Social Physicians

Doctors, like some other types of scientists, suspect that they might be able to clean up some of the mess that politicians have made. More than a score of the world's most famous physicians met in Manhattan last week to consider the idea. The occasion was a centennial meeting of the New York Academy of Medicine. Their topic: "Social Medicine."

What is "social medicine?" Some doctors thought it sounded like socialized medicine--which it is not. Social medicine, as its eminent sponsors were more than willing to explain, is an ambitious project to improve man's health by attacking the environmental causes of disease.

One of the champions of the idea was on hand--Britain's Dr. John A. Ryle, first professor of social medicine at Oxford.

"Thirty years of my life," he said, "I have watched disease in the ward being studied more and more thoroughly--if not always more thoughtfully--through the higher power of the microscope." Dr. Ryle thought it was high time to switch to a telescope, to consider man "as a person and a member of a family and of much larger social groups, with his health and sickness intimately bound up with the conditions of his life and work."

Professor Ryle suggested that doctors should look for answers to some unexplored questions: What makes healthy people healthy? Why has the prevalence of intestinal ulcers, once rare, risen so enormously in the 20th Century? Why did the stillbirth rate in Wales, and tuberculosis in Britain, drop sharply during the war? Why do workingmen die of stomach and skin cancer twice as often as professional men? Why do doctors have twelve times as high a death rate from angina pectoris as farm workers?

Added Dr. Dean A. Clark, medical director of New York City's Health Insurance Plan: "How many [doctors] remember that a wife's relation to her husband, or to her dreary isolation in household tasks, a man's reaction to his job or his wages or his living quarters, a child's to his parents or his school, may be the clue to a major illness?"

But it was Britain's famed Lord Horder, consulting physician to St. Bartholomew's Hospital, who offered the most ambitious description of a doctor's mission. Medicine, said he, must write the prescription for a healthy state,* and "guide the politicians. ... It is the doctor's duty to protect the worker against excess fatigue, against dullness and against the various hazards of his job. . . . The doctor's work in the future will be more and more educational and less and less curative. . . . He will spend his time keeping the fit fit rather than trying to make the unfit fit." Famed Dr. Henry E. Sigerist of Johns Hopkins (TIME, March 10) added a hearty (but possibly overhopeful) Amen: "The doctor is now becoming the adviser to the statesman."

* But Lord Horder, a firm opponent of socialized medicine, attacked Britain's new National Health Service Act: "We had hoped that it would be through . . . evolution, rather than through the method of revolution that is now being adopted, that Government would help us to [improve medical care]."

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