HOSPITALS AND MEDICOS

NZ Truth, 15 March 1924, Page 7

HOSPITALS AND MEDICOS

B.M.A. CONf-RENCE PATIENTS WHO CAN PAY BUT DON'T . $ Big Bugs m Drug and Knife Business Hold PowWow m Auckland (From "Truth's" Auckland Rep.) Hospital reorganisation on the lines of enforcing payment by those who can pay is an old story, but the case is not hopeless. The Medical Conference In Auckland sounded a forward note m this and other directions, though it narrowly esoaped a breeze over politics.

No less than 250 disciples of the surgeon's knife and the physician's philtre foregathered at Auckland last week for the annual conference of the New Zealand branch of the British Medical Association. And not only were the local medicos there, but many big bugs m the profession from England, America and Australia, who had come over the seas to tell their brethren here of the latest things done m splitting and removing interiors, and m the administration of horrid compounds for the betterment of the health of the race and the preservation of human life. Among the distinguished visitors was Dr. Mayo, of the famous Mayo Clinio, Rochester, New Jersey, U.S.A., who talks with a humorous Yankee drawl and is a plain, ordinary-looking, quiet, unobtrusive lhan, ■ despite the fact that he has had conferred upon him the degrees of half the Universities df the world, and has probably removed more appendixes, kidneys, , granulations and growths than any surgeon all Ye. Dr. Mayo was a distinctly popular figure, owing to his particular lack of "dog," or professional "swank," and to see him pointing with an unerring finger to blackboard illustrations of diseased and degenerated organs which had come under the. scope of the skilled carvers of his craft waa a source of infinite joy to members of the conference, who apparently enjoyed the proceedings with far greater relish than does the schoolboy the circus. The more horrible (to the lay mind) the drawings and diagrams of dlsembowelments, the more did the medicos delight m them, "Truth's" representative quailed with trepidation, m literal terror lest he.be "spotted" as an intruding layman and laid upon the altar of knowledge for eager operators to provide a living illustration of how to cut, or how not to cut, However, he escaped with HIS INTERIOR, QUITE WHOLE, though troubled with grave palpitations, after witnessing some "beautiful" lantern slides of cancerous kidneys—at the conclusion of which it was stated that the mortality rate for this highly successful operation was not more than about 94 per cent., or, at least, that no more than some six per cent, of the patients finally recovered. But, fascinated, as It were, with the slides of slaughter, "Truth" returned on sevoral more occasions, and Indeed became quite absorbed m some of the discussions — just as the small boy becpmes a gluttonous witness of gory doings iwhen he is lucky enough to get a sneak visit to the abbatoirs. There are some queer anomalies about the medical man. The doctors tell you that you must not on any account, smoke cigarettes. "Truth" wondered whether they want for themselves all the cigarettes manufactured, for there were fully ninety per cent, of the delegates to the conference inhaling smoke from these "tubes of death," with great gusto, all through the sittings; and there were quite a number who "took a walk around the corner" m between sessions to see the famous man about the historical dog. Yea, despite their predilection for opening interiors, they are very human, are most of these medicos, and they thoroughly enjoyed their stay In the Queen City. Of particular interest was the discussion on the management of hospitals, which was initiated by Dr. Franklin Martin, a man who holds much sway m the surgery of the United States. Dr. \Martin told how the hospitals of the Land . of Liberty were pretty hot stuff m the matter of inefficiency until the American College of Surgeons was formed and formulated rules for their proper conduct, and for THE CONTROL OF "CROOKS" ln the profession who bought and sold patients for the enrichment of their pockets. The old "gag" was for a country doctor to tell a patient that he needed an operation, and send him to an unscrupulous licensed butcher, who would quite unnecessarily remove a portion of the patient's anatomy, charge him a. heavy f ee — and whack the 111-gotten prooeeds with the precious physician who sent him along. At one time, lt appears, a man could perform any kind of operation and "get away with it." Not so now, said Dr. Martin. In a few years' time, despite the fiercest opposition, the majority of the hospitals had been placed on the register of the standardised hospitals; that Is, institutions which agree to comply with the standards of efficiency demanded by the College of Surgeons and which were allowed to have on their honorary staffs only medical men of proved worth and the highest ethical standard. In all these hospitals, fee- splitting was rigorously disallowed and on any pretext whatever, and so most of the unnecessary operations which had disgraced America m the past had been done away with — or left to these comparatively few practitioners m the medical underworld who lived on those of the public who were fools enough to go to them. In the standardised hospitals, conference was assured, there could be no concealment. Every doctor's work was recorded ln detail, and the results were charted for the Inspection of all the staff, who , held meetings at least once a- month to analyse and criticise what was being or had been done. With all humility, and not wishing to force any doctrine or Bystem down the throats of tho New Zealand profession, the big medicine men from America recommended that some system of the sort should be adopted here, although It was graciously taken for granted that there were no professional crooks ln this country of the kind that had formerly PREYED ON THE PUBLIC of America. (But with ell duo respect to this opinion of our distinguished medical visitors. It may lie mentioned, In passing, that New Zealand ls not altogether clean of black sheep m the profession, and that the B.M.A. knows it and ls seeking to shear these gentlemen who arc shearing the public by performing unnecessary operations for tho sake of thc golden fleece. That, however, by tho way.) The Americans wero assured by Dr. (Professor) Barnett. of Dunedin, ono of our best surgeons (who gave a striking demonstration of how to remove kidneys through tho abdominal route Instead of the more orthodox lumbar route, nnd so earned the high praise of Dr. Mayo himself), that he had drawn up a scheme for the better administration of hospitals and the control of surgery, but that the B.M.A. had turned lt down. However, tho B.M.A. did not reject the scheme by any overwhelming majority — In fact there was a very strong minority — and no doubt Professor Darnctt will yet overcome the conservatism or nervousness of thc opposing members, and gain his point, which will bo all to the good of tho profession and thc public m this country. And If he doesn't (he pays bo himself), the "movement will have to be organised outside the

8.M.A., for organised and carried out it must be. Loud applause greeted the statement that m America the public hospital was not alone for the poor, and for the least deserving of the community — for the "rum bar bum" and his ilk. as Dr. Mayo put it. In America they do things differently. They da not maintain highly equipped hospitals, attended by the best medical skill, for the non -paying patient alone, and compel the man of the middle class — the tax-payer — to enter the inferior private hospitals. The well-to-do man and the man of means can "enter, and can pay — and can pay the proper fee to the attendant surgeon or physician, Just as he would be. required to do il In a private nursing home. If he can pay, well HE HAS GOT TO PAT. On the other hand, the poor are not expected to pay, but they get exactly the same attention, accommodation and treatment as the patients who do— and this is seen to by the provision that a hospitals record shall be judged by its total results — paying and nbnpaylng patients being considered together m the records of what is accomplished. Yes, verily the local medicos were pleased, for there ls a feeling that there are far too many people (who can afford to pay fees to the men who strive to cure them of their complaints) who enter the publio hospitals for the express purpose of getting the best possible attention, from the best men available, without having to pay anything but a nominal hospital fee for that attention. It was urged that the doctors should demand their rights m this respect and be allowed to charge those patients they attend m publio hospitals when those patients are well able to afford to pay. This suggestion nearly evoked cheers and speakers who referred to the patients who thus dodged doctor's fees as "spongers" and "contemptible" were vociferously (and commendably) applauded. There was a little rift m the lute — a small- storm, of disruption, a tiny fly m the ointment — at the conclusion of the addresses of the medical men, but the mists finally cleared away, and all were happy thereafter. It arose thusly: Some of the speakers had referred to * POLITICAL CONTROL of hospital boards and governors, and there were hints at "party pulling," etc., whilst Professor Barnett told his great assemblage of colleagues that they would never get justice whilst politics ruled the roost, and that they would have to take matters m their own hands. This palpably raised the ire of Warrior W. W. Wallace, chairman of the Auckland Hospital Board, who had been invited to hop along and hear the views of the great Americans on the hospital question. Warrior Wallace Indignantly denied that \ there was any political control Of his board, or that lt was under the domination of any party. He told the doctors plainly that his board ran its own roost without reference to any of the highbrows, and was responsible to no other power than that of the 202,000 electors who put the members of the board ln their nice, comfortable chairs. That was the only power that dominated them! Their ambition was to make the Auckland Institution the best hospital m New Zealand, and that was the only axe they had to grind. The board had no friction of any kind with its honorary staff — and the only time when there was trouble was when one of the staff was on the board. (Wallop!) Having thrown this bomb, Warrior Wallace very courteously thanked the B.M.A. for Inviting him along, and he assured delegates that nil that had been said with regard to hospital management would be fully considered by his board. And so the skies oleared, and the meeting ended amicably, the doctors and the boardsmen promising to 00-op and co-ord to the very last ditch ln the Interests of / the bleßsed public. 'Twa.B a great gathering, this- conference of the 8.M.A., and "Truth," by unlucky lack of space, has only been able to touch on the fringe of the week's work. The doctors do their best for us. Sometimes thoy (accidentally) kill us, but often they save our useless lives. So here's a health to 'em! and may their deliberations bear valuable fruit.