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- particular purposes so that the Chief Medical Officer, under the
general direction of the Commissioner, will have a freer hand for
effective administration.
The Chief Medical Officer should be supplied with a small staff of specialists to aid him in developing and perfecting the specialized medical services which must be rendered. The position of epidemiologist at present authorized should be filled. New positions should be created for specialists representing the fields of tuberculosis, trachoma, child hygiene, venereal disease, and hospital administration. Their duties should be primarily consultive rather than directly administrative. Additional trained clerical assistance should be provided to permit of the compilation and analysis of the medical data necessary for the efficient planning and control of the medical activities of the Service.
To provide more adequately for the development and supervision of the public health nursing work, the present supervisor of public health nursing should be given not fewer than four trained assistants, each to be assigned to a district in the field. The public health nursing work should be under the general direction of the Chief Medical Officer.
A system of medical cost accounting should be installed.
A thorough study of existing law relating to health work among the Indians should be made and a report submitted to Congress through appropriate channels, including a draft of a bill or bills to bring the law on this subject abreast of present developments in the field of public health.
- District Medical Directors: The Indian medical service
should as soon as possible take over full responsibility for the district medical directors.
Need for the cooperative service rendered by the specialized field personnel of the Public Health Service will always exist. An extension into more of the Indian communities should be sought. Consultation and codperation with private national health services should be further developed.
Subdivision of the territory embraced in the three districts numbered four, five, and six into five districts, should be made, on the basis of existing population and transportation facilities.
Adequate trained clerical assistance should be provided for each of the district medical directors, without depletion of the clerical forces of other branches of the service.