The Health bulletin [serial] - University of North Carolina at Chapel Hill

June, 1951The Health Bulletinneed for improvements in the care ofindividual illnesses and injuries, haveoverlooked their opportunity and dutyfor leadership in planning the provisionof efficient local health departmentsand hospital and medical careservices for their community to assureprevention, early case-finding and adequatetreatment promptly available. Itis desirable that our grievance committeesaim toward a basis for long-rangeconstructive planning as well as delayedcorrections. If physicians fail to leadin community health planning throughboards of health, formation of healthcouncils, rural health conferences, andthrough all other means, those whotake over this function may even omitmedical consultation during the planningstage of their activity.The public is not fully informed onits part in adjustment to some of om*modern changes. With good roads, electricityand telephones and desirable developmentsin clinics and hospitals thereis no more need for a physician atevery crossroad than for a general store.A doctor ten miles away may be morereadily available now than the one whoa generation ago was in walking distance.A well-informed public can alsoconserve the doctor's time and saveconsiderable expense by office insteadof home visits, day rather than nightcalls, and by more prompt but shorterhospitalization. In former generationsthe doctor and hospital were used onlyin extreme emergencies. Medical costsare less when the physician is consultedearly for the "ounce of prevention" orthe "stitch in time."Perhaps the glamor of the medicalspecialist and the specialized or categoricalpublic health worker has beendisproportionately emphasized; certainlytoo little is associated with the generalpractitioner and the generalizedservice of the local health department.Medical students fear lack of prestigein general practice and the public andappropriating bodies get exaggeratedviews of individual diseases and otherhealth problems rather than an enthusiasticappreciation of the value of thebest generalized medical and health servicefitted to the needs of each individualand cpmpiunity.Constructive suggestions for improvementof public health practices are alwayswelcome from individuals andfrom the county and state medicalsocieties. These should be made to localboards, or the state board, of health,however, and not handled so as to leavethe impression that we in medical andhealth work are a house divided againstourselves. County medical societies areurged to furnish leadership and guidancein medical and health planning.Local health departments are relativelyfree and should be responsive to theirlocal medical societies and the peoplethey serve. State Board of Health ruleson policy are general and flexible.Where we fall short in uniformity wegain in freedom and utmost accomplishmentin school health and other servicesas we appreciate more fully ourlocal health departments. Your healthofficer, local or state, welcome the kindof relationship each of you would wishif you were a health officer.Two misconceptions that I would liketo speak against have been encountered.One is that the use of tax fundsinevitably leads to bureaucratic controland loss of individual freedom. The selectiveand wise use of tax money mayhave the opposite effect. Federal appropriationsto our State Board of Healthand state and federal monies used byour local health departments aid andassist, but have not interfered with,our complete state and local freedom.The same can be said, so far, with regardto Hill-Burton funds in the constructionperiod. Hospital maintenanceproblems are becoming complicated anddeserve careful long-range planning.Another misconception is the ideathat North Carolina public health workinfringes upon the field of private practiceand leads to increasing governmentalcontrols. Each and every oneof you are invited to analyze the workof your State Board of Health and yourlocal health department with care andyou will convince yourself otherwise.Which of these services would you asprivate practitioners eliminate or be