STRENGTH IN NUMBERS
both the COVID-19 pandemic and the rise in online “ community .” However , what we view as a contemporary challenge brought about by change may well be a continual challenge , not just present but omnipresent . Dr . Murphy placed “ increase in membership ” very early in his address . He opined on the “ method of becoming a member ” of the AMA , noting the common practice whereby “ membership in the county society carries with it a membership in the state medical society ,” but not the national society ( AMA ). He makes a call for all county society members to become members of the AMA . He foreshadows the discussions we still have regarding tethering of dues . Almost comically , his words written in 1911 , bring to mind the annual parade of those-with-the-most-lapel-ribbons at the KMA Annual Meeting , addressing each caucus individually , pleading for all to join the AMA as an extension of their local and state membership .
Relevant , as well , to our ( post- ? neo- ?) COVID era , Dr . Murphy insisted that organized medicine not exist as a belly-gazing , incestuous model , suggesting that the AMA meeting ’ s educational program leave “ lasting impressions on the public mind and of the community in which the meetings are held .” Further , advantage should be taken of these occasions to produce a spirited awakening in medical and health truths .” Dr . Murphy urges the AMA , via a subcommittee , to “ supply the lay press with the extensive articles , not alone on the novelties but on the common disease , giving the people plain information .” Ahead of his time , realizing that physicians should be leaders in educating the public and caring for them outside of the walls of the clinic , he stated , “ The education of the public is the most important obligation of this Association .” He minced no words when declaring ( and seemingly to this author worth reprinting here in 2024 ), “ For centuries the medical profession has criticized the public for its lack of judgment in its selection of doctors . The public employed the quack ; it has employed the irregular or sectarian ; it has employed the bone-seater , the chiropractor , etc . These were employed not alone by the ignorant , the foreigner or the poor , but by the so called ‘ intelligent , reasoning , educated ’ and wealthy people of every community .” Dr . Murphy wisely asked why these healers garner such support and arrived at the conclusion that they are not supremely skilled or intelligent , but they are more masterful at “ giving the patient some kind of explanation or reason or working hypothesis … in other words , they educate the people in their theories , beliefs , or sophistries .” Asking what the medical profession has done to educate , he states “ Nothing ! We have demanded of the public our acceptance on blind faith and the age of blind faith in individuals is passed .” Ouch . In the age of the internet where the truth and the lie are just a click away , laid bare by the throes of COVID and rambling politicians , this passage feels as relevant in 2021 as in 1911 .
It is hard to believe the following words were written in 1911 , and not 2024 : “ The gross and unpardonable indifference of the people to their own physical welfare , that of their children and neighbors , is more discouraging and a greater barrier to progress than active opposition .” Then , as now , “ When the people are educated and interested , they will support and enforce every proper method for their betterment .” The physician is , indeed , “ the natural flag-bearer ; the people the great beneficiary .”
Dr . Murphy , throughout his address , espoused a standard grounded in truth . Recalling education of the public as a primary goal of the AMA , he pondered , “ How much the mortality of a variety of maladies could be reduced if the laity had a little instruction from the profession .” He lamented the “‘ patent-medicine ’ almanac , quack advertisements and leaves of healing ” as the “ principal instructors of the public .” He criticized the presence of “ clinics in which truth and science are violated in almost every line … the public accepts these as truths .” Sound familiar ? Further , he wisely reflected on the quality of advertisements in The Journal ( JAMA ), noting “ It has always demanded clean advertisements and insisted that advertisers of medical products in and outside of the profession shall tell the truth .” And while his appeal to the right to conduct animal research , the dismissal of antivivisectionists and his opinion on osteopaths did not age well , he defended the imperative of ongoing medical research . He , sparing no tongue , described opponents as “ ill balanced sentimentalists – people with limited capacity for estimating educational factors … without capacity for perspective ” ( of which , among many , he includes “ antivaccinationists ”). He , thereafter , serially eviscerates his “ opponents ” of medical research . Further , he takes a swipe at government , listing the roles government should play in the support of physicians , including “ keeping them honest , upright , and courageous .” He concludes , “ Since it has failed , we of the profession are forced into the breach and at our own expense are carrying society ’ s burden .”
The health of our populace in the U . S ., as that of the organized medical society , is tenuous at best . The life expectancy of both are , arguably , declining . Stepping back to the future , Dr . Murphy instructs that “ the medical profession should be the unquestioned forerunner of humanitarian undertakings . Our sacred calling should be exemplified in our acts , that each individual citizen may have every possible opportunity for the conservation of his health and the perseveration of his life regardless of his ability to compensate the physician .” Yet he reminds us that “ they will not enlist as his workers … until he shows that he possesses and practices a standard of morality and integrity that is irreproachable .” Organized medicine exists to achieve these lofty goals , independent of those with a conflict of interest invested principally in productivity and profitability . Indeed , the struggle endures , the circle of history seemingly unbroken .
Free Full Text Article available :
Murphy , J . B . ( 1911 ). Organized Medicine ; Its Influence and Its Obligations . Journal of the American Medical Association , 57 ( 1 ), 1-9 .
Dr . Kolter is a practicing internist with Baptist Health .
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