Progress Report

Although the American Medical Association was a progressive, reform-minded organization in the first third of the 20th century, it has since suffered a severe case of intellectual atherosclerosis. Last week, as some 12,000 of its members pounded the Atlantic City boardwalk between sessions of its annual convention, the A.M.A.'s 242-member house of delegates voted to catch up with the present in several areas, and also cast a constructive eye toward the future.

By acclamation, the delegates chose Dr. Dwight Locke Wilbur, 63, a San Francisco gastroenterologist, as the organization's president-elect to take office next June. He is one of two doctor sons of the late Dr. Ray Lyman Wilbur, longtime president of Stanford University, Herbert Hoover's Secretary of the Interior, and A.M.A. president in 1923-24. Wilbur will be the first president in the A.M.A.'s 120-year history whose father also served in the office.

"Slightly Left." Unlike most A.M.A. officers, who traditionally reach their posts by persistent politicking from the county level on up, Dr. Wilbur is well known for his contributions to medical practice. Long associated with the Mayo Clinic and Stanford's School of Medicine, he is rated one of the top internists in Northern California, has been president of the American Gastroenterological Association and of the American College of Physicians. He has also exerted a notably moderating influence on doctors' attitudes in his state as editor of California Medicine since 1946. A lifetime Republican, like his father and physician son,* he is described by those who know him best as "slightly left of center" in medical-policy matters. Largely because of Dr. Wilbur's counsels in the board of trustees, the A.M.A. has eased its opposition to Medicare and refrained from a boycott.

Ironically, the man whom Wilbur will replace next year, and who was installed as the A.M.A.'s president last week, is one of the association's most conservative members. Dr. Milford O. Rouse, 64, a Dallas gastroenterologist, is personal physician to Oilman H. L. Hunt, a former director of Hunt's far-right Life Line Foundation, and a member of the Association of American Physicians and Surgeons, an ultra-conservative political-action group. Unremittingly hostile to Government involvement in health care, Dr. Rouse still refuses to treat patients who insist on being billed through a Medicare agency. Attacking Government programs that he considers to be threats to private practice, he declared in his inaugural address: "We must increase the effectiveness of our opposition."

Alarming Shortage. Despite Dr. Rouse's attitude, the A.M.A. last week reversed a number of positions it had long held. In 1933, the association urged medical schools to curtail enrollments for fear that they would produce too many doctors. Subsequently, as warnings multiplied of an impending crisis in the supply of doctors, the A.M.A. kept insisting that there was no cause for concern. Last week, the board of trustees did an about-face. In a report using words that it had once rejected vehemently, it declared that the shortage of doctors is reaching "alarming proportions," and called for "an immediate and unprecedented increase." It urged medical schools whose enrollments have remained static to figure out ways of admitting more students "in the light of national demand," also called on the five schools of osteopathy that are still independent to convert into regular medical schools.

Now that a number of states are liberalizing their laws to permit more therapeutic abortions, the A.M.A. also conceded that its 1871 rule against abortion, except "with a view to the safety of the child," was "antiquated." "Change and reform in this area are inevitable," said the policy statement. It condoned abortions on essentially the same grounds as those recommended by the American Law Institute, already voted into law in Colorado, North Carolina and California. Among the differences: the A.M.A. would require "documented medical evidence" of the need for an abortion, and rape or incest would have to be "legally established."

* And like his physician nephew Richard, who advises Governor Ronald Reagan on medical affairs.

This file is automatically generated by a robot program, so reader's discretion is required.