tion is simply that, starting with our present overcrowded condition, production henceforth at the ratio of one physician to every increase of 1500 in population will prevent a shortage, for the next generation at least. In 1908 the south, then, needed 240 more doctors to take care of its increase in population. In the course of the same year, it is estimated that 500 vacancies in the profession were due to death.[1] If every vacancy thus arising must be filled, conditions will never improve. Let us agree to work towards a more normal adjustment by filling two vacancies due to death with one new physician,—once more, a decidedly liberal provision. This will prove sufficiently deliberate; it would have called for 250 more doctors by the close of the year. In all, 490 new men would have amply cared for the increase in population and the vacancies due to death. As a matter of fact, the southern medical schools turned out in that year 1144 doctors; 78 more southerners were graduated from the schools of Baltimore and Philadelphia. The grand total would probably reach 1300,—1300 southern doctors to compete in a field in which one-third of the number would find the making of a decent living already difficult. Clearly, the south has no cause to be apprehensive inconsequence of a reduced output of higher quality.[2] Its requirements in the matter of a fresh supply are not such as to make it necessary to pitch their training excessively low.
The rest of the country may be rapidly surveyed from the same point of view. The total gain in population, outside the southern states already considered, was 975,008,—requiring on the basis of one more doctor for every 1500 more people, 650 doctors. By death, in the course of the year there were in the same area 1730 vacancies. Replacing two vacancies by one doctor, 865 men would have been required; in most sections public interest would be better cared for if they all remained unfilled for a decade to come. On the most liberal calculation, 1500 graduates would be called for, and 1000 would be better still. There were actually produced in that year, outside the south, 3497, i.e., between two and three times as many as the country could possibly assimilate; and this goes on, and has been going on, every year.
It appears, then, that the country needs fewer and better doctors; and that the way to get them better is to produce fewer. To support all or most present schools at the higher level would be wasteful, even if it were not impracticable; for they can
- ↑ Based on figures collected by the American Medical Association.
- ↑ As Kentucky is one of the largest producers of low-grade doctors in the entire Union, it is interesting to observe conditions there. The following is the result of a careful study of Henderson County made for me by one thoroughly acquainted with it.
Total population, 35,000; number of doctors, 56; ratio, 1:624.
Place Population No. Drs. Ratio City of Henderson 17,500 27 1:644 Anthaston 24 1 1:24 Baskett 200 2 1:100 Cairo 200 1 1:200 Corydon 1,000 4 1:250 Dixie 300 1 1:300 Geneva 100 2 1:50 Hebardsville 400 2 1:200 Zion 250 3 1:84 Robards 500 3 1:167 Niagara 100 3 1:34 McDonald's Landing 25 Alzey 25 1 1:25 Smith Mills 200 3 1:67 Spottsville 700 3 1:234 Throughout the county there are doctors within five miles everywhere.
