Doctor Shortage

What effect is the war having on the number and distribution of civilian physicians? G. St. John Perrott and Burnet M. Davis, who asked that question in last fortnight's Public Health Reports, also came up with some startling answers:

>> Early in 1944 there will not be enough U.S. doctors to meet both the armed services' requirement of one doctor for every 155 men and the wartime civilian minimum of one to 1,500. From then on the civilian situation will get worse.

>> By Jan. 1, 28 states, with a combined population of 54,500,000, are expected to have more than 1,500 persons per physician ... and seven of these will have more than 2,000.

>> Because of the tendency of doctors to gravitate to states whose citizens can pay well for medical care, the doctor shortage will increase fastest in the "medically poor" states (e.g., Alabama, with 2% of U.S. population, gets only one-third of 1% of available medical graduates).

>> Within individual states, medically poor rural areas lose doctors faster than the cities do.

To find out how U.S. doctors and civilians are taking it, TIME queried correspondents in medium-sized towns from coast to coast, got replies as varied as a patchwork quilt:

Rutland, Vt., pop. 17,082. Rutland's 24 doctors are merely busy; the town's greatest need is for nurses for the local hospital. But the doctor shortage is acute in Vermont's rural areas, has had some tragic results--e.g., a young boy in one rural town recently died of acute appendicitis for lack of a doctor to diagnose his case. When Dr. Harry Leslie Frost of Pittsford died, he left thousands of patients in the town and surrounding mountains without medical care. The young physician in nearby Proctor, who is trying to cope with Dr. Frost's practice as well as his own, now has between 6,000 and 7,000 people on his list. TIME'S correspondent explained that no doctors have come out of retirement to help the situation "because in Vermont most doctors don't retire until they die."

Charlotte, N. C., pop. 100,899. Charlotte gave 14 physicians to its evacuation hospital which made history in North Africa (TIME, Aug. 9); 17 others are also in the services. But like most U.S. cities its size, it was medically rich in the first place. Charlotte still has one doctor for every 1,040 citizens.

Emporia, Kans., pop. (in 1940) 13,188, (in 1943) 12,183. Emporia has no doctor shortage, because it has lost only five doctors to the services. The remaining 20 (two on the verge of retirement) are busier than usual because of the lack of doctors in outlying towns. As in Rutland, a shortage of nurses is developing--43 of the town's 49 student nurses are in the Government-subsidized Cadet Nurse Corps. TIME'S correspondent says that Kansas generally still has enough doctors. Even Wichita, which has boomed from 114,966 to 184,115, can make out--it still has 270 doctors after giving 30 to the services. A few tart Kansas comments came from famed Horse-&-Buggy Doctor Arthur Emanuel Hertzler of Halstead: "The worst part of this doctor shortage from our point of view is that people will find out how well they can get along if left alone. . . . There is hospital space for adequate care if you keep out patients who like to be milked and those who need care because their insurance entitles them to it."

San Jose, Calif., pop. (in 1940) 68,000, (in 1943) 79,000. San Jose feels the pinch because its doctors in private practice have decreased from 112 to 69, despite acquisition of two refugee physicians (licensing requirements still keep them out of many states), one woman doctor from the East and one retired doctor who resumed practice. These doctors not only take care of the town but also tend many patients from outlying areas. There is only one obstetrician left and he sometimes delivers ten babies a day. Surgeon Robert Stanley Kneeshaw now receives 50 office patients a day (he used to have 30), has not played golf since January 1941. The doctors are training patients with minor ailments to use the telephone, patients with serious ailments to come in by taxi and wheel chair.

Some people still do not realize how busy the doctors are. One woman asked Dr. Kneeshaw to come and see her at 4 o'clock. He asked why 4 o'clock as his office would be full of patients at that hour. The woman replied that she had a hairdressing appointment at 4:30.

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