Utah Medical Association Bulletin

Utah Medical Association Bulletin: Devoted to Medical Improvement in Utah. The Utah Medical Association Bulletin, published since 1953, is now known as the Utah Physician. This publication is filled with the information Utah doctors need to know about Utah medical and socioeconomic issues.

People aren't perfect-neither are machines. Both can slip up occasionally. Take an ampoule in a paper carton for example. How can we be absolutely sure that the ampoule is really inside? • Here's how: A machine folds the carton, inserts the ampoule, seals the carton, and then places it on the finishing line. Further down the line, the detective waits-a jet of air sweeping across the finishing line just strong enough to blow an empty carton off the belt. Properly filled cartons proceed for further inspection and packaging. • Perhaps this is a small point, but it is another in a long series of control measures designed to deliver quality pharmaceuticals every time. Eli Lilly and Company • Indianapolis 6, Indiana, U .S.A. 2110326 I~ I president's message Because I have as usual procrastinated m the writing of this letter the election is now over and I think all of us can be happy with the outcome. Certainly we have .. '-an excellent delJohn F. Waldo, M.D.egation going back to the national congress, men of good judgment and basic understanding of many of our problems. I think it is fair to say that we individual doctors in the State have become active and certainly as good citizens we should continue to take an active interest in politics and not feel that there is "nothing I can do anyway". This should give you confidence that hard work will pay off in politics as well as anywhere else. It is now anticipated that the new schedule of welfare payments will go into effect on December 1 of this year. We are sufficiently close together on our agreement that I believe there are now no major bars to its consummation. It seems to me that in our thinking about our relationship with the welfare that two facts must be kept in mind and that these are the only important considerations. It is important and evident that we must not allow the Welfare Commission or any other lay group to 2 tell us how we will practice medicine or to dictate how a patient will be treated. On the other hand the Welfare Commission as any other state agency has a budget within which they must live, therefore, they must be in a position to tell us what they can pay for given services. I believe the current agreement is based entirely on these promises and would like to stress again that nothing in this agreement prevents you as a doctor from giving whatever medical care you consider appropriate to a welfare patient. What it does do is tell us how mnch and under what circumstances you will be paid for these services. In certain situations where a complete workup is deemed justified where it is not an emergency it is wise to go ahead and secure authorization from the Welfare Commission inasmuch as this will assure payment when a report is rendered. We have been assured that these reports will be reviewed by physicians and will be useful to prevent duplication of efforts as a welfare patient goes from one doctor to another as a good many of them do. The Industrial Commission requires such reports and it seems to me that this welfare requirement is in no way different. It is inevitable that certain irritations will arise occasionally on both sides. It is my firm hope that these can be discussed and smoothed out rather than acting as fuel for further contention. I believe that if we as physicians UTAH MEDI'CAL BULLETIN- NOVEMBER, 1962 - ~· of the Sta:te will accept this agreement in this spirit that it will not interfere with good medical practice and will result in a better rate of pay than we have ever had before . generic drug names is simply a matter of learning this name rather than the trade name. If we were to develop habits of doing this the welfare formulary would become less formidable. Along the same line we hear of a certain amount of dissatisfaction with the current list of drugs used for welfare patients. Since we have started using this formulary a very substantial amount of money previously spent on drugs has been saved. If this continues, I believe it will ultimately put us in a position to negotiate an even better rate of pay for the physician. I realize that the ubiquitous dr ug detail man does everything in his power to teach us a trade name rather than a generic name of a new drug and that for simplicity we are inclined to follow this. It is worth remembering, however, that writing prescriptions using I hope and trust that physicians of the State will make every effort to make our present agreement with the Welfare Commission function well and that they will keep us informed about any sources of irritation that might be ironed out by discussions with the Commission. I hope that one and all in these times still feels that we have reason for thanksgiving and that each of you will have a very pleasant Thanksgiving. JOHN F. WALDO, M.D. President DOCTOR: Have You Investigated Your Own Utah State Medical Association INCOME PROTECTION PROGRAM? • Premiums far below comparable coverage on an individual basis . • Broader benefits . • Plans from $25 .00 per week up to $900 .00 per month . • Up to seven years coverage on illness - Lifetime on accident. CONTACT NED H. NELSON or LEO R. PORTER, Administrators 325 KEARNS BUILDING TELEPHONE Elg in 9-7769 SALT LAKE CITY 1, UTAH -ALSO AVAILABLE- BUSINESS EXPENSE COVERAGE PROFESSIONAL LIABILITY PROTECTION 4 UTAH MEDfCA'L BULLETIN - NOVEMHER, 1962 These leading antihypertensive combinations are practically all alike. This one is different . .. because Ser-Ap-Es offers a unique benefit which makes blood pressure control more certain : the central and peripheral antihypertensive actions of Apresoline . By adding Apresoline to the regimens of their patients, Dupler et afl succeeded in bringing blood pressure down after rauwolfia-diuretic therapy failed . Using Ser-Ap-Es, Hobbs 2 reduced average blood pressure from 175/ 100 mm . Hg to148/85 mm. Hg in 74 hypertensive patients . Side effects? Rarely a problem with Ser-Ap-Es because effective dosage is low, SU PPLIE D: SER- AP - ESTablets,each contai ning 0.1 mg . SERPASIL ~(reserpi n e CIBA), 25 mg . APRES OLINE~ hydrochlo ride (hydralazine hydrochloride CIBA), and 15 mg. E S IDRI X~ (hyd roc hloroth iazide CIBA). For co mplet e inform at io n abou t Se r-Ap-Es (i ncludi ng dosage, cautions, and si de etfect s),see current Ph ysicians' Desk Ref erence or w rite CIBA. 1. Dupl er, D.A. , Greenwood, R.J ., and Conneii ,J.T.: J .A. M.A. 174 :123 (Sept. 1 0) 1960. 2. Hobbs, L.F.: To be pu blished·. >/>o""" -- C I B A SUMMIT, N. J . UTAH MEDICAL BULLETIN- NOVEMBER, 1962 5 executive secretory's report The results of the election and i t s implications were thoroughly discussed at the November meeting of the Board of Trustees. It was generally agreed that those elected to h i g h Harold Bowman pub 1i c positions from Utah did not favor any type of bill which would link medical care of the aged to the social security system. However, it was felt that elections on the national level would again force a contest in congress over this legislation. However, it was felt that such legislation had passed its peak as a public issue and politicians would find it difficult to bring it to the fore again. The matter of review committees was again brought up for discussion. Last year the Board of Trustees approved the idea of review committees and recommended that component societies adopt such a procedure when asked to do so by insurance carriers or consumers of medical car e. Subsequently, committees have been formed in Salt Lake County for this purpose. However, the Board of Trustees felt that such a committee should be adopted on a state level for the purpose of handling matters which have a state-wide implication, and for the purpose of assisting component societies in the solution of any problems that might arise. The Council on Medical Service was given the job of formulating rules and regulations 6 to guide the committee and to assist in selecting the members. An agreement with the Welfare Department in the form of a memorandum of understanding was agreed to, thus clearing the last hurdle before implementation of the program, December 1, which was agreed to at the September meeting of the House of Delegates. Due to general misunderstanding of the new law (H .R. 10) permitting self-employed to establish tax-deferred pensions, your Association has agreed to sponsor, in cooperation with the legal profession, a two-day symposium in Salt Lake City on November 30 and December 1. In cooperation with the First Security Bank, speakers of national importance, including members of the law department of AMA, will be brought to Utah for the purpose of reviewing f i r s t hand, not only provisions of the law, but various types of investment programs. Efforts are being made to secure a representative of the Department of Internal Revenue. The inadequacy of the provisions of H.R. 10 are apparent an a panacea for providing a retirement program for the self-employed, but it is a move in the right direction and its provisions will undoubtedly be broadened over the years. Provisions of the new law, should be broadened so that the self-employed with three or more employees on their payrolls could at least gain some benefit. The way it looks at this point, persons with three or more employees would realize little or no benefits from the new law. (Continued on Page 36) UTAH MEDI'CA'L BULLETIN - NOVEMBER, 1962 ,., This message is of significant importance to DOCTORS - The favorable tax-deduccible provisions previously characteristic only tO compa ny and corporation pen- sion or retirement plans are now available to the self-employed. You owe it to yourself tO get the facts immediately. It may pay you well ro investigate now how YOU may benefit from the "Self-Employed Individ uals Tax Retirement Aet of 1962 " recently enacted by Congress and signed by the President. Come in for in/ormation We will gladly help answer many practical questions that confront self-employed people in taking advantage of these tax savings. Our experienced Trust Officers will assist you without cost or obligation. Trust Department FIRST SECURITY BANK First Security Bank of Utah, N.A. UTAH MEDI'CAL BULLETIN - NOVEMBER, 1962 7 .. HERE 'S HOW LAW (HR 10) WILL BENEFIT SELF-EMPLOYED The "Self-Employed Individuals Tax Retirement Act" provides tax benefits to those self-employed individuals and partners who set aside some of their earned income into formal retirement plans. Up to 10 % of earned income or $2,50q, whichever is less, can be contnbuted each year to a specified retirement plan. Half of this amount will be allowed as a tax deduction. A physician who contributes $2,500 to this plan will be able to deduct $1,250. All realized earnings within the plan are permitted to accumulate tax free. This is how the new law will ben efit the self-employed: Compare the situation of a sole practitioner (without employees) before and after the new law. Assume he's in a 50 % tax bracket and is able to put away $2,500 a year towards his retirement. A married taxpayer with a taxable income of $32,000 is in the 50 % tax bracket. Under the new law, by putting away the same $2,500, he ends up with an additional $625 of after-tax cash (half of the $2,500 is deductible and in t_he 50 % tax bracket that saves him $625 in cash) . So, if nothing else, he can put away an additional $625 each year toward retirement. Assume the money is invested at 4 % . After 25 years, $2,500 accumulating at the full 4 % (there is no income tax on the earnings) will come to $108,280. Before the new law, the same $2,500 a year accumulating at 4 % would come to a total of some $81,700. Also, under the new law the additional $625 a year that is available can accumulate to an additional $20,420 (even after taxes are paid each year). On the payout from the fund, however, there is a tax to be paid. 8 Assume for purposes of illustration that his other income in the year of payout will equal all his deductions so that his payout from the retirement fund will be subject to the lowest possible tax. The tax will be figured t h i s way: The $108 280 accumulated would first be ~educed by the twenty-five $1 250 annual contributions which w~re not deductible (only half of each $2,500 contribution was deductible). That cuts down the taxable portion to $77,030. The tax on 1/ 5 of that is first figured. On a joint return that is $3,742. This figure is then multiplied by five, giving a tot a I tax of $18,710. Therefore, of the $108,280 accumulation, the physician will keep $89,570. Add to that the $20,420 (after taxes) he has accumulated outside the plan by investing the annual $625 tax savings. The total comes to $109,990. That is $28,290 more than he would have accumulated after taxes without the tax benefit of the new law. It should be emphasized, however that the illustration is based upo~ the assumption that his oth~r income in the year of payout will equal all his deductions. If this is not the case, the tax benefit will be less depending upon his tax bracket. Also, it may be that for the physician without other significant income there may be an advantage to take his payout over a number of years in the form of an annuity. In general, the new law will be most valuable to the self-employed with no employees, as in our example above. The more employees and the higher their compensation, the smaller the advantage to be gained from the new retirement system. For example, assume a physician pays out $14,000 a year in salaries and realizes $25,000 for himself. He sets aside the maximum 10 % for his retirement, and contributes the same percentage, or $1,400, to a pension plan for UTAH MEDJlCAL BULLETIN- NOVEMBER, 1962 For the doctor concerned with infant feeding ... CALORIES / oz. Human Whole Cow 's M ilk( l) Br eo5t Homog . oncf Milk 111 Vit. 0 20.9 20.4 Typical Premi •ed Form . 1: 1 20. Sp•c iol Morning Milk Form . 13 oz .+ 19oz . H ,O ~ 1 oz . CHO 20.2 Special Morn ing Milk form . I 0 01 . + 15 oz . H 1 0 .._ 1 oz . CHO Morning Milk (hop) form . 1: 1 21.4 21.8 PROTEIN gm ."'o 1.2 3.3 1.7 2.87 2.9 3.7 FAT gm .% 3.8 3.7 3.4 3.2 3.3 4.2 CARBOHYDRATE gm. "'o 7.0 4.8 6.5 7.0 8.0 5.3 ASH 0.21 0.72 0 .38 0 .6 0.6 0 .8 gm .% VITAMIN CONTENT PER QUART I •I I I I I I I THIAMINE mg . 0 .15 0.4 0 .65 0.2 0 .19 0.25 RIBOFLAVIN mg . 0.4 1.4 1.00 1.44 1.4 1.8 ASCORBIC ACID mg . 40.7 15.1 4 .0 4 .0 5.0 VITAMIN A I.U. 1670 1071 2500 3168 3092 202 1 VITAMIN D I.U . 4 400 400 315 308 400 50 .0 (I) Macy, 1. G.; Kelly, H. P.; and Sloan, R . P.: Composition of Mill1s, Publication 2.51, National Academy of Science, National Research Council, 1953. ~----------------------------------- . Special MORNING MILK - the only evaporated milk fortified with extra vitamins A and D (2,000 U.S.P. units vitamin A and 400 U.S.P. units vitamin D per reconstituted quart). his employees. After allowing for the tax savings - counting deductions for what he contributes for himself and employees - he is out of pocket $2,995 a year. That is $495 more than he has set aside for his own retirment. Based upon the present yield of tax-exempt municipal bonds, he might be better off to avoid the mechanism of the new law and set up a retirement fund with tax-exempt bonds. Reinvesting the tax-exempt income in the more tax-exempt bonds can also produce a good retirment fund without fulfilling the technical requirements of a law that provides for tax penalties if you revise your estate planning or if your financial needs change. Eligibility to draw on retirement funds begin at age 59lj2 insurance age 60. It is mandatory by age 70Y2· These ages apply without regard to whether the selfemployed person has actually retired. If an individual with a retirement fund starts drawing on it before he reaches age 59%, he will be required to pay a penalty tax. If he dies, the fund will be paid to his beneficiaries under one of various methods set up in the law. As shown in our illustration above, if he draws his money in a lump sum after age 59%, he must pay regular taxes, but on an averaging formula applied as if the fund had been drawn over a period of five years. How contributions may be invested : The amounts put into a retirement plan under the new law may be invested in any of the following ways: (1) Trusteed Plan: The contributions to the plan are turned over to a bank as trustee. The trustee can then invest them in stocks, bonds, mutual funds, annuities, life insurance contracts, other investments. Investment decisions can be controlled by the 10 self-employed person setting up the plan. (2) Insurance and Annuity Plans: In addition to the trusteed plan, one of the following is available: (a) Trusteed insurance plan w here someone other than a bank is trustee: Here the trust investments must be limited to an annuity, endowment or life insurance and the life insurance company must supply whatever information about the t1·ust the Treasury Regulations will require. (b) Custodian account: No trust is required. Contributions are turned over to a special bank custodial account and invested solely in endowment, annuity or life insurance. (c) Direct purchases: No trust is required where annuities (including variable annuities) or face amount certificates are purchased . (3) Special Mutual Fund Plan: Custodian bank account (same as (2) (b) above, if the contributions are invested exclusively in stock of a mutual fund or other regulated investment company which issues only redeemable stock). (4) U. S. Bond Purchas es : Contributions can be used to purchase directly a special new issue of U.S. Bonds (interest rate not yet determined) which would pay out principal and accumulated interest when cashed in at retirement. TAXPAYER-Cont. from Page l instructions for such form. Afte1· 1962, an individual needing an account number must file an application for an account number on either Form SS-5 or Form 3227. An application form may be obtained from any District Director, or any District Office of the Social Security Administration. UTAH MEDICAL BULLETIN- NOVEMBER, 1962 ... Stelazine® will stop anxiety-but not your patient! brand of trifluoperazine To be truly useful in your office patients, an ataractic agent must not only relieve anxiety; it must also leave these patients sufficiently alert to engage in their normal activities. 'Stelazine' is such an agent. Its ability to relieve anxiety without producing appreciable sedation has been established in thousands of patients and documented by many published reports. Typical is the finding of Kolodny, 1 who concluded that the primary advantage of 'Stelazine' over many other tranquilizers seems to be "its ability to relieve symptoms of anxiety without undue interference with alertness." When you wish to relieve anxiety, yet encourage the patient to engage in his normal activities, consider 'Stelazine'. 1. Kolodny, A.L.: Dis. Nerv. System 22:rsr (Mar.) 1961. For prescribing information, please see PDR or available literature. Smith Kline & French Laboratories, Philadelphia leaders in psychopharmaceutical research salt lake county president's letter As I write this message, the activities and problems facing the Salt Lake County Medical Society seem almost insignificant when I contemplate the r.&.:~llli!:1.l- earth- shaking Garner B. Meads, events of recent M.D. w e e k s . L ik e everyone else I have been stirred to my very roots by the gravity of the International situation. The realization that we were literally on the brink of a nuclear holocaust was sobering, indeed. I, too, felt a sense of relief when the Soviet Bear conceded to withdraw. However, this is no great victory for us or the free world. This is not the time for cheering but of sober reflection. I am proud of the courage and determination of our people. As a nation, for the moment at least, I felt that we measured up to the expectation of a country dedicated, under God, to liberty and justice for all, willing to fight alone if necessary, to protect and defend these high principles, fully realizing the extreme hazards of such a decision. Though the pressure of crisis has passed, we are still involved in a titanic struggle that reaches out and touches the lives of all. 0 ~1r immediate and long range national problem is the combat of communism. Each of us, in our own sphere, can do much to safeguard our freedom and individual rights. How far we succeed depends upon how vigorously we uphold the principles upon which 12 this nation was founded and that have made Americans great. Anytime we allow anything to undermine these basic concepts, nationally or individually, we suffer a loss of strength, something our communist adversaries seek and and strive for. We as free men in medicine, know the value and vitality of freedom as well as the tragedy of its loss and thus, this struggle relates to each of us in a very personal way. , In these uncertain days it is necessary that we be alert, calm and stable. Histor ically, physicians have always been a s o u r c e of strength in their communities. As into the sickroom the doctor brings courage, confidence and stability, in these troubled times, in a sick world, we can reflect and radiate this same spirit, leading out in the solution of problems that face us and the nation. Inasmuch as we do this, we wage the war against communism. One very pressing problem that threatens the profession is the mounting pressure of medical economics. This comes as a result of rapid advances of medical technology, greatly expanding our services, increasing longevity, requiring more frequent and extensive use of hospitals etc., - all contributing to increased cost. We continue to work in an unfettered atmosphere largely through the influence of the voluntary prepaid mechanism developed to help pay the medical-care bill. This has been challenged severely in the past and certainly will be in the future. That there will be other "KingAndersons" you can be sure. This UTAH MEDICAL BULLETIN - NOVEMBER, 1962 c: .,- has been our strength in a shaky world threatened by socialism and communism, a strength that we must preserve and increase by improving what we have. Dr. Norman Welch, speaker of the House of Delegates of the A.M.A., told the National Blue Shield Conference in Miami, in October, "that the future of medicine in this country is in the hands of the voluntary prepaid movement, and that it is later than we think" as it relates to the free practice of medicine. It was pointed out by more than one speaker that to survive in a competitive world facing increasing social and economic pressures it behooves us to critically evaluate our services and explore ways and means of filling unsatisfied needs and demands of the public out patient service, home and office calls, diagnostic x-ray and laboratory benefits, convalescent andnursing care needs etc. These are gaps in our health coverage system that leave room for dissention and dissatisfaction . . . cracks in our front that the communists are probing for and will exploit to the utmost. I am confident that if the dedicated leaders of medicine and of the health care team apply themselves unitedly to this problem a solution will be found . The more completely we meet the public's health care needs the more freedom we retain and the less chance there is for a socialistic or communistic environment to be set up in our midst. During the past month at the meeting of the Utah Hospital Association, the problem of utilization as it affects cost was considered. This also is an area that is a matter of concern to physicians. Inasmuch as decisions relating to admissions, length of stay, use of h o spit a 1 facilities, drugs, discharges, etc., all rest in our hands, we are to this extent, directly responsible for utilization. It is to our own interest to study, evaluate, as well as help control this phase of health care, to assure maximum effectiveness of medical facilities compatible with high standards of care at the lowest possible cost. This would have farreaching effect toward protecting our voluntary pre-paid mechanism, not only the Blue P lans but the commercial health carriers as well. Inasmuch as many aspects of this problem are specifically of a medical nature, professional knowledge and background are required to appraise and exercise some degree of control of utilization. Of necessity this falls on the doctors and we have a responsibility to participate. The steady rise of medical cost, the increasing concern of the public make it imperative that we do so without delay. To delay is to further sap our strength, to invite more socialism, (Continued on Page 20) HILLHAVEN CONVALESCENT NURSING HOME INSPECTED AND LISTED BY AMERICAN HOSPITAL ASSOCIATION "Nationally Known for Excellence of Patient Care " 35 South 9th East St. - Salt Lake City - DAvis 2-2944 14 UTAH MEDICAL BULLETIN - NOVEMBER, 1962 "" . sign of infection? symbol of therapy! llosone® is better absorbed- It provides high, long-lasting levels of antibacterial activity- two to four times those of other erythromycin preparations-even on a fu II stomach. llosone is bactericidal - It provides bactericidal action against streptococci, pneumococci, and some strains of staphylo· cocci. llosone activity is concentrated-It exerts its greatest activity against the gram-positive organisms- the offending pathogens in most common bacterial infections of the respiratory tract and soft tissues. The usual dosage for infants and for children under twenty-five pounds is 5 mg. per pound every six hours; for children twenty-five to fifty pounds, 125 mg. every six hours. For adults and for ch ildre n over fifty pounds, the usual dosage is 250 mg. every six hours. In more severe or deep-seated infec· lions, these dosages may be doubled. llosone is available in three convenient forms: Pulvules®- 125 and 250 mg .*; Oral Suspens1on- 125 mg.* per 5-cc. teaspoonful; and Drops- 5 mg.* per drop, with dropper calibrated at 25 and 50 mg . ~ Ej This is a remind er advertisement. For adequate information for use, please consult manufacturer's literature. Eli Lilly and Company, Indianapolis 6, Indiana. llosone® (erythromycin estolate, Lilly) *Base equivalent 232603 llosone works to speed recovery UTAH MED'I·CAL BULLETIN - NOVE•MBER, 1962 15 to alleviate cardiac anxiety IN BRIEF\Vislaril, hydroxyzino pamoato (oral) and hydroxyzlno hydrochlorido (parontoral), Is a ealmlng agont unre. lated chemically to phenothiazine, reserpine, or meprobamate. Vistaril has antinauseant and antiemetic properties, and has been shown to lower narcotic requirements by as much as 50 per cent when administered preoperatively and prepartum. Its usefulness in relieving anxiety, apprehension, or fear- occurring alone or in association with physical disease-is enhanced by the fact that no toxicity has been reported from its use under proper tech· niques at recommended dosages. and by its remarkable record of freedom from serious side effects. Drowsiness, usually transitory or correctable by dosage reduction, may occur in some instances. Dryness of mouth may occur with higher doses. Its potentiating action should be taken into account when Vistaril is used in conjunc· tion with anticoagulants and central nervous system depressants. Intravenous injection of Vistaril should not exceed a rate of 1 cc. per minute or 100 mg. per dose. For complete information on Vistaril dosage. administration. and precautions, consult package insert before using. More detailed professional information available on request. Sclence 16 for the w01ld's wefl-bein g• ~ PFIZER LABORATORIES Divisiol\ Chas. Pfizer & Co.• Inc. New York 17, New York UTAH MED1'CAL BULLETIN - NOVEMBER, 1962 ... ., Vistarir is a specific choice In addition to the calming action you expect from an effective tranquil· izer, Vistaril provides extra benefits specifically for the cardiac patient. 0 unsurpassed record of safety o mild sedative action o reported beneficial effects in arrhythmias of acute on set and short duration o compatibility with digitalis o excellent control of nausea and vomiting o reduction of analgesic and narcotic dosage on parenteral administration VISTARIL Capsules and Oral Suspension, hydroxyzine pamoate/ Parenteral Solution, hydroxyzine hydrochloride UTA H MEDI'CAL BULLETIN - NOVEMBER, 1962 17 What Is a House Call Worth? . . . Reporter Gets Facts on Home Service Charges in Many Fields and Comes Up With Some Interesting Figures Utah's doctors will be interested in reading and remembering the facts presented in an article by Ned Stout of the Columbus (Ohio) Dispatch, in which Stout points out that many other fees for services rendered are higher than that of the physician, so they can cite the article to the next person who charges that the average fees of most physicians are excessive. "It's getting to the point that it may cost you more to get the kitchen stove repaired than to have your physician stop by to save your life," comments Stout. He then makes these comparisons : Comparisons Made "Doctors, who make house calls in the Columbus area at fees from $5 to $8, have been known to reflect sadly on their plus nine years of schooling after getting a bill for a midnight plumbing call. "Home service is big business in Columbus, as everywhere, with an estimated 200,000 service c a II s made yearly in Franklin Countyexclusive of telephone service calls. Not Including Parts "Independent dealer and factory service shops use several methods of arriving at their service call charge, 'not including parts.' "One independent stove repair specialist charges service call fees ranging from $6 to $10, depending on the location of the customer's home. "Another has a call-charge of $3.25 plus a half-hour rate of $3.25, while a third charges a minimum $5 for the first hour of work. "Plumbers generally charge from $6 to $6.50 per, in the normal working day, with a 'time and a 18 half' fee for work done after 5 P.M. ) TV Service Calls High "An independent television repair operation reported a minimum service charge of $4.50, but claimed most other repairmen 'are considerably higher.' "A factory service television repair operation sets a $6.95 service rate and adds a $2.50 charge if the set must be cleaned. "Service calls on other home appliances - washers, dryers, ironers, water heaters, air conditioners, freezers, refrigerators, etc. have various rates. "One company has a minimum $6.50 service charge for the first hour, dropping to $6 for any additional hour. "Another firm states a $4.50 'arrival-at-your -door' charge plus a $6.40 labor fee. A third sets its rate at '$4.50 for the call plus $1.80 per 15 minutes for labor.' "One of the larger appliance repair operations found an average of 6.5 to 7 television home repairs completed daily per man and an average 5.5 to 6 home repairs on other appliances completed per serviceman. Travel Time Involved '1 "E. M. Steger, manager of General Electric's factory service operation locally, commented, "Those of us in the business know that the charges seem high to many customers, but there are a number of factors involved which aren't apparent at first. " 'We've found that actually our workers are in the home only 53 per cent of their day. The rest of the time is involved in travel. UTAH MEDICAL BULLETIN- NOVEMBER, 1962 .... HIGH-LEVEL VITAMIN SUPPORT FOR SEVERE B AND C DEFICIENCIES TDERA·COMBEX® KAPSEALSID A high-potency formula, THERA-COMBEX helps meet the increased need forB complex and vitamin C during periods of physiologic stress . . . aids in the correction of serious vitamin Band C defic iencies. Each Kapseal contai ns: Vi tamin 81 (thiamine) mononitrate, 25 mg. • Vitam in 82 (G) (riboflavin), 15 mg. · Vitamin 812 (cryst al line), 5 meg. • Ni cot inami de, 100 mg. • Fol ic Acid, 0.1 mg. • Vitamin 8 6 (pyridoxine hydrochloride), 1 mg.· d/- Panthenol, 20 mg.· Vitamin C (ascorbic acid), 150 mg.· Taka-Diastase ;;> (Aspergillus oryzae enzymes), 2lf2 gr. Bottles of 100 and 1,000. Also available: COMB EX& Kapseals-f or prevention and correction of 8 complex deficiencies; COMB EX wi th Vitamin C Kapsea ls- f or co mb ined 8 complex an d vit amin C def icie ncies; TAKA-COMBEX® Kapseals- for prevention of vitam in 8 complex and vitamin C defic iencies particularly where aid is requi red in digestion of starch y food; TAKA.. COMB EX El ixir-for conve nie nce of administration in the young and elderly. PARKE. oAv, . . coMPANY. o""" "'M'"'••• I PARKE-DAVI~ I 'I ~06 z " 'The labor cost, about $3 per h?ur, ~or the seFviceman, backing h1m w1th a radw communications system, expensive mobile equipment and a substantial inventory of parts needed in appliance repair, results in a very small margin of profit. Less Efficient Ma.n " 'Sometimes we suggest, when we get complaints of the 'he was only here 45 minutes and my bill was $10,' variety that the next time we could send a less efficient man to stay two hours for the same charge. That usually takes care of it.' " COUNTY PRES.-Cont. from Page 14 and to encourage communism. To be safe from either or both, and if we would be the master of our own destiny, we J?USt be free, s~ron~ a_nd. self rehant, yet exercise d1sc1phne and restraint in the interest of the common good. This is the month of Thanksgiving, when we acknowledge to the Giver of all blessings our gratefulness and thanks for all that we enjoy. This is most appropriate especially at a time when we ar~ so much in need of strength, courage, and inspiration to meet the challen~e of a Godless society, competmg relentlessly against us in a shrinking world where earthshaking events occur at such a tempo there is no time for hesitancy or false moves. May each of us, as we offer our thanks, remember the priceless heritage that is ours and supplicate Him who gives {ls all for the courage and strength to do that which is right and to help us build a world where men can live in peace and walk in the light of freedom and justice. PROGRAM TO STUDY BALANCE IN EAR A research program concerning balance in the ear which was begun in Sweden will be continued at the University of Utah College of Medicine in the Laboratory of Clinical Biology and the Division of Otorhinolaryngology of the Department of Surgery. The research will be related to a pilot study carried out at the University of Lund in Sweden. Dr. David A. Dolowitz, Associate Professor of Surgery and Chairman of the Division of Otorhinolaryngology, attended the Swedish university from July 1, 1961 to June 30, 1962. While in Sweden, Dr. Dolowitz became familiar with a technique for electronystagmography which involves measuring movements of the eye in response to caloric stimuli of disease. This technique is important because it provides an exact physical measurement of the balance organ. With Swedish researchers, Dr. Dolowitz also developed a technique to measure spinal response of the same stimulus. Called "laterotorsion," an apparatus was developed to take an exact measurement of this reflex. OVERWEIGHT? THE ANOREXIC THAT'S DIFFERENT: NO REPORTED CONTRAINDICATIONS TENUATE® GARNER B. MEADS, President 20 UTAH MEDICAL BULLETIN - NOVEMBER, 1962 ! .your patient becomes with . ltlJ/flCOpal effective tranquilizer and skeletal muscle relaxant THE TRUE "TRANQUILAXANT " FOR A RELAXED MIND IN A RELAXED BODY • quiets the anxiety of the tense patient • eases tense muscles, relaxes the patient • reported side effects are rare and usually mild. AVAILABLE: 200 mg. Caplets• (green colored, scored), 100 mg. Caplets (peach colored, scored), each in bottles of 100. DOSAGE: Adults, I Caplet (200 mg.) three or four times daily; children (5 to 12 years), kom 50 to I 00 mg. three or four times daily. Before prescribing, consult Winthrop's literature for addi· tional information about dosage, possible side effects and contraindications. cw~ UTAH MEDIICAL BULLETIN - LABORATORIES, New NOVEMBER, 1962 York 18, N. v. 21 WOMAN'S AUXILIARY On October 18th and 19th a Western Region meeting of the American Medical Association Education a n d Research Foundation was held at the Hotel Utah in Mrs. Roy A. Darke Salt Lake City, U t a h. Thirteen Western States were represented by their State President and their State AMA-ERF Chairman. Mrs. Erie E. Wilkinson of Nashville, Tennessee, was the chairman of the meeting and Mrs. Martin Goodwin of Clovis, New Mexico, was the co-chairman. This was a very stimulating and informative meeting and it brought into focus the great need for funds to continue and enlarge the AMA-ERF Program. This is an exciting program and one in which every Doctor's wife can help. In the past ten years the Woman's Auxiliary has contributed over one million dollars to medical schools through this program. This represents untold hours invested in the planning and carrying out of projects. However the need continues to be greater than the amount which we obtain. A medical student's tuition pays only 18.2 % of his medical education. The Auxiliary this year is seeking funds to support two foundation programs: (1) Funds for Medical Schools and ( 2) Loan Guarantee Fund, providing assistance in financing loans to medical students, interns and residents. This program provides for us the means of asserting our faith in the free enterprise system of the private practice of medicine as our husbands have thus far practiced it. Some of the important advan22 tages of the AMA-ERF Loan Guarantee Plan are : a. It creates the opportunity one-half the cost of a medical education for any student in guod standing. The total number of students who can be assisted is limited only by the size of the guarantee fund . b. It assists financing of medical education without subsidy of any kind . c. It provides loans at low cost. d. The length of t i m e over which the student in medical education can borrovv is designed to fit the period of time required to complete his educational plans. Furthermore the repayment may be spread over a subsequent tenyear period so that installments are of reasonable size even for a maximum loan. e. Contributions to the Guarantee Fund multiply to provide 12% times their amount in student credit. This is a magic dollar. Give one dollar and a student is able to borrow $12.50. Every dollar raised for AMAERF goes directly to medical education. All costs of administration are met by the American Medical Association. Also, money contributed to this program is tax-deductible. $1,377.00 was contributed last year by the Woman's Auxiliary to the Utah State Medical Association and I hope we will be able to increase the amount this year. Every Auxiliary member should be a ware of the need and every County should promote at least one fund raising project. If our non-medical friends know about our various projects, they too can invest through us in the medical future. Let us all participate. MRS. ROY A. DARKE. President UTAH MEDI'CAL BULLETIN - NOVEMBER, 1962 . ~l Whatever happened } · :;:% \ to handker£hiefs? Remember when handkerchiefs were used for stuffy or runny noses? That was before Naldecon. Naldecon lets your head-cold patient breathe the way he should. Through the nose. Honest relief that lasts up to 8 hours with one sustained-action tablet. (When you need it, even half a tablet retains the sustained-action feature.) The counterbalance between two antihistamines and two decongestants* usually gives excellent results-seldom causes overstimulation or sedation. Keep handkerchiefs for showing. Prescribe Naldecon. •Each tablet contains phenylephrine HCI 10 mg., phenylpropanolamine HCI 40 mg., phenyltoloxamine citrate 15 mg., chlorpheniramine maleate 5 mg.-half in the outer layer, half in the sustained-action core. Each teaspoonful (5 cc.) of Naldecon Syrup contains the equivalent of one-half tablet. NALDECON® long-acting nasal decongestant/ antihistamine BRISTOL LABORATORIES Div. of Bristol-Myers Co. Syracuse, New York ~ ·. · UTAH RESEACHER PICKED FOR HEALTH-TOBACCO PROBE Dr. Walter J. Burdette, professor and head of the University of Utah Medical College Department of Surgery, has been named to the Surgeon General's Advisory Committee on Smoking and Health. IN MEMORIAM HEBER C. HANCOCK (1889- 1962) Dr. Heber Chase Hancock, prominent physician and civic worker died Monday in the Dee Hospital following surgery. He was 73. Dr. Burdette is one of ten members on the newly formed committee and will participate in the committee's first meeting in Washington this month. Dr Hancock had been active in Rotary Club and local and state medical activities. He was a fellow of the American College of Surgeons. After a study of all data available on the relationship of smoking to health, the committee will recommend any action it deems necessary on the subject. A graduate of New York University and Bellevue Colloge of Surgeons, Dr. Hancock also studied in Vienna and Budapest. He was a member of Phi Kappa Alpha and Phi Zeta Phi fraternities. Dr. Hancock was a member of the Utah Hospital board of ethics and had served on the staffs of the Dee and St. Benedict's hospitals. He was a member of the American Medical Association, Utah State Medical Association and was a past president of the Weber County Medical Society. He was a member of the LDS Highland Ward and a high priest in the Mount Ogden Stake. Dr. Hancock was born in Ogden on June 18, 1889, a son of Haratio H. and Lucy Gibbons Hancock. SICKROOM EQUIPMENT 24·HOUR SERVICE- 7 DAYS A WEEK Hospital beds • Whirlpool baths Wheel chairs • Lamps· Walkers Crutches • Traction equipment Refrig. oxygen tents • Bennett pressure breathing units Aspirators SALT LAKE CITY HU 6-7151 ... and sells, too 1811 S. State St. easy budget terms 26 On September 10, 1913, he married Lucille Cozzens in the LDS Salt Lake Temple. Surviving are his widow, three sons, John C. Hancock, Hayward, California; Douglas 0 . Hancock, Manhattan Beach, California; Heber Paul Hancock, Huntington Beach, California; six grandchildren and one brother, John G. Hancock, Ogden . UTAH MEDrCAL BULLETIN - NOVEMBER, 1962 - A Factor BLUE SHIELD GROWS In the first six months of 1962, 75 Blue Shield Plans paid for nearly a half billion dollars worth of professional services that were rendered for those of the 50 million Blue Shield members who needed such medical services in that period. At its present rate of growth, Blue Shield will probably pay physicians more than one billion dollars in 1962. By any measuring stick, Blue Shield is a major factor - probably a dominant factor - in the medical economy today. And it is the one operative factor which is controlled by the profession. The Blue Shield program is the only program that reflects medicine's ideas as to how a prepayment plan should be operated, what services it should cover, on what terms, and with what provisions for reimbursement of the physician's services. While the several hundred commerical accident and health insurance companies, in aggregate, cover more people a n d p a y out more money in the course of a year than do the 75 Blue Shield Plans, it is Blue Shield that has set the pace and established benefit patterns and fee schedules at levels that will substantially protect the patient and reasonably compensate his doctor. What has medicine invested in Blue Shield? For the past 25 years, thousands of dedicated doctors have given lavishly of their time and energy as trustees, directors and committee members in their local Plans. Thousands more sup- Prenatal treatment and threatened abortion _!JceKapS With H eliperidil! Complex 100CA."5VLU EACH CAPSULE CONTAINS : Th iam in HCL .......... .. 1 5 mg. Riboflav in ... ............. 1 0 mg . N ia ci namide ... ......... 50 mg . Calcium Pantothenate ... ... 1 0 mg . Ascorbic Acid ........ 200 mg. Hespe ridin Complex ............ 1 00 mg . PHil liMA C E V TICALS UTAH r,ifEDICAL BULLET! r - NOVEMBER, 1962 27 ported t heir efforts by providing services u nder arrangements which, in the early days represented a substantial contr ibution t o the Blue Shield program as well as to the welfare of their pat ients and the freedom of our medical care system. And this investment is paying off, in benefits vastly more important than even t he billion dollars worth of medical services it is underwriting this year. Medicine's investment in Blue Shield is paying off as a solid demonstration of the ability of physicians - working together with labor, ind ustry and community leaders - to solve the social and economic problems of modern medicine without recourse to government. It's paying off as a strong and versatile instrument by which medicine can continue to guide the economy of medicine in the days ahead. Suites For SOLO or CLINICAL GROUP M.D.'S * CHOICE MURRAY LOCATION IN ULTRA MODERN MEDICAL BUILDING WITH FOUR M.D.' S AND TWO DENT ISTS. PLENTY OF OFF STREET PARKING AND ONLY TEN BLOCKS FROM NEW COTTONWOOD HOSPITAL * 4600 SOUTH STATE STREET PHONE : AM . 6-3517 or AM. 6-1340 .~-el~ OFFICE OUTFITTERS 24 E. Broadway Salt Lake City 11 , Utah Beautiful, Efficient, Complete Enjoy a MODERN MEDICAL OFFICE Tailored to your requirements through our All Inclusive Service INTERIORS D esigned & executed - your office, patienrts waiting area ( camplet ely r en ewed each 5 y ears on our leasing plan) OFFICE PLANNING- For better space utilization EASY FILING and finding - of patients' records SINGLE WRITING accounting syst:ems Speeding up of PATIENT BILLING & collecting LEASING- Planned to your specific requirements Call EM 4-8424 fo r an Office Planning Consultant to b ring specific information. 28 U TAH MED'ICA L BU LLE TI N - NOVE MBE R, 1962 -:, Hospital Growth The new Cottonwood Maternity Hospital at Murray is scheduled to open in the early spring. The 120-bed hospital will replace the present 24-bed facility. PROTECT Your PRACTICE Also, construction is under·w ay for a new 40-bed community hospital in Granger. Meanwhile, William P. Moore, administrator of the South Davis Community Hospital, announced that the hospital in its first year of operation has achieved an 80 per cent occupancy average. Dr. Dewey C. MacKay, chairman of the South Davis board, summed up the first year of the hosiptal's operation as "extremely satisfactory, both in acceptance of the hospital by the public and in the medical services that the hospital renders." Reputation and standing in profession and community ore of the utmost importance to o professional man. Liability suits for alleged malpractice con jeopardize this standing or even threaten your entire medical career. The hospital's Board of Directors recently approved a 40 bed addition, which will double the hospital's capacity. During the year ending Aug. 31, a total of 2,337 patients had been admitted to the hospital for a total of 9,548 patient days. During the year, 493 babies were born in the hospital. The average length of stay for all patients was 4 days. An Aetna Casualty Professional Liability Insurance Policy con safeguard your professional standing and defend you against all damage claims. This policy assures you of thorough investigo· lion, skilled legal defense and payment within the terms of your policy of all claims and judgments against you. NO CLAIMS, HOWEVER, ARE SETTLED WITHOUT YOUR WRITTEN CONSENT. FRACTURE APHORISMS No physician or surgeon con afford to face alone the growing threat of molpractice claims. -Treat every case of injury as a fracture until it is proven to be otherwise. Protect and immobilize all injured patients until the diagnosis is made. "Splint 'em where they lie." -Always use gentleness and care in handling any broken limb. Roughness is inexcusable. -Do not be deceived by the absence of deformity and disability. In many cases of fracture, some ability to use the limb persists. Protect your practice with Aetna Casualty Professional Liability Insurance by contacting Ed. D. Smith and Sons in the Salt Lake City area. (In Ogden, call Eubank Insurance Agencyz. EX 4-7785; in Provo, call Dixon Real t:stote Co., FR 3-2264.) ED D. SMITH & SONS 425 South Main Street Salt Lake City 10, Utah Phone: [phone] UTAH MEDI'CAL BULLETIN- NOVEMBER, 1962 29 UTAH NEWS ITE'M S Ogden Surgical Society Meeting The Ogden S u r g i c a I Society meeting will be held next year on May 22nd, 23rd and 24th, 1963. Fall Seminar Dr. Preston Burnham spoke at the Fall Seminar of Dona Ana County Medical Society on October 27 and 28 in Las Cruces, New Mexico. Subject for October 27 was "Care of Tramatic Injuries of the Hand." Discussion forum. Subject for October 28 was "Care of Infections and Burns of the Hand." Discussion forum. Speaks in Vermont Dr. N. Frederick Hicken spoke on September 19 to the tri-State medical meeting of New Hampshire, Maine and Vermont, which was held at Woodstock, Vermont. Dr. Hicken discussed "The Surgical Abdomen." ~ ~ THE ONLY COMPLETE OPTICAL SERVICE IN UTAH • • • • EYE GLASSES ARTIFICIAL EYES CONTACT LENSES HEARING AIDS YOUR LOCAL GUILD OPTICIAN 4 LOCATIONS THE OPTICAL SHOP 420 BOSTON BUILDING 368 EAST I st SOUTH 1062 EAST 2100 SOUTH 4792 SOUTH STATE STREET 30 " U" Anesthesiology The Division of Postgraduate Medical Education, University of Utah College of Medicine will hold a "Continuation Course" in Anesthesiology January 14-17. The course will be the 8th annual postgraduate program in anesthesiology conducted at the University of Utah. Lectures, demonstrations, panel discussions, question and answer sessions, hospital observation and practical experience will be used in presenting the current practices in anesthesiology. Even though the program is designed for full-time anesthesiologists, it would also be of interest to part-time workers in this field. Tuition is $60.00. Health Officers Honor Utah Director Utah's Director of Public Health, G. D. Carlyle Thompson, M.D., was voted Honorary Life Membership in the Conference of State and Provincial Health Authorities of North America in Miami Beach on October 15, 1962. The Conference, holding its 76th Annual Meeting in the Florida City, is composed of Health Directors from all the states in the Union, from overseas United States territories and from the Provinces of Canada. Dr. Thompson was president of the Conference in 1961 and had served as Vice President in 1960, and as Secretary-Treasurer in 1957-1959. The practice of the organization in the past has been to award honorary life membership to past presidents upon retirement as state, territorial or provincial health directors. Coming within a year of the beginning of Dr. Thompson's service as head of Utah's Health Department, the award is considered a signal and unusual recognition of his leadership in the organization and of his long service and national public health activities. UTAH MEDICAL BULLETIN- NOVEMBER, 1962 Doctor Returns from Military Duty Utah Medical Students Get AMA Help Dr. Lealand Clark just completed one year of active duty with the Utah National Guard and is resuming practice in Salt Lake. He was attached to the U. S. Army Hospital at Ft. Leonard Wood, Missouri, as Head of the Dermatology Section. Sixteen Utah medical students are benefitting from a new medical education loan guarantee program. So far, the students have been loaned $16,700. In addition, 19 interns and residents in Utah hospitals have received $22,200 in loans. "The loan program for medical students, interns and residents is the result of a cooperative effort by American medicine and private enterprise," reported Dr. Fister. The program is administered by the AMA's Education and Research Foundation which has established a fund to guarantee the loan made to the students. On the basis of this fund, the bank will lend up to $1,500 each year to students. More than 3,300 students, interns and residents have borrowed more than $6,000,000 through this fund since it was started. Physicians and others have contributed almost $700,000 to Two Utah Surgeons Gain Honors Two Utah surgeons were inducted as fellows of the American College of Surgeons during a five-day annual clinical congress in October. Doctors Harold P. Hargreaves, Salt Lake City, and Fred S. Endsley, Jr., Provo, were among 1,100 surgeons upon whom the honors were bestowed. The fellowships are awarded to doctors fulfilling "comprehensive requirements for acceptable medical education and advance training as specialists in one or another branches of surgery." (Continued on Page 33) NEW MEDICAL CENTER PROPOSED IN WEST JORDAN Building 80 X 33. Red Brick- Over I 00 car parking. Will renovate to suit tennant. Excellent Location. From West Jordan town west, includes Copperton and Bingham Canyon, South includes South Jordan, Riverton, Bluffdale, Southwest includes Lark and Harriman, North includes Taylorsville. Estimated population 12,000. All pass through West Jordan to Midvale or other points to receive medical attention because of no doctor located here. The only problem a general practitioner would have, would be too many patients. We need several doctors. PLEASE. Projected growth by professional survey is 75"/. in I 0 years. West Jordan Chamber of Commerce. There are 6 subdivisions under construction at the present time with a total amount of homes exceeding 200 to be completed within 5 years in West Jordan alone. Also there is a permanent type trailer subdivision when completed in four years will house over 600 families. Most of these people are retired or professional people working with Hercules Powder Company. We have U and I Sugar factory in West Jordan and Kennecott Copper Mines in Bingham Canyon. There is one drug store, West Jordan Pharmacy. We have one dentist, Dr. Douglas A. Teeples, a young man who started practice 3 years ago. He now has such a flourishing business, he requires advance appointments. Dr. Teeples would be very happy to talk to any interested parties. For further information please contact: MR. NICK M. MACRIS 1550 WEST 7800 SOUTH, WEST JORDAN, UTAH PHONE AM. 5-4139 UTAH MEDICAL BULLETIN - NOVEMBER, 1962 31 450 MEDICAL ASSISTANTS MEET IN DETROIT, DISCUSS CERTIFICATION, SELF-IMPROVEMENT Elaine Newton, Ogdtn, medical assistant, tells Dr. George M. Fister, president of the American Medical Assn., about the important activities of the American Association of Medical Assistants during convention in Detroit. Nearly 450 medical assistants tion examination next year. attended the American Association Present plans call for offering of Medical Assistants sixth nation- the examination two days prior al convention Sept. 26-30 in De- to the 1963 convention simultaneously in three locations - Kansas, troit. Certification and self-improve- California and Miami Beach, the ment programs as well as a plan convention city. "This will give girls unable to to divide the association into six districts, electing one trustee from attend the convention an opportueach area, were among the major nity to take the examination in a actions taken at the convention. location convenient to their home AAMA's educational s e 1 f - i m- towns," said Mary Kinn, chairprovement program leading to cer- man of the Certifying Board. tification for women employed as Charters were granted to four medical secretaries and assistants new constituent chapters - Ariin physicians' offices got off to a zona, Kentucky, New Mexico and running start. The new Certifying the District of Columbia - bringBoard, made up of physicians, edu- ing the total number affiliated with cators and medical assistants, met · AAMA to 34 and the total numfor the first time to map tentative ber of members to m o r e than plans for presenting the certifica- 10,000. 32 UTAH MEDrCAL BULLETIN- NOVEMBER, 1962 -. -. NEWS ITEMS-Cont. From Page 31 Ex-Ogdenite Given Grant in Pediatrics make the loan guarantee fund possible. Dr. Edgar S. Brichta, former intern at St. Benedict's Hospital, is one of 20 doctors in the nation to be awarded a Wyeth Laboratories residency in pediatrics. The fellowship provides a two-year, $4,800 grant to Dr. Brichta which will enable him to devote advanced study in the care and treatment of children. Seminar Held At Utah Valley The first seminar under the Dr. Garn Clark lectureship was conducted at the Utah Valley Hospital last month. Doctors from the central Utah area were invited to participate. Speakers included Dr. Junior Abildskov, native of Salem, Utah County, who is now associate professor of medicine and chief of the cardiovascular division at Syracuse University. In Utah on other medical business, he addressed the Provo seminar on "The Physiologic Basis of ElectTocaTdiogmphic Changes in CoTona1·y Diseases." Dr. Gerald T. Perkoff, associate professor of medicine at the University of Utah, spoke on "Diagnosis of Hyp eTglycemic and Hypoglycemic States." Dr. Ralph Richards, associate professor of surgery at the University of Utah spoke on "Diagnosis of A..:ute Abdominal EmeTgencies ." The seminar was staged with revenue from a fund set up years ago by the late, Dr. Garn Clark, prominent Provo physician and surgeon, for two purposes: 1. Obtaining equipment for the pediatric department of the Utah Valley Hospital, and 2. Furtherance of post-graduate study and continuance of medical education for doctors of the area. The fund specifies that the principal remain untouched and the income, or interest, be used for the purposes outlined. The income amounts to several thousand dollars a year, according to Dr. Glenn Allen, Provo, representative of the Clark family, who administers the fund. New Dean Speaks Dr. Kenneth B. Castleton, newly appointed Dean o£ the University of Utah College of Medicine addressed a dinner meeting of Utah medical alumni in the Los Angeles area on Tuesday, October 20, at the Ambassador Hotel in Los Angeles. Some 100 alumni, including wives attended. Dr. Castleton was appointed to the Utah Deanship October 1, 1962. A TOTAL ELECl"RI{. GOLD MEDALLION HOME A wonderful new way to live UTAH POWER & LIGHT CO. ~s. lluy ~from UTAH MEDICAL BULLETIN- NOVEMBER, 1962 your dealer ~ 33 Problem for L. A . Meeting HOUSE OFFICER FUND BACKED A recommendation that fees collected from paying hospital patients for assigned care performed by members of the house staff be used exclusively in support of intern and resident training programs including salaries for house officers - will be considered by the American Medical Association House of Delegates. The proposal, a part of a special report on COMPENSATION OF I N T E R N S AND RESIDENTS prepared by the A.M.A.'s Council on Medical Education and Hospitals and Council on Medical Service, will be submitted to the House during the A.M.A. Clinical Meeting Nov. 25-28 at Los Angeles. The House had asked that the study be done. LOW SALARIES: The Council's report points out that "While . . . the house officer undertakes graduate training primarily for educational purposes, this does not alter the fact that (he) is assigned the professional responsibilities which he discharges and for which he receives a salary inappropriately low." Urging the medical profession to make "an objective reappraisal of the true value of house officer service," the report recommends that when the house staff has an assigned role in the care of paying patients, all applicable fees should be collected and deposited in a special fund, administered by a committee of the attending staff. OFFICE SPACE AVAILABLE FOR GENERAL PRACTITIONER Inquire . . . KOLOS DRUG STORE 3954 Highland Drive Phone IN. 6-6743 34 The councils recommend that this fund not be used to support general opera:tions of a hospital, medical school, university, or welfare department, but be used exclusively to support intern and resident training programs. The councils advise that compensation from the fund for any individual house officer should not be related to the fees collected for his services. NO NATIONAL SCALE: In the report, the councils agree "that a specific minimum salary level cannot be set aside for nationwide application in all hospitals." However, they urge that 'remuneration in all hospitals ... be sufficient to assure that the beginning house officer will be able to support himself and his family without the necessity of resorting to outside help or work." The report suggests that costof-living estimates could be used as guides by hospitals, and further recommends that "As house officers progress through their training, the increase in their professional responsibilities should be recognized" through annual salary increases. FIVE FACTORS: The councils cite five factors which "have caused widespread concern" about the need for changing the traditional attitude toward compensation of the house staff: Competition for t a I en t by other professional and scientific fields. The increasing cost in time and money for a medical education. The increasing cost of living for the young MD and his family. The changing economic status of the hospital patient population. The increasing cost of hospitalization to the patient. The complete text of the special UTAH MEDICAL BULLETIN- NOVEMBER, 1962 report appears in the October 27 edition of the J o u r n a l of the A.M.A. HOSPITAL CARE COST SURVEY ANNOUNCED A nation-wide study of the hospitalized patient and the cost of his care is being made by AMA's Commission on the Cost of Medical Care. Announcement of the hospital study was made by David B. Allman, M.D., Commission chairman, following the Commission's Oct. 19-21 meeting in Chicago. 15-Yea·r Trend : The study will determine trends in hospital use over the past 15 years as reflected in changes in the characteristics of patients and in patterns and costs of care for specific illnesses. Data for the Commission project is being collected by the U. of Michigan's Bureau of Hospital Administration. Dr. Allman emphasized that the hospital study is only one of four major projects that the Commission has undertaken. He said : "We also have a project which will study the significant medical advances of the past 25 years and analyze their economic and social implications. Another project involves a study of the ways in which medicine has organized professional review programs to secure the wisest possible use of health insurance and prepayment plans. A fourth project is a study of the comparative cost of medical care under group and solo practice." Final Report: The Commission will present its final report, which will include details on these projects, at AMA's 1963 Clinical Meeting. The hospital study will be based on a nation-wide sample of patients discharged from short-term general hospitals during the years, 1946, 19'54, and 1961. A number UTAH MEDfJ:CAL BULLETIN - of illnesses will be selected for intensive study in order to demonstrate the manner in which patterns of hospital care have changed for specific diagnoses. The project on medical advances will develop a listing and brief description of the significant medical advances over the past 25 years. It will also present a detailed analysis of approximately 10 medical advances to determine whether they can also be considered significant from an economic point of view. The third part of this study will focus on the total contribution of changes in medical science and technology to the economy. Surveys Completed: Dr. Allman reported that 12 field surveys had already been completed on the study of professional review committees. "We hope," he said, "that the information collected on the tech- ~ravel Center Authorized Domestic International Agency • Trained Specialists in Travel • We want to be "your" travel agent • BEEHIVE BANK BUILDING 67 South State Street Salt Lake City, Utah NOVE'MBER, 1962 Phone DA 8-1 551 35 niques used by the various groups to secure the wisest possible use of prepayment and health insurance plans will be of assistance to other medical societies interested in similar programs." NEW HEALTH CARE BILL ADOPTED BY WAYS AND MEANS COMMITTEE In a surprise move the House Ways and Means Committee voted unanimously to adopt a bill providing tax incentives to employers who would include health care benefits in their employee retirement programs. The bill, H.R. 10117, authored by Congressman Thomas B. Curtis of Missouri, himself a member of the tax writing Committee, was introduced as an alternative to the King Bill last February. The fact that it received unanimous endorsement by the Ways and Means Committee has been interpreted to imply wide spread support in the House of Representatives. Under existing law, employing companies may claim a tax deduction on all money contributed towal·d employee retiriment plans. However, if medical expenses are included, the entire tax deduction is lost to the employer. Because of the tax penalty under current law, industry has avoided adding medical expenses to its retirement plans. Approximately 15 million employees are currently covered by pension funds valued at approximately $50 billion. As adopted by DOCTOR'S OFFICE 850 EAST THIRD SOUTH , CITY AVAILABLE TENANT MAY SUB-LEASE WITH O PTION TO BUY. INCLUDES REC EPTI ON ROO M, OFFICE AND 4 TREATMENT ROO MS. ONE ROOM EQUI PPED WITH X-RAY. For Furth er Information CALL ELgin 9 -4820 36 the Ways and Means Committee, H.R. 10117 would permit medical benefits for retirees, their spouses and dependents to be added to retirement programs without a tax penalty to the employer. At this writing no tentative target date has been set for the adjournment of the 87th Congress. The middle of September has been suggested as the most likely time. Should this be the case, Congress will have to move rapidly in order for this bill to be enacted prior to adjournment. Should this bell not be enacted this year, it must then be reintroduced and sent to the Committee on Ways and Means for approval or rejection next year. Passage of this bill would go a long way toward taking the steam out of Administration insistence of passage of Social Security based health care legislation. EXEC. SECRETARY-Cont. from Page 6 However, in the meantime it is the feeling of your officers that the Association should back revisions of state statutes to permit physicians to incorporate for the purpose of obtaining the same tax advantages as other segment of our society. Generally lawyers feel this way and are preparing a bill which is scheduled to be introduced in the next session of the Utah Legislature. Best opinion is that the medical profession should not sponsor such a law, but should back the lawyers in their efforts to enact this legislation. Our congratulations go out to Doctors Stanford Rees of Gunnison and George Aiken of Kanab, who were successful in their campaigns for election to the Utah Legislature. Dr. Aiken, you will recall, has served several terms in the Utah House of Representatives. Dr . Rees will be serving his first term in the Utah Senate. HAROLD BOWMAN Executive Secretary UTAH MEDICAL BULLET I - NOVEMBER, 1962 . , or as a plant turns leaf and bloom away , . from· the dark and toward the sunlight, so will a wise man grow in the direction of enlightenment. r a pidly now than at any it s hi s t o ry. Blue Shield eep pac e · with c hanging concepts care if it is to continue to perits mission effectively. In this condoctor does not like what Blue is doi ng, it b e h o oves him to join that governs the Plan in his corn. Those who constantly complain deserve no consideration whatsoever." BLUE SHIELD® by Doctor, You Prescribe ... Let Us Fulfill We offer you the home use facility of a complete line of medical appliances and hospital equipment . . . for your patients' added comfort, and for easier nursing care. All can be rented or purchased at moderate rates for as long or short a time as necessary. You'll appreciate our trained male and female fitters of all surgical appliances. PLENTY OF FREE PARKING TOO, at the "house of friendly service. " Telephone Elgin 5-7459 SURGICAL and HOSPITAL EQUIPMENT and SUPPLIES SICKROOM NEEDS Sales and Rentals 48 South Fourth East • Salt Lake City, Utah " Since I 924 , Your House of Friendly Service " • ·