Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/282

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Health
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  1. Special Physicians: In selecting special physicians, due consideration should be given to their fundamental background in general medical work and to their general adaptability for their work.

    Appointees should receive special training at trachoma clinics where cases are being handled under the various methods, but which are not connected with the Indian Office, and they should be allowed subsistence and transportation in connection therewith. This is important because of the present uncertain knowledge of the causative factors in trachoma and the fact that all specialists in the field of ophthalmology do not agree on the methods of its control.

    The future activities of special physicians should include only the number of cases that it will be possible for them to follow-up at regular periods of three months.

    A complete medical file should be kept of every case treated containing all data relative to general physical as well as eye conditions. This is absolutely essential if a reliable and constructive method is to be evolved for the care of trachoma.

  2. School, Agency, and Hospital Physicians: The medical personnel in the Indian Service should be brought to as high a standard as that maintained by the Public Health Service, the Army, the Navy, and the Veterans’ Bureau. To achieve this object it will be necessary to raise the general level of salaries and to adopt a salary scale comparable to that used for the Public Health Service. When salaries are raised, higher entrance qualifications can be set and an effort made to draw into the service promising younger men well trained for the work.

    New physicians entering the Service should be given an apprentice assignment to a well organized field service hospital and reservation to prepare them for the special conditions they will meet in the Indian Service.

    When higher salaries and higher qualifications make available a supply of well qualified candidates, the Indian Service will be in a position to deal effectively with its existing personnel. This problem would, however, be simplified if Congress would amend the retirement act so that Indian service physicians could be retired as early as age 60 at a reasonable retirement allowance. The Service should promptly establish high standards for the medical service and require compliance with these standards. Those of the existing

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