Medical Economics 100th Anniversary: The place of the physician in politics

Editor's note: This article appeared in the first issue of Medical Economics in October 1923. It is being republished in celebration of our 100th anniversary.

If a group of statesmen or other citizen should be called upon to define the purposes of government, I suppose there would be as many answers as there were individuals questioned. Why can we not all agree that the purpose of government is to establish justice and to promote the welfare of all the citizens?

When we look back to the early settlement of America we are impressed by the number of persons who came here to gain religious freedom. Their ethical and religious ideas had been called in question in the older countries. They sought a place where every man could worship God according to the dictates of his own conscience.

Others came because of the opportunities to get gold, or other things of monetary value. Likewise, there were those who crossed the seas in the spirit of adventure.

As with every other county emerging from a purely pioneer state, it became necessary to establish some form of orderly government. In the course of time, the recognition of authority was a demand made upon every citizen. In the language of the Declaration of Independence everybody is entitled to life, liberty, and the pursuit of happiness, and, quoting “to maintain these rights governments are instituted among men.”

In the last analysis the object of government is to insure the safety and welfare of the citizen.

The preamble of the Federal Constitution declares its purposes to be to establish justice, and to promote the general welfare.

I think no one will deny that the first duty of government is to make it possible for the individual to provide himself with clothing, shelter, heat, and food. His body must be protected against injury, either accidental or intentional. So far as may be, the citizen must be made immune to the attacks of disease. The public health must be guarded by raising barriers against infection. To this end there must be furnished food and drink which are free from contamination.

As the country grows and becomes increasingly populous, cities come into existence. As these great centers increase in population there arise larger social problems. Some of these are founded on the intimate contacts of tenement and factory life. The physicial surroundings of the people have much to do with the development of such problems. They cannot be solved without intimate knowledge of the underlying causes of social distress. Government, like a wonderful mother, must dives ways and means to guard her children, the citizens of the country.

It must be apparent, I am sure, that when we really consider the purpose of government, most of its vital problems have to do with things more familiar to the physician than to anybody else in society. There is a popular idea that lawyers are the natural staemen. It is supposed that their training somehow or other fits them to take charge of government. That this is the popular conception is shown by the fact that of the ninety-sixe member of the United States Senate, eighty-two are lawyers.

I hold no brief against the lawyers. Many of my most intimate friends belong to this inspiring profession. They will forgive me, I am sure, if I speak frankly of the lawyer in politics, as compared to what the doctor might accomplish in this field.

Laws are the instruments through which countries are governed. These laws are written in legal language, the language of tradition. Certain formulae have existed “since the mind of man runneth not the contrary.” It is admitted that in the formulation of laws, it is wise to perpetuate the recognized methods of expression of the intent of the people. But is not the work of a lawyer remarkably similar to the work of the printer in the printing office? The compositor knows his “case.” With remarkable speed he can pick the type from the boxes of the case and assemble them, making words and sentences. In due time, in the make-up, he brings together an entire article. This may be a convincing sermon, an appeal to patriotism, or a proclamation of war. It may be the expression of some great human instrument capable of changing the intellectual outlook of a nation.

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Certainly no one can contend that the printer, by whose skill this message was prepared for the people, is in any sense the author of the thoughts visualized by his work. We have lawyers to formulate in legal language the conclusions reached by legislative bodies, but it does not follow that the lawyers originate the ideals expressed in the finished laws. In all modesty I contend that the doctor is better qualified to know the desires and the necessities of the human family than the lawyer, the engineer, and even the priest.

Who goes into the home, no matter how humble it may be? Who recognizes in the symptoms of his patient the lack of proper food? Who is so well able to testify to the lack of clothing, the want of proper housing and the deprivation of heat? Determined as he is to seek ultimate causes, who is so well qualified as the physician to get at the bottom of the great social problems, the natural accompaniments of modern civilization?

If he is a thoughtful man, does not the doctor find out why decent houses are not furnished our people? Is he not the first to discover that the wrong kind of a tariff may interfere with a building program, because of the high costs of materials necessary to erect houses? This particular need of our people involves the problem of the tariff, the problem of transportation, the problem of the labor union, and the problem of finance. Certainly the training of the lawyer does not fit him to form different or better conclusions in these matters. Indeed, however kindhearted he may be, the lawyer has not had the human contacts necessary to stir his heart and soul and to make him an ardent advocate of better laws in order that those who suffer may be relieved of their tortures.

The physician goes into the homes of the poor. He sees there the lack of nourishing food and the undernourishment of the children. He hears the story from the wife and mother of the lack of funds to buy the very necessities of life.

As he drives into the country and sisits his rural patients, he sees the fruit spoiling upon the ground and knows that the vegetables are rotting in the earth. He sees these great quantities of food going to waste, food that would furnish health and life to the poor of the cities.

Is it any wonder, then, that the doctor finds fault because proper markets and marketing facilities are not provided? He wants to know why the transportation facilities and rural credits are not arranged in order that the farmer may get these things to those who need them in the city.

He is an eyewitness to the suffering of the poor and knows the great and startling inequality between the poverty-stricken of the crowded sections of the city and the affluence of those who live on the avenues. In consequence his soul is moved and he becomes an advocate of social justice. He yeans to have reduced the artificial and manmade division between the rich and the poor. He begins to think about the minimum wage and a fairer distribution of the profits of business.

In his talks with the farmer he finds that the surplus grain cannot be sold because of the lack of markets. The farmer confides in the doctor and finds there a sympathetic listener. They discuss together these matters of vital importance to the citizens of the farming districts. I believe the doctor, more than any other man, comes to recognize that the buying power of the world must be guaranteed in order that the producer may have an output for his products.

This gives the doctor a wide vision, a vision which becomes more acute by reason of the fact that in his reading and in his study he comes in contact with the men of every country. He goes to the medical center of the old world and mingles with professional men from every part of the earth. Naturally the vision of the physician is comic. He thinks in terms of human beings, whom he knows better than anybody except the priest.

The doctor does not speak the language of the banker. However, he recognizes that prosperity in business is fundamental to the happiness and health of the human family. The doctor will never be a revolutionist or an anarchist, because he knows that revolution and anarchy make for bloodshed and death.

It is the business of the physician to staunch the flow of blood and to protect human life. Therefore, medical men will strive for orderly and stable government. They cannot be “standpatters,” however, because they realize that life depends upon progress. There can be no health or long life for an individual who vegetates. There can be no health or long life for a nation which fails to exercise its powers by activity and progress.

I suppose I could go on indefinitely in pointing out the reasons why the doctor has an important place in politics. But the medical man is so devoted to his profession that he hesitates toleave it to take on the larger work of helping to heal the ills of a nation. However, when he does venture into this field, his education, his experiences, his human contacts, his broadened sympathies and intimate knowledge of the endless needs of the human family must make him useful and active agent for the good of the nation. He knows the heart of humanity.

The doctor can point out the human reasons why a coal strike is an unthinkable thing. He can show why the transportation system, carrying the necessities of life, must never be hampered. He can point out why the banking and financial systems of the country must be fostered so they can further the plans of a better humanity. He can point out the effects of bad government upon the human welfare of our country. He should be able to inspire legislative bodies to make laws for the betterment of society.

When these plans are agreed upon, the lawyers may choose the language in which to write the laws. They may take it from the boxes of tradition and place it upon the statute books in a form which can be understood by the courts which must interpret it. This the lawyer’s job. But I am sure our country would be better if more men of the medical profession entered the field of politics.