Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/284
- To permit of the maintenance of higher standards of practice it will be necessary materially to increase the number of physicians. The number to be employed should be determined after a careful study of the field with due consideration to the factors of distance and accessibility. A rough estimate would be that at least twice the number now employed will be needed. Every hospital of fifty beds or more should have a full time physician selected with special reference to the type of service to be rendered by that hospital. Physicians at hospitals for fifty or more patients should not be expected to do reservation work. All boarding schools of three hundred pupils or more should have a resident physician specially qualified for the type of work in such institutions. These physicians should have general oversight of all activities of the school which affect health and should give or supplement instruction in health.
- Contract Physicians: The contract plan should be replaced as
rapidly as possible with a fulltime personnel, except for certain
specialized services, such as surgery.
Permission to utilize contract physicians should be granted, however, when it is necessary to fill positions which would otherwise be vacant. The maximum patient population should not exceed four hundred.
A careful inquiry into the qualification and standing of physicians to be given contracts should be made, and contracts awarded only to those of the highest standing.
- Dentists: Much more adequate dental service should be rendered the Indians, both in schools and on the reservations. The
dental service in schools should be comparable with that in the best
public school systems.
The number of dentists should be materially increased to render this service. Effective use can, however, be made of dental hygienists, especially at schools, thereby reducing somewhat the need for dentists. One full-time dentist and one full-time dental hygienist can together probably take care of the needs of two of the largest schools or even more of the smaller ones.
- Nursing Service: The number of trained graduate nurses in the hospitals in the Indian Service should be materially increased. Every hospital should have a minimum of not less than two graduate nurses so that one may be always on duty for day service and one on call, at least, for night duty. Where the amount of surgery