Medicine: Creating a Doctor Corps

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With some 318,000 practitioners, the U.S. has more doctors than most other industrial nations. In rural and slum areas, however, many Americans are unable to see a physician when they are ill. Few medical men are willing to settle or practice in locations that offer high personal risks or poor medical facilities. At least 5,000 rural communities across the country have no doctors at all; some city ghettos have only one for every 10,000 residents.

Now President Nixon has signed into law a $60 million program that could, before the end of the year, put a corps of Government-paid doctors into areas where they are needed most. Known as the Emergency Health Personnel Act of 1970, the bill, which was signed without fanfare on New Year's Eve, allows Public Health Service doctors to dispense medical care in areas where local officials request their presence.

The proposal was given scant chance of passage even by its Democratic backers, and less by Administration officials, who voiced only token opposition. It blooped through Congress largely because none of its opponents bothered to stop it.

The authorization, which allows a first-year appropriation of $10 million, could be used to recruit new doctors, dentists, nurses and other professionals. They will be invited to enlist in the U.S. Public Health Service for duty anywhere in the country. Some of the new personnel will serve in such traditional PHS programs as the Indian Health Service and marine hospitals. But others could go wherever their services were needed, receiving a straight federal salary. Any patient fees not covered by Medicare or Medicaid would go to the Government.

HEW officials, who must administer the new program, are divided as to its merits. Some feel that the plan, which provides draft exemptions for participating physicians, will be used merely as a means to avoid military service.

Backers of the program, who see it as a first step rather than an ultimate solution, are confident that they can make the plan work. Their confidence seems justified. The PHS currently has seven times as many applications as it has vacancies in its commissioned officer corps, and enough hospital and clinic facilities, if used efficiently, to meet existing needs.