Dunn, Hugh E.

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The Linacre QuarterlyVolume 34 | Number 2 Article 5May 1967Prodeedings: Conference on the Responsibility ofthe Physician in a Changing SocietyHugh E. DunnFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationDunn, Hugh E. (1967) "Prodeedings: Conference on the Responsibility of the Physician in a Changing Society," The Linacre Quarterly:Vol. 34 : No. 2 , Article 5.Available at: http://epublications.marquette.edu/lnq/vol34/iss2/5,. ·"" .• .. t- ~.: I . ! Conference on The Responsibility of the Physician in. a Changing Society VERY REVEREND HuGH E. DuNN, S.J. President John Carroll University Cleveland, Ohio Perhaps the readers of the LINACRE QuARTERLY wonder why a libe al arts university was involved in a professional conference, such as < ur medical seminar on "The Responsibility of the Physician in a Chang 1g Society," the proceedings of which are being published in this issue. Tb re are, we believe, good reasons~ First, though John Carroll has students enrolled from many states it serves intensively the industrial area of northeastern Ohio. As a cor -;e-quence, it must and does have a deep interest in the problems which e. ist in that great community. We at John Carroll cannot isolate ourselves, - e must take a part in the civic life of the area which we serve. We m1 .st, where we can, help to throw light on the area's problems and hopeh lly help to solve them. Because we wen~ convinced that medical problems are important to all of our neighbors in this total area, we felt it wo 1ld be helpful if John Carroll were to organize and promote such a meeti 1g. Second, though John Carroll is a liberal .arts university, it has a ' ·ell integrated ~and thorough curriculum in the field of science. In physics, for instance, the number of our students, both on the under and post gradt ate levels, ranks us high on a national comparison. Our chemistry facili ties are excellent. The $4 million Science Building which we have begun to build and which will be ready for some classes in the fall, will va.' tly increase the scope of our science program. Finally, a large number of young men who look forward to joiuing the medical profession take their pre-medQoal education at John Carroll. Among our graduates are more . than 300 physicians. Of this very sub-stantial number, ISO practice in the Greater CleveLand area. We, there£ re, feel that we have a close relationship -to the medical profession. We also feel that we have the pleasant obligation of being helpful to doctors individually and collectively, in any way we oan. It is a great source of encouragement that an important professional journal, the LINACRE QuARTERLY, feels our conference to be relevan t to its readership. We sincerely appreciate the LINACRE making available "The Responsibility of the Physidan in a Changing Society" to a national audience. 106 LIN ACRE QuARTERLY SCOPE JoHN F. SHEEHAN, M.D. Dr. Sheehan, Moderator of this Confer-enc~, is. vice-pr~sident of the new Loyola Umverstty Medtcal Center at Hines Illi-nois. Dr. Sheehan has been a Loyola faculty member for 27 years and chair-man of the pathology department from 1940 to 1962. He had been dean of the ~edical 50ool since 1950, and in addition, Is respo~st ble for the teaching, research, and pattent care activities in the Univer-sity's new medical center. The topic of this conference is !he responsibility of the physician m a changing society. It is to be taken UJ? from three standpoints, or pers pect1 ves: I. From the standpoint of the community 2. From the standpoint of the government (public health agencies) . 3. From the s,tandpoint of the physician . I _thought I might start by men-tionmg some of the factors that have caused change in society and as a correlative, similar factors which ha~e changed medicine and, in so domg, have had an effect on society rnd posed problems for it. I have Isted four: (I) the rise of science and technology, (2) the rise in the ~o~omic level, at least here in the nited States, (3) emphasis on group action and interaction and (4) the role of government. ' With regard to science and tech-nology, I think one of the most marked effects has been the change from an era of therapeutic nihilism to one of profound activity in the area of drugs. This immediately MAY, 1967 brings to mind discoveries such as sul~a drugs, and later penicillin, which have brought an increase in longevity and the disappearance of many of the acute diseases with which we were afflicted, leaving us now with an aging population and a heavy preponderance of chronic disease. These in turn have pre-sen ted problems on an economic level to the various agencies in the health fields. Another effect of science due to the tremendous growth of new knowledge, is the fragmentation of ~edicine and the rise of specializa-tiOn. Because of the expensive tech-niques that came from the attendant technology, emphasis has · been placed on the hospital as the focus of health care as against the doctor's office and periodic visits to patient's homes. Technology has given rise to a large variety of paramedical personnel and various other health professions besides medicine. It has led to an increase in the number of physicians functioning full-time in institutions with a concomitant de~rease in !he number going into pnvate practice. Because of the great rise in the economic level, money has become available to the population in gen-eral, for services as against satisfac-tion of basic needs. Because of the ease of communication and its effi-ciency, individuals know what health care facilities are available as well as their adequacy. Becaus~ people can pay for services, there is an increased demand. Furthermore we have reached a point wher~ people think they not only have a right to life, liberty and the pursuit 107 > • . ..... .·' ,• ... , ·. : '~,· ' . ... . ,· ' · , .. ,• . ,. : '·.·.: ··:: : . .. ;•::· I , ' .. , .. •·. .. '' t ', . ' ' . .. ... · ·' '· ', · .' ~ ·, •.t. o ',t I of happiness, but also a basic right to health. The cost of providing the type ot care the American p~ople feel ·they are entitled to, has stimu-lated various groups, public and private, to attempt to relieve the individual of the burden of complete payment for health care. The first of these "third-party payers" was the private pre-payment plan. Later the government became a third party. These are some of the factors that have to be reckoned with as we consider the role of the physician in a changing society. -medical schools to provide a suffici t ~1t number of physicians to prov le adequate care. The increa~e in : 1e number of aged has also mcrea. ~d the burden on physicians beca, se this age group requires and demar Is In addition to the increased effi-ciency of medicine, the enhancement _ of public health, and the rise in the economic level, another factor has led to a greater demand for physi-cians' services- the marked increase in the population which many believe will outstrip the capacity of 108 more care. There are also other factors t' at have disturbed the traditional n a-tionship of the physician to 1is patients: the mobility of the po: u-la tion and access to groups < 1d centers because of ease of tra el. (Individuals no longer need to c n-sult a physician in their immedi tte neighborhood. They can go tc a center or a clinic group.) Urban. ~a­tion has contributed. Finally, tr ~re is little doubt that we are ir a period in which individuals, ~t sc ~e sacrifice in personal relatwm 11p with physicians, are incli~ed to approach institutio~~, predo~nna1 tly hospitals, for defin1t1ve medtcal c .re. LINACRE QuARTERLY REGARDING THE COMMUNITY Eow ARD H. nECoNINGH Mr. deConingh is partner and chief engi-neer of Mueller Electric Company in Cleveland. He has long been active in Cleveland health and welfare activities, is president of the Cleveland Community · Chest, and chairman ex-officio of its executive committee. He is a former United Appeal chairman and a past presi-dent of the Welfare Federation of Cleve-land. He is currently a member of several of the Federation's committees, and is a board member of many welfare and edu-cational institutions. I have been asked to present a community evaluation of how well the health needs of the community are being met and what future pros-pects seem to be. I don't have any standing, no one elected me for this, I don't represent any organizations. I suggest that if what I S?Y meets with your approval, you say that I studied my background material well. If you disagree with me, you can say I just plain don't know the score. If you look at the Cleveland health system, you can view it in several ways. First, the type of serv-ice it has - prevention, diagnosis, treatment, rehabilitation, long term or terminal care. Then, there is the locale of the service: is it in-patient, out-patient service, or service at home. Then who is the provider of the service? This is professional per-~nnel in the institutions or organ-IZation through which you work -physicians, dentists, nurses, hospitals, n?rsing homes, health agencies. Fmally, I think we should think of the financier of the service -the individual himself or a third-MAY, 1967 party payment through govern-ment, philanthropy, or insurance organizations. I think it fair to say that health is a joint responsibility which is shared by the individual and the community. The individual carries the responsibility for himself and his family to develop habits, atti-tudes to undertake practices con-ducive to good health, and I think it is his responsibility to arrange to use the available health and medi-cal services in so far as his abilities permit. On the other hand, the community carries the responsibility for making programs and services available for him. Thus, the . com-munity has a responsibility (I) to develop and maintain a system for diagnosis and treatment of the acutely ill, the chronically ill, the disabled, (2) to maintain and pro-mote good sanitary environment to live in, to protect against communi-cable diseases, and the other health and safety hazards of that kind, (3) to inform the . public about health and the resources that we have for health in the community, and ( 4) to plan and to develop efficient and coordinated systems which will ensure that all these resources are available to the people, and even more important, are properly utilized by the people for whom they have been made available. And that sometimes is the most difficult part of the story. I think our community has assumed its responsibilities well and if we look at the provider of services, we see 2400 physicians, 1270 den-tists, 7000 registered nurses plus what are called the ancillary group: 109 . 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Prodeedings: Conference on the Responsibility of the Physician in a Changing Society

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Prodeedings: Conference on the Responsibility of the Physician in a Changing Society

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