of those who are above the battle, but with little success.
Mary Stanton, secretary of the health division of the Council
of Social Agencies, was the only social worker among the large
number with whom I talked who really knew what had taken place.
She feared that the plan would result disastrously for the community.
"When the depression is over, the doctors won't look at these
patients for fifty cents a visit. Then what? Our health-center
service has been destroyed. We shall have to build all over
Dr. Emory R. Bogardus, head
of the sociology department of the University of Southern California,
said, "Although there may be some saving to the county now,
I believe that in the long run the San Fernando Plan will prove
more expensive. Cases of illness that are now neglected will
have: to be cared for ultimately by the county. I am glad to
comment favorably upon the excellent health program that has
been put into operation by Dr. J. L. Pomeroy and to say that
it would be a calamity to have this progressive plan cut off."
Dr. George B. Mangold of the
same school, chairman of the Social Legislation Committee of
the Council of Social Agencies, said: "I object to the whole
San Fernando Plan on principle. I object to spending the taxpayers'
money in the interest-of a group of doctors rather than in the
interest of the general public."
In Alhambra, the local conflict
had acquainted the public with the situation and had roused
strong feeling. Mrs. Rose Wallace, chairman of the board of
trustees of the Institution for Women, the new women's prison,
said: "I believe that the doctors should be paid for their work;
but I believe also that our health center must be preserved
for all of its original purposes."
Mrs. C. B. Hannah, also of
the same community, a leader in women's clubs in Alhambra, said
with feeling: "All that one has to do is to listen a few minutes
to the type of men who are opposing Dr. Pomeroy; their selfish
interests are apparent in every word that they speak. Our health
center is going to remain open."
Grand Jury opinion, which is
conservative if not reactionary when social work is concerned,
evidently favors the new plan. The chairman of the Health and
Sanitation Committee of that body expresses herself as follows:
These past few years, previous
to 1929, were not normal years. Every department of government
spread itself to encompass a supposed ideal, but with the
coming of diminished income and a period of time as subnormal
as the previous was abnormal, the ideal of the former time
only became a top-heavy, awkward machine, a drag on the whole
community whose private burdens are of a crushing weight at
She says further:
Our county institutions
of all kinds are of so fine a quality that our hard-pressed
taxpayer feels as if a premium were being offered by himself
to those whose education did not seem to include that fine
fact that the ability to care for one's self is one of the
great privileges of life.
And then finally:
MANY of us talk of public health as vaguely
as does this member of the Los Angeles County Grand Jury, as
if it were something unrelated to individual human lives. The
"dangerous source of contamination," ultimately the only source,
is a human being who is ill, in whose body there develop the
germs of disease. Dr. Pomeroy maintains that no definite line
can be drawn between curative and preventive medicine. A situation
was discovered a few weeks ago in one of the health-center districts
which makes this point clear.
Twenty-three cases of smallpox had suddenly
come to the attention of the health officer. If these people
had come to the health-center clinic when they felt the first
symptoms of illness, instead of being sent as they were to private
physicians' offices, where some of the cases were diagnosed
as acidosis and high blood-pressure, there would have been no
faulty diagnosis; for public-health nurses and doctors are trained
in the symptoms of contagious diseases as few private physicians
are. It took all the skill of that health-center doctor to avert
a serious epidemic in that community.
A young social-worker diagnostician
may send a case of incipient tuberculosis to some general practitioner
who will fail in diagnosis until it is too late for a cure.
Then the patient will be sent to the tuberculosis sanitarium
to be cared for until the end comes, at heavy expense to the
county. Those routine smears and examinations to which Dr. Berman
referred are the means by which dangerous disease was discovered
in its incipiency in the scientifically conducted health centers.
The usual private physician is not trained to make them even
for his remunerative patients. Is there much chance that he
will do so when he is paid fifty cents a visit? What
will be the cost of this San Fernando Plan if the depression
is slow to lift? How long will it be before doctors other than
those who served the health centers also will demand pay from
Already men in Pasadena and Long Beach are
asking for their share, although there has never been a health
center in either of these communities. Suppose that prosperity
does return shortly. How many doctors who now clamor for the
fifty-cent fees will be willing to keep county patients when
they can collect SIX times as much from private patients? The
San Fernando Plan can be only an emergency measure. It has disrupted
an orderly, scigntific piece of work which was years in the