The practice of medicine is in a state of transition which is perhaps analogous to the state of industry during the early period of mechanization. There is a marked survival of traditional, individualistic practice, to which many physicians cling as did the early handicraftsmen seeing their independence and their creative skill threatened by the machine.

There is serious dearth of physicians in rural districts, an oversupply in cities. The field of the physician has grown far too large for any one man to master, and the necessary equipment is often too elaborate and expensive, even for the rich doctor. Here the hospital and private clinic come in to play the part of the factory, furnishing the machinery which the individual craftsman cannot secure for himself or, indeed, use if he could, so complicated has it become.

The private clinic represents an effort at cooperation in the interest, not only of efficiency, but also of economy and protection against the evils of unrestricted competition. Such an effort does not, however, strike at the deeper lying problems of present day medical practice, namely the uneven distribution of service and the more uneven distribution of its costs. Medical organization has not changed as rapidly as scientific medical research.

To meet these problems organization is needed, of which three types may be mentioned. One is the growth of private organizations, of which examples are found in universities and industries, which might be developed on a community basis. Aid and regulation by the state may be a feature. Another type is found in the rise of governmental health bureaus, federal, state, county, and municipal, which apparently without much deliberate planning have increased the amount and scope of their work. A third type, compulsory health insurance, has been tried for many years by European nations. It seems probable that this latter method will be considered by the American public at some time in the future.

Naturally, scrutiny will have to be given to the weaknesses of the European system and the changes which will be needed to be coordinated with the practice in this country.

The concern of social policy regarding medicine is with the extent and direction of the development of these different types of organized medicine. The problem is to make available to the whole people the results of scientific research and experiment at a reasonable cost.

Source: Recent Social Trends in the United States, an examination of the social state of the United States at the end of the 1920s undertaken at the direction of President Herbert Hoover.