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Show xx R&OP*T OF THE CO~~MISSIONEOEF INDIAN AFFB~RB. This ,&fl important branch of the service is with011 competcllt supervision. There is no professional head. The supervision of the medical service should require the entire time of a competent expert. Nan7 of the men sow eaeving as physicians are men of high personal character, of good professional attainment and experience, and are faithful in the performance of their duties; others I have been obliged to discharge for immorality, neglect of duty, incompetency,' or unpro-fessional conduct, and especial care has b3en taken to fill their places with those who are trustworthy and competent. With the hope of securing a more satisfactory order of things, I wish to point out some defects inherent to the plan now pursued in supplying the Indians with medical service. Physicians are appointed without any examination. They are re-quired to produce a diploma from some reputable medical school and to submit testimonials m to moral character and correot habite, and pet their appointments are not guarded with that care which the nature of the services required of them demands. No one should be appointed except upon an examination as to his health, his profesaional attain- ,men&, and his moral qualifications. In addition to his qnali6ca-tions for general practice, his ability to give instruction on hygienic ,subjects to school pupils should be tested, and he should possess such scientific and practical knowledge as will prepare him to have an over-sight of the entire sanitary conditions of a whole tribe. In short, he shonld be capable of being a health offlcer as well as a physician and surgeon. The work of the ph~sicians is without supervision. The average agent, inspector, and special agent has no expert knowledge of medical practice, and the Indiana areignorant and helpless to make complaint either of neglect or malpractice. The physician at an Indian agency, far removed from civilization, having the care of a barbarous people beset with the formidable difficulties of his anomalous situation, having no professional associations and with no possibility of gaining either in-crease of income or reputation by devotion to duty, is under % very strong temptation to slight his work. Intelligent, faithful inspection by a medica.1 expert, and official supervision of his labors, with a recog. nition of good service when performed, would necessarily secure better results than are now reached. The duties devolving upon the physician are very severe. He has the work of a surgeon anti physician, with the aadtary oversight of people with whose language he is nnfamiliaiand who areignorant, superstitious, and prodisposed to a great variety of diseases. He must be his own apothecary; he usually has no hospital and no nurses, and his patients have few of the most ordinary colnforts . of home, and little, if any, intelligent care in the preparation of their food or the administering of prescribed medicind. Xe is alone and has , to cope w:$b accident. and d i s e a w~ i thoutcmnsnltation, with few book% - and but few surgical instrumente. |
