The same 1932 report that considered the doctor shortage idea unfounded, emphasized the importance of poor distribution. Only 48 percent of the physicians settled in towns with less than 100,000 people were over 70 percent of the population resided. Yet speaking even in 1932, the report suggested that communications had been so improved in rural areas to permit country doctors to cover much greater territories.
Inducement of physicians to rural areas, the medical groups think, cannot be forced. The AMA spokesman at the July hearings stated that "one of our large philanthropic foundations has experimented with such a program (indenture) and found it to be unsatisfactory."
The doctors organizations both feel that indenture represents too much regimentation plus the fact that an important career in medical research or teaching might be interrupted.
In the hearings, numerous alternatives to federal scholarships were proposed. Some of the medical educators felt that a loan system would work--either 1) a government loan which would be retired at an annual rate for rural area service, teaching and research, or service in government agencies or 2) a loan from the medical school.
Dr. Herman G. Weiskotten, dean of the Syracuse University College of Medicine, testified that his medical school had "loaned thousands of dollars over the past 27 years and never lost a cent of principal or interest."
Scholarship Program
Another form was the scholarship from the medical school; at Harvard Medical School, Dr. Reginald Fitz '05, assistant dean, stated that "we are able to help many students every year who otherwise would be unable to go through medical school. Our principle consideration is need. We do not want Harvard Medical School to become a school for rich men's sons." The final alternative suggested was state and local scholarships; the AMA thought that if any governmental aid was needed it ought to come from and be controlled by the region concerned.
The Fear of Federal Control
Although more implicit than explicit, the AMA still nurtures a fear of too much federal control. Especially in the case of the scholarship grants the organization feels that political appointees will replace qualified medical students.
The AMA thinks that political interference would be the result of any government participation in the profession. But the bill explicitly states that "no officer, agency or department of the government shall influence the curriculum or choice of students in any way."
In the final analysis, there must be some resolution between the medical groups' fear that the profession will be over populated and the government's fear that not enough of the right caliber student can afford modern medical education. Both are justifiable fears; the medical profession was dangerously overcrowded in 1906 before the accrediting of medical schools, while the administration knows that fewer and fewer students will be able to pay 600-800 dollars yearly to become doctors. H.R. 5940 is the first legislative attempt to resolve this problem