Criticism & Censure

One of the most potent forms of hidden government in the U.S. is the county medical society. Since the average patient does not know that it exists, he cannot know who its officers are. Yet the societies' officers may wield powers of life and death over him by deciding whether his personal physician or surgeon can admit patients to the best local hospitals and treat them there. Last week one of the nation's biggest and toughest county medical societies drew an unflattering spotlight on itself and the system in general.

The stage was Houston, where the Harris County Medical Society was founded in 1903, when many such groups were burgeoning in a praiseworthy effort to distinguish legitimate doctors of medicine from quacks and graduates of diploma mills. The society has grown numerically from 65 to 1,450, thanks mainly to the gusher spurt of Houston (pop. 925,000). With a medical school, plus postgraduate facilities, the city teems with professors and researchers. But the county society is run by officers less renowned for achievements in scientific research than for politicking.

"Mess of Politics." Biggest fight in the society's history has been over relocation and staffing of Jefferson Davis Hospital for indigent patients. The society wanted to keep it downtown, with staff membership open to all practicing physicians. City-county authorities and the medical schools wanted to move it four miles to a new medical center, staff it mainly with research-minded faculty members.

Into the fight stepped Dr. Abel J. Leader, 48, a urological surgeon and professor in Baylor University's College of Medicine, often acclaimed as an able leader by grateful graduates. Dr. Leader, though a member himself, needled the society where it hurt by asserting that many members would not be able to meet the higher standards for staff membership which would be required in the new medical-center setup. "The wounded pride of those physicians in the medical society who have been weighed in the scales and found wanting is basically the cause of the animosity toward the medical school and its objectives," he said. Dr. Leader used other strong words. In "a degrading mess of power politics," he accused the society of "a disservice to the profession of medicine and to the citizens." Finally, "the physician who would knowingly do injury to a medical school--and there can be no doubt as to what is intended--differs little in my opinion from the man who beats his parents."

Intemperate Language? A countywide referendum settled the town v, gown hassle in favor of the gown (TIME, Aug. 4, 1958). But with elephantine memory, the society spent more than a year deciding how to get at Dr. Leader under the bylaws. Then it charged him with "unethical conduct by use of intemperate language . . . [which] contained general criticism designed to lower the medical profession." In December the executive board set itself up as judge and jury (one of its members tripled as a hostile witness), found Dr. Leader guilty in court-martial style.

Key question remaining was whether the jurymen-judges would expel Dr. Leader, thus depriving him of the right to use his admitted skills in treating patients in Houston's major hospitals. They stopped short of that, contented themselves with censuring him.

Dr. Leader appealed to the Texas Medical Association, composed of delegates from county societies. The state group held a more judicial hearing, solely on the issue of whether Dr. Leader's basic right of free speech could be curtailed in the name of loyalty to the county society. Dr. Leader argued that on a public issue, his duties as a citizen took precedence over his obligations as a physician. But last week the T.M.A. upheld the censorious Harris County Medical Society.

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