Address at the Annual Meeting of the American Medical Association, Atlantic City, New Jersey.
Dr. Orr, Dr. Gundersen, Distinguished Guests, and Ladies and Gentlemen:
I am honored in this opportunity to extend greetings and felicitations to you and your colleagues in the medical profession. The American Medical Association, representing physicians in general practice and specialties in many fields, has brilliantly earned the high position it holds in the Nation. In making this statement, I cannot logically be accused of self-flattery--because even though I am exceedingly proud of belonging to the College of Surgeons, I assure you that my credentials of membership in the College are not the kind that entitle me to wield a knife upon my fellow man.
Because health, including bodily and mental vigor, is an essential asset in everything we do, all national progress is facilitated by progress in health. Whether it involves healing the sick, guarding the public against quackery, evaluating drugs or helping to maintain high hospital standards, the medical profession is steadily promoting better health among our people.
Indeed, Lord Bryce observed, on one of his last visits to the United States, that "medicine is the only profession that labors incessantly to destroy the reason for its own existence."
By working toward this end the medical profession promotes broad national progress.
Today, as every schoolboy knows, diseases like diphtheria, scarlet fever, and smallpox, which brought such tragedy to so many American families a few generations ago, have all but disappeared.
In our country medical science has virtually eliminated typhoid, pellagra, and malaria, and is well on the road to conquering tuberculosis and poliomyelitis.
Even more dramatic have been the gains of modern medicine against deaths among infants.
Forty years ago, 10 percent of the babies born in this country died before their first birthday; today the figure is below 3. During the past decade alone, deaths of mothers in childbirth dropped 65 percent. Happily also, the Nation has experienced a steep decline in deaths from childhood diseases.
For all this the Nation is profoundly grateful.
Only a century ago the average physician in America was a man with rarely more than a high school education. He learned about the treatment of diseases as an apprentice to another man who was called a physician, but who was likely to be as poorly educated as his pupil. We are told that sick people in great numbers avoided physicians as much as they sought them out, since it was uncertain whether they would profit or lose from the encounter.
But the need for better medical education could not long be ignored. And it was no accident that as medicine advanced and professional medical skills developed, in the United States, as in Europe, they were associated closely with the great universities where the spirit of inquiry and instruction were at the forefront. For in medicine, as with all scientific discovery, professional progress flourishes best in an atmosphere of scholarly inquiry.
In reflecting upon the well-nigh unbelievable advances of medicine during this past century, we do not forget the nursing profession and our hospitals, which developed side by side with the medical sciences.
It was not until the War Between the States that, in America, any sizeable number of volunteer women--and I stress the word volunteer-recognized that care could help bring the sick and the injured back to health. The help they gave was in doing only the simple things--keeping the patients clean, feeding them, changing their bandages. Nurses were not then expected nor were they trained to do more. But today the leaders of the nursing profession are college graduates. Many hold Masters', others Doctors' Degrees. Within half a century, the nurse has been transformed from a sympathetic attendant to a thoroughgoing professional.
Even as late as 1911, when I joined the military service as a cadet at West Point, the presence of a trained nurse in any military hospital was a rarity. Trained nurses were on duty in only four military hospitals in the United States.
Moreover, more than a hundred years ago, when your organization was founded, our hospitals were, all too frequently, places that individuals did their best to avoid--for their chances of coming out alive were not encouraging. As for the unfortunates with contagious illnesses, they were merely sent into isolation so that they would not endanger the lives of other citizens.
Today, about 35,000 new hospital beds--all in modern and efficiently equipped hospitals--are being added to our national resources. One out of ten Americans enters a hospital each year, and most of them quickly return to their normal activities.
You men and women of the medical sciences bring to all our people healing and disease prevention practices through your cooperation with many organizations--including hospitals and universities, voluntary health organizations, industry and Government.
This all thoughtful Americans applaud. For the real measure of our strength--our Nation's strength--lies in the diversity, extensiveness, and interdependence of the American system.
The advances achieved by the medical profession are an inevitable reflection of American life. A rising living standard has contributed materially. Every day we have better food, better sanitation, higher standards of housing, better water supply systems, and vastly extended education. Each of these factors underscores the intimate link between a productive and expanding economy, and high standards of medical and health care.
We see, then, that our economy, like our bodies, must be vigorous.
In this sense the relationships between the balanced diet and the balanced budget are easily understood. Neither is an end in itself. There are some useless items of food all of us crave and often eat, no matter how unwisely, just as there are always products and services for which we the Federal Government thoughtlessly spend, often to our own detriment. But in each instance we must conduct ourselves with a wary eye on the consequences. Habitual violation of the requirements of a balanced diet can lead to ruined health; deliberately to unbalance the Federal budget in time of huge indebtedness and rapidly increasing prosperity can bring about an enfeebled economy. The choice, therefore, is ours, and we must act with clear mind and resolution in either case.
In the management of our governmental activity one simple need is for judgment, frugality, and restraint.
The Federal Government can be, with some accuracy, likened to a bank which uses the money deposited in the form of taxes by the American people to finance many businesses--some necessary, some not so necessary. In these Federal operations are involved, in one way or another, all the banks' depositors--every man, woman, and child in this room, and in the United States.
If a bank--in this case the Government--should persistently use its funds foolishly, or too lavishly, because of a yielding by its directors to the demands of specially favored or powerful groups of depositors, the result would be exactly the same as in the case of a commercial bank following the same reckless course. The bank would finally go bankrupt, the businesses financed by it would be destroyed and the depositors would be impoverished. Now, of course one advantage enjoyed by the Government over a commercial bank is that, when the Federal Government spends its money foolishly it can, by law, call upon its depositors--all the people--for more and more funds in the form of taxes. Worse, the Government can inflate your money. Finally, all prices would go out of sight and everybody would go broke.
We must live within our means if we, as a people, are to prosper. Unless both responsible officials--and by this I mean the Congress and the Executive--and all our citizens begin to insist that we make significant annual payments against our burdensome national debt, we will weaken the credit of the Nation.
The medical profession, as much as any other, has a vital interest in preventing inflation. Certainly it wants to provide its services for a fee within the range of what people can reasonably pay.
If the time ever comes when large numbers of our citizens turn primarily to the Government for assistance in what ought to remain a private arrangement between doctor and patient, then we shall all have suffered a tremendous loss.
For, my friends, the cost of inflation is not paid in dollars alone, but stagnated progress, lost opportunities, and eventually, if unchecked, in lost freedoms for doctor and patient, and all the rest of us.
For those who will take the trouble to look, there is no difficulty in seeing a connection between fiscal responsibility and a successful, meaningful life for all in a climate of freedom. I am confident that you doctors, as community leaders in great urban centers and in the villages and farm areas of America, can do much to promote greater understanding of the importance of this vital relationship.
So I believe that, as you show us how better to preserve our own health, you can do a great service to yourselves, and to the Nation, as you teach that the future of the Republic and the free world depends upon our ability to maintain fiscal soundness in Government, a robust economy, and a stable dollar.
Impressed as we are by progress in the medical sciences, including miracle drugs, miracle operations, and breakthroughs in eliminating heretofore incurable diseases, we sometimes forget that this progress deposits new problems on our doorstep.
Familiar conditions, even perspectives, have a disturbing habit of changing profoundly over a short period of time. For example, some of you may recall a remark made by your distinguished fellow professional, Sir William Osler, at the turn of the century. In his farewell address at Johns Hopkins University in 1905, he said:
"My second fixed idea is the uselessness of man above 60 years of age and the incalculable benefit it would be in commercial, political, and in professional life, if, as a matter of course, man stopped work at this age."
By 1905 I was 15. And it is quite likely that I then, and others here of a comparable age, would have agreed with Sir William. But certainly we now repudiate the thought.
Nonetheless the sober fact was that half a century ago, relatively few people reached the age of 60. The average life expectancy for a person born in 1900 was 48. Today it is over 70. In 1910 there were 3 million men and women 65 years of age and over; today there are more than 15 million.
This shift in the age pattern of our population has been accompanied, of course, by revolutionary changes in our social and economic structure.
We are no longer an agrarian society. Industrial and technological changes have centered our population in cities and large towns, bringing far-reaching alterations in our living habits.
Thus most of our senior citizens of today no longer can enjoy the relative security which their pioneering parents or grandparents provided for themselves individually as farmers or as small independent shopkeepers or professional workers. Our older people largely live, today, on fixed retirement income represented in pensions, insurance policies and savings. To this group, inflation is not merely a threat--it is a robber and a thief. It takes the bread out of their mouths, the clothes off their backs, and it limits their access to the medical care and facilities they need.
So here is a situation that calls for true team effort among the medical profession, industry, Government, and the broad body of our citizenry.
We must work together to make possible for our senior citizens, meaningful activity so that they can become--as they all hope to--independent, useful, and creative members of our society.
I learn that the American Medical Association has embarked upon a program to orient our thinking about the place of elder citizens in modern society and to help them meet their health care needs. I am indeed gratified to know of this program. In health as elsewhere in American life, our summons to greatness calls for a lively partnership of individual effort, with action by voluntary agencies and private enterprise and, where necessary, Government action at appropriate levels.
As civilization expands, of course, there are many other kinds of challenges-to medicine and to society.
In the beginnings, at the time of Homer, activity and good habits meant good health. We read from a Roman author about those times "that with no aids against bad health, health was generally good because of good habits which neither indolence nor luxury had vitiated." It seems like one of the doctors' prescriptions would be hard work and lack of indolence.
So--we are constantly called upon for new assessment of our environment, imagination, and effort to force and prevent, or to recognize and conquer, these changing problems.
And three thousand years later, an American physician, Dr. George Miller Beard, was writing about diseases that today we would call neuroses. He observed--this was in 1830, by the way:
"They all occur under similar conditions, and in similar temperaments. They are all diseases of civilization, and of modern civilization and mainly of the nineteenth century, and of the United States."
Today, increasing speed of transportation has forced us to revise immigration practices to protect against certain contagious diseases.
Here at home the rising curve of highway deaths and injuries is another reminder that progress on one front is overlaid by tragedy on another. More than 2,800,000 Americans were killed or injured in 1958 alone. Since the automobile first coughed and crawled onto the road, the ranks of its injured and dead have included more than 60 million of us.
Elsewhere new industries present new health hazards in the form of occupational diseases. Millions are exposed to new health risks brought on by an exploding urbanization bringing with it contamination of the air and pollution of our streams.
In an age of ceaseless challenge our society looks to, and understandably expects from, the medical profession a dynamic response. Accelerated progress must lead to the mastery not only of the newer threats to human health and vigor, but the age-old scourges of cancer, diseases of the heart and mind, and disorders of the central nervous system.
And let us not forget the common cold. Medicine provides one field in which all humankind can unite against a common enemy--disease. And beyond and above this battle, we must still tirelessly work to overcome the most menacing of all our maladies, the social sickness of war and the untold suffering it brings upon us.
Members of the medical profession, peace and ennoblement of the human spirit are the common aims of free societies. True to our country, to the cause of freedom and to our God, we shall pursue these aims, without ceasing or tiring. So doing, we shall one day establish a durable world community of peace-loving nations in which suffering born of strife will be known no more. In bringing about this happy result no one can or will do more than the doctors of medicine.
Thank you and goodnight.
Note: The President spoke at the Traymore Hotel, Atlantic City, N.J. His opening words "Dr. Orr, Dr. Gundersen" referred to Dr. Louis M. Orr and Dr. Gunnar Gundersen, President-elect and retiring President of the American Medical Association, respectively.
Dwight D. Eisenhower, Address at the Annual Meeting of the American Medical Association, Atlantic City, New Jersey. Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/234955