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of Montana reports the following laboratory service rendered Indian Service physicians for the years 1925 and 1926:

This service was rendered only partly in connection with hospital service; some was undoubtedly done in connection with routine reservation practice.

Facilities for confinements are in most instances the same as for any other case. Delivery is made either in a ward or in the operating room.

The organization of the hospital administration staff has been defective. In the past, authority and responsibility were frequently divided. Usually the physician had no control over hospital employees. At one agency the superintendent was arranging with physicians in a neighboring city to locate a hospital nurse, when the physician in charge could have secured a capable nurse whom he knew and could undoubtedly have worked with to advantage. This situation has been remedied by a recent order, placing all hospital employees under the direction of the physician. As a rule, this order is being carried out, although at one agency the physician in charge of the general hospital had to get authorization from the superintendent before he could change his nurse from night to day duty.

In all agencies the hospital physician is expected to do a certain amount of reservation work. Often on reservations where there is more than one position for physicians, and some are vacant, the physician at the hospital must assume full responsibility for the outside work in addition to his hospital duties. Under such circumstances the hospital work must obviously be neglected to a considerable degree.

Outside consultant service is usually available only at those stations situated near an urban community, except for rather infrequent visits by special field personnel.