MEDICAL CONGRESS

Manawatu Standard, Volume XLVII, Issue 57, 4 February 1927, Page 2

MEDICAL CONGRESS

ADDRESS BY PRESIDENT. COMMUNITY SERVICE. PREVENTIBLE MALADIES. DUNEDIN, Feb. 3. Speaking at the inaugural session of the Australian and. New Zealand Medical Congress to-night, Dr. L. E. Barnett (president), after welcoming the delegates and outlining the constitution and aims of the congress, said community service in the domain of the incidence of disease had been rightly placed in the forefront of the recommendations of the General Medical Council and the B.M.A. At this and every B.M.A. conference public health questions would be given the greatest prominence. Thoy anticipated that their discussions on goitre and trydated cysts would result in a very decided lessening in the frequency of these troublesome and yet largely preventiblo maladies. CANCER RESEARCH. They would endeavour to stimulate and correlate cancer research in the various Australian and New Zealand centres. Although far more cases of cancer were cured now by operative and radiological means than in former years, chiefly because the patients were learning the wisdom of seeking treatment when the disease was in its early stage, yet owing to the increasing prevalence of this mysterious malady the total death rate from cancer kept mounting higher and higher. The cancer problem was still with them, but ever nearing solution as a result of extensive labour in a hundred fields. He took this opportunity of congratulating Sydney University on the generous response of the people of New South Wales to its appeal for a cancer campaign fund. With a sum of well over £IOO,OOO a splendid plan of research could bo instituted, and he only hoped that other scientific centres in Australia and New Zealand, including Dunedin, might have the same good fortune. Cancer was one only of many devastating diseases that called for intensive study. PUBLIC HEALTH. The Governments in every civilised country now regarded it as their bounden duty to encourage research that had for its object the betterment of the public health. The Royal Commission on Health for Australia, so ably presided over by Sir George Symo, had recently reported the conclusions of one of the most valuable investigations into public health matters that had ever been made, and one of the recommendations —and a very significant one —wns that a health research council should be established and provided with an endowment of £30,000 per annum. They would at their meetings give detailed attention to the important subjects of maternal and infantile mortality, of tuberculosis, and of certain tropical diseases of great public concern in Northern Australia and the Pacific Islands; to questions concerning diet in health and sickness, and to many other matters of special interest from the preventive medicine point of view. COLLEGE OF SURGEONS. He must refer also —and he did it in optimistic vein—to the proposed inauguration during the currency of this congress of the Australian and New Zealand College of Surgeons because lie believed that such a college was likely to have a valuable influence on the public welfare, and because he had for some years been trying to mould professional feeling in New Zealand towards something of this kind. The promoters would endeavour to combine the good points of the Royal College of Surgeons of the British Isles with those of the more recently founded American College. The aims were to raise the standard of surgical efficiency, surgical endeavour and surgical ethics in both hospital and private practice and to encourage the provision of facilities in hospitals whereby a sufficient number of suitable men could be specially trained to undertake the responsible duties of a surgeon. In Great Britain it was quite exceptional for anyone without special training experience to do major operations, but in the newer countries like America, Australia and New Zealand there was not the same restriction. In these countries major operative work was quite commonly undertaken by men who—though adequately equipped with what was popularly called “nerve”—were lacking in varying degree of that knowledge and experience which were requisite in deciding such questions as: (1) Was an operation really necessary? (2) When should the operation be performed ? (3) How were the unanticipated difficulties and complications to be handled? (4) How should the scope of the operation be limited or extended according to circumstances- He dill not insinuate that the only competent surgeons would be those who were fellows of a college for various reasons. A man who really was a good surgeon might not wish or might not be in a position to obtain a hallmark of this kind. The patient’s choice would be unfettered. If he selected an operator who was not a fellow of a college he might or might not get a properly trained man, but if he chose a fellow of a college lie could rest assured that he had the services of a fully qualified practitioner. The passing of a highgrade academic examination was desirable but was not essential to the performance of high-grade surgery.

HOSPITAL WORK. The main thing was good hospital work at first under supervision and later independently it was often alleged that doctors gave their gratuitous services to the sick poor in hospitals for purely selfish motives; that it paid them indirectly; that the experience and prestige they gained were splendid advertisements for a lucrative practice, and that consequently these honorary positions were eagerly competed for. There was a measure of truth in all this, but it was not the whole truth. Painstaking, skilful and kindly hospital work materially helped in the building up of the very best class of private practice, but the kind of advertisement a hospital gave was similar to that of a shop window exhibited, however, "not to the public generally, but to those only who knew the worth if the articles displayed. When a surgeon or a physician habitually showed work of a good quality within a hospital it was appraised accordingly by competent observers; that was to say, his colleagues, his students, and his nurses. If, on the other hand, his work was habitually faulty, then instead of a good advertisement lie got a bad one. A hospital appointment might place a man in consultant rank, but only if he was worthy of it. Tho public benefited enormously by this automatic method of grading medical practitioners through tlie medium of their hospital service. HOSPITAL STANDARDISATION. Modifications in their hospital systems were now receiving serious consideration, largely stimulated by the

investigations and reports of Dr MucEachern, the American expert on hospital standardisation. He hoped that many of his valuable suggestions would be adopted, and in particular ho would like to see their public hospitals made available to all classes, but with tho proviso that the sick poor should continue to have the gratuitous services of an honorary staff in accordance with tho honourable traditions of the profes sion, for in this as in all things they must iealously guard the great prestige of public esteem and public confidence that they owed to their predecessors. In conclusion, let him quote what had been said about them by the Hon. Neville Chamberlain, the Minister of Public Health, speaking at the London Hospital a few months ago: “No one could doubt the fundamental seriousness of mind of any practising surgeon or physician. I don’t mean that doctors have no sense of humour—God forbid! their worst enemies have not accused them of that—but inevitably there must be in them a serious vein. They must feel that their calling is something beyond a mere means of earning one’s livelihood; that they have a purpose in life which is neither selfish nor superficial and that they concern themselves not only with the care of the individual, but with the much wider task of trying to improve the general health of tlie people.” That was the, kind of criticism that was sweet to their ears. Lot them show that they of to-day were worthy of it.