History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: March, 1953 Vancouver Medical Association Mar 31, 1953

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 THE
BfULLETI
OF . J||'
The Vancouver Medical Association
EDITOR
dr. j. h. MacDermot
EDITORIAL BOARD
DR. D. E. H. CLEVELAND DR. J. H. B. GRANT
DR. H. A. DesBRISAY DR. J. L. McMILLAN
Publisher and Advertising Manager
 W~. E. G. MACDONALD	
VOLUME XXIX. MARCH, 1953
Dr. D. S. Munroe
Vice-President
Dr. J. C. Grimson
Past President
Dr. J. H. Black
Hon. Secretary
OFFICERS 1952-53
Dr. E. C. McCoy
President
Db. George Langley
Hon. Treasurer
Additional Members of Executive:
Dr. G. R. F. Elliot Dr. F. S. Hobbs
TRUSTEES
Dr. G. H. Clement Dr. A. C. Frost Dr. Murray Blair
Auditors: Messrs. Plommer, Whiting & Co.
SECTIONS
Eye, Ear, Nose and Throat
Dr. J. A. Irving.^. Chairman Dr. W. M. G. Wilson Secretary
Paediatric
Dr. J. H. B. Grant Chairman Dr.»A. F. Hardyment Secretary
Orthopaedic and Traumatic Surgery
Dr. A. S. McConkey. Chairman Dr. W. H. Fahrni Secretary
Neurology and Psychiatry
Dr. B.  Bryson Chairman Dr. A. J. Warren Secretary
Radiology
Dr. J. S. Madill Chairman      Dr. H. Brooke Secretary
STANDING COMMITTEES
Library
Dr. J. 1i. Parnell, Chairman; Dr. D. W. Moffat, Secretary;
Dr. A. F. Hardyment ; Dr. W. F. Bie ; Dr. R. J. Cowan ; Dr. C. E. G. Gould
Go-ordination of Medical Meetings  Committee
Dr. W. M. G. Wilson Chairman Dr. B. T. Shallard Secretary
Summer School
Dr. S. L. Williams, Chairman; Dr. J. A. Elliot, Secretary;
Dr. J. A. Irvine ; Dr. E. A. Jones ; Dr. Max Frost ; Dr. E. F. Word
Medical Economics
Dr. E. A. Jones, Chairman; Dr. G. H. Clement, Dr. W. Fowler,
Dr. F. W. Hurlburt, Dr. R. Langston, Dr. Robert Stanley, Dr. F. B. Thomson
Credentials
Dr. W. J. Dorrance, Dr. Henry Scott, Dr. J. C. Grimson
V.O.N. Advisory Committee
Dr. Isabel Day, Dr. D. M. Whitelaw, Dr. R. Whitman
Representative to the Vancouver Board of Trade: Dr. D. S. Munroe
Representative to the Greater Vancouver Health League: Dr. W. H. Cockcroft
Published  monthly  at  Vancouver,  Canada.    Authorized  as  second  class  mail,  Post  Office Department,
Ottawa, Ont.
Page 239
V $m&£
«
for simpler, more-effective
"acid-douche" therapy
*
Trade-Mark Registered
Acv-;&
*
Ortho
ORTHO PHARMACEUTICAL CORPORATION
(Canada) Limited • Toronto, Ont.
Page 240 VANCOUVER MEDICAL ASSOCIATION
PROGRAMME FOR THE FIFTY-THIRD ANNUAL SESSION
Founded 1898; Incorporated 1906
VANCOUVER  GENERAL  HOSPITAL
Regular Weekly Fixtures in the Lecture Hall
Monday, 8:00 a.m.—Orthopaedic Clinic.
Monday, 12:15 p.m.—Surgical Clinic.
Tuesday—9:00 a.m.—Obstetrics and Gynaecology Conference.
Wednesday, 9:00 a.m.—Clinicopathological Conference.
Thursday* 9:00 a.m.—Medical Clinic.
12:00 noon—Clinicopathological Conference on Newborns.
Friday, 9:00 a.m.—Paediatric Clinic.
Saturday, 9:00 a.m.—Neurosurgery Clinic.
ST. PAUL'S  HOSPITAL
Regular Weekly Fixtures
2nd Monday of each month—2 p.m. Tumour Clinic
Tuesday—9-10 a.m . Paediatric Conference
Wednesday—9-10 a.m Medical Clinic
Wednesday—11-12 a.m. Obstetrics and Gynaecology Clinic
Alternate Wednesdays—12 noon Orthopaedic Clinic
Alernate Thursdays—11 a.m. Pathological Conference (Specimens and Discussion)
Friday—8  a.m; Clinico-Pathological Conference
(Alternating with Surgery)
Alternate Fridays—8 a.m Surgical Conference
Friday—9 a.m  Dr. Appleby's Surgery Clinic
Friday—11 a.m. - Interesting Films Shown in X-ray Department
SHAUGHNESSY  HOSPITAL
Regular Weekly Fixtures
Tuesday, 8:30 a.m.—Dermatology. Monday, 11:00 a.m.—Psychiatry.
Wednesday, 10:45 a.m.—General Medicine. Friday, 8:30 a.m.—Chest Conference.
Wednesday, 12:30 p.m.—Pathology. Friday, 1:15 p.m.—Surgery.
BRITISH  COLUMBIA  CANCER  INSTITUTE
2656 Heather Street
Vancouver, British Columbia
SCHEDULE OF CLINICS AND MEETINGS—1953
Every Monday—9:00 a.m.-10:00 a.m Ear, Nose and Throat Clinic
11:45-12:45 p.m. | . . Therapy Conference
Every Tuesday—11:00 a.m.-12:00 p.m M. Clinical Meeting
12:00 noon-1:00 p.m Therapy Conference
Every Wednesday—11:45  a.m.-12:45  p.m Ji Therapy Conference
Every Thursday—11:45 a.m.-12:45 p.m Therapy Conference
Every Friday—9:00 a.m.-10:00 a.m it Lymphoma Clinic
(during February)
10:15 a.m.-ll:15 a.m.  (as of March 6) Lymphoma Clirfic
11:45 a.m.-12:45 p.m Therapy Conference
Page 243 Announcing a New and
Specific Narcotic Antagonist
potent and
well-tolerated
Effect ofNAixmE on
respiratory depression caused by
57 milligrams of morphine.1
Nalline is a specific antidote for poisoning following accidental
overdosage with morphine and its derivatives, as well as meperidine
and methadone.
This new product, the Merck brand of AT-Allylnormorphine, rapidly
reverses respiratory depression. The respiratory minute volume
promptly increases and the rate increases two- or threefold.
A recent study2 of 270 parturient women indicates that Nalline may
be of value in obstetrics. Onset of breathing occurred significantly
sooner in infants from mothers (sedated with meperidine) who were
given Nalline 10 minutes prior to delivery.
Literature available
iEckenhoff, J. E., Elder, J. D., and King, B. D.,
Am. J.Med. Scs. 223:191,February 1952.2Ecken-
hoff, J. E., Hoffman, G. L., and Dripps, R. D.,
Annual Meeting of the American Society of Anesthesiologists, Washington, D. C, Nov. 8, 1951.
SUPPLIED:
Solution of Nalline Hydrochloride
in 2-cc. ampuls containing 10 mg.
of active  ingredient, 5  mg./cc.
Nalline comes within the scope of the Opium and
Narcotic Drug Act and regulations made thereunder.
NALLINE
TRADE-MARK
(1V-ALLYLNORMORPHINE HYDROCHLORIDE, Merck)
Research and Production
for the Nation's Health
Page 244
MERCK & CO. Limp
Manufacturing Chemists
MONTREAL • TORONTO • VANCOUVER • VAttlt VANCOUVER HEALTH DEPARTMENT
Statistics—January, 1953
Total Population  (estimated)
Total deaths  (by occurrence)  	
Deaths, residents only	
3irth Registrations—residents and non-residents  (includes late registrations)
rlale   	
-ema
le
Infant Mortality--^-residents only
Deaths under 1 year of age	
Death rate per 1000 live births __.
Stillbirths  (not included in above item)
CASES OF COMMUNICABLE DISEASES REPORTED IN THE CITY
January, 1953 January, 1952
Cases Deaths Cases Deaths
Scarlet Fever	
Diphtheria	
Diphtheria   Carriers	
thicken  Pox	
ifeasules	
lubella	
vlumps	
Whooping Cough	
Typhoid Fever	
Typhoid Fever Carriers	
pndulant Fever	
Poliomyelitis	
Tuberculosis	
Erysipelas	
Meningitis   (meningococcic)
nfectuous  Jaundice	
Salmonellosis	
•almonellosis   Carriers	
Dysentery !	
[Dysentery Carriers	
[Tteanus	
Syphilis	
gonorrhoea	
lancer (reportable resident)
flDount peasant TUnoertaking Co. Xtb.
KINGSWAY at lUh AVE.
KINDLINESS
UNDERSTANDING
10
1
15
159
—
135
97
63
54
Telephone: EMerald 2161
VANCOUVER, B.C.
DEPENDABILITY
Page 245 Now combinedi
i
BICI     I It —the new penicillin compound
SulfOSG —sulfadiazine, sulfamerazine
and sulfamethazine
/
or
Broad antimicrobial spectrum
High antibacterial potency
Abundant experimental and clinical evidence proves that a
combination of penicillin and sulfonamides has greater effectiveness and a broader antibacterial spectrum than either used alone.
Reports demonstrate not only the effectiveness of both Bicillin
and Sulfose, but also the relatively low incidence of untoward
reactions.
In Bicillin-Sulfas, the physician has at his command a unique
preparation, incorporating both Bicillin—the new penicillin
compound—and Sulfose—the sulfonamide combination recognized as unsurpassed for effectiveness and safety.
Oral Suspension—Each teaspoonful (5 cc.) contains: Bicillin,
150,000 units, sulfadiazine, sulfamerazine and sulfamethazine,
0.167 Gm. each, (.5 gm. total sulfonamides) as a palatable suspension in a special alumina base.
Tablets—Each tablet is equivalent to 1 teaspoonful (5 cc.) of
Oral Suspension Bicillin-Sulfas.
Suspension & Tablets
Bicillin-Sulfas      i
BENZETHACIL AND TRIPLE SULFONAMIDES
Dibenzylethylenediamine Dipenicillin  C and Triple Sulfonamides
References available
Supplied: Suspension: Bottles of 3/1. ozs.
Tablets: Bottles of 18
W*\
»»mi iin JiMnii
JOHN WYETH &  BROTHER  (CANADA)   LIMITED
WALKERVILLE - ONTARIO
Page 246 A new analgesic compound
containing acetyl-p-aminophenol
. . . the non-toxic therapeutic metabolite of acetanilid
"Long known as one of the most potent, rapid-acting
analgesics, acetanilid has now been found to have a
non-toxic therapeutic factor—acetyl-p-aminophenol.
Studies at the Yale Laboratory of Applied Physiology
and New York University School of Medicine show
that acetyl-p-aminophenol has the high analgesic
potency of acetanilid, without its toxicity.
Acetanilid
metabolizes to
Acetyl-p-aminophenol
non-toxic therapeutic metabolite
Toxic aniline compounds
TRIGESIC
Squibb acetyl-p-aminophenol, acetylsalicylic add and caffeine tablets
Trigesic offers all the advantages of acetanilid . . :
none of the disadvantages . . . plus the benefits of
acetylsalicylic acid and caffeine.
Each tablet contains 0.125 Gm. (approx. 2 gr.) acetyl-p-aminophenol; 0.23 Gm. (approx. 3 }4 gr.) acetylsalicylic acid and 0.03
Gm. (approx. H gr.) caffeine. Bottles of 100 and 1000.
Available also as Trigesic with Codeine in 2 strengths, either
Y% gr. Codeine Phosphate or 34 gf- Codeine Phosphate. Bottles
of 100 and 1000.
"Trigesic" is a registered trademark of
E. R. SQUIBB &. SONS OF CANADA, LIMITED
2245 VIAU STREET, MONTREAL.
SOXJIBB MANUFACTURING CHEMISTS TO THE MEDICAL PROFESSION SINCE 1858
Page 247 -( CONNAUGHT >
ANTI-MEASLES SERUM
Concentrated and Irradiated Human Serum
FOR  MODIFICATION  OR  PREVENTION  OF  MEASLES
Human serum prepared from the blood of healthy adults so as to
involve a pooling from a large number of persons provides an economical
and effective agent for the modification or prevention of measles.
Modification is often preferable since it reduces to a
minimum the illness and hazards associated with measles,
but does not interfere with the acquiring of the active and
lasting immunity which is conferred by an attack of the
disease. On the other hand, complete prevention of an
attack of measles is frequently desirable, and can be
accomplished provided that an ample quantity of serum is
administered within five days of exposure to the disease.
Serum supplied by the Connaught Medical Research
Laboratories is concentrated to one-third the volume of
normal adult serum and is irradiated so as to minimize the
occurrence of homologous serum jaundice.
HOW SUPPLIED
Irradiated Anti-Measles Serum, pooled
and concentrated, is distributed by the
Laboratories in 5-cc. rubber-stoppered
vials.
CONNAUGHT   MEDICAL   RESEARCH    LABORATORIES
University of Toronto Toronto, Canada
Eatablithcd  ia  1914  for Public Service through  Medical  Research  and  the development
of Products  for Prevention or Treatment of Diaease.
DEPOT FOR BRITISH COLUMBIA
MACDONALD'S    PRESCRIPTIONS    LIMITED
MEDICAL-DENTAL BUILDING, VANCOUVER, B.C.
Page 248 Looking through an old number of the Bulletin the other day, we came upon an
account of the Benevolent Fund: and it occured to us that probably very few men in
the profession know much about this organisation, which is one of the most important
and most beneficent features of organised medicine in this province. It is, as far as
we know, the only Benevolent Fund in Canada which deals with cases of need in the
families of medical men: and it has done a tremendous amount of good, in complete
privacy, which, of course, is absolutely essential to its operation.
The Benevolent Fund was first organised in 1944 by the Vancouver Medical
Association. The fund was the property of the V.M.A.—and was administered by it.
Dr. W. E. Ainley was the Chairman of the Fund, as he has been ever since, and under
his wise leadership the Fund was able to do a great deal of good work.
In 1947, the status of the Fund was changed.    It was taken over by the B.C.
[Medical Association: since it was felt that this activity should be province-wide, and
that the provincial body should administer it.    The Vancouver Medical Association
agreed readily to this, and at a special meeting voted to hand over to the provincial fund
the moneys that it then had.    The B.C. College of Physicians and Surgeons gave a sum
jof $10,000.00 and instituted an annual levy of $10.00 per member.
In 1952, when the B.CiM.A. became reorganised as the B.C. Division of the C.M.A.
jit took over the administration of the Benevolent Fund. It was not long, however,
before the Directors of the Division came ta the conclusion that, since the B.C. Division
is a voluntary organisation, and cannot collect dues for such a purpose as this, a more
satisfactory arrangement should be sought. Moreover, the Division does not yet include
all members of the profession, as did the B.C. Medical Association—and so could not
cover the whole province in administering the Fund. Accordingly, it asked the B.C.
fclollege of Physicians and Surgeons, through its Council, to assume the management of
the Fund—and the latter agreed to do so. The transfer was made legally and the
Benevolent Fund is now a function of the College, and its funds are the property of
the College.
The Council promptly asked Dr. W. E. Ainley to continue as Chairman of the
Fund, and he agreed to do so, which is, in the opinion of all who know anything about
the work of the Fund, a most fortunate thing. Dr. Ainley has, for many years, been
;the presiding genius of the Benevolent Fund—and he and his Committee, of which Dr.
Dan Busteed has long been, and remains, a most valued member, have steadily carried
put the functions of administration in a way which could not have been bettered. The
Fund has helped a great many people—where actual cash payments have been needed,
they have been given—where loans would be of aid, they have been made, for educational purposes, as a temporary stopgap and so on.
And all this has been done with the greatest regard to economy. The only money
k>ent has been the interest on the bonds, etc., owned by the Fund, and in nearly ten
rears of operation, there has been a deficit of only a very few hundred dollars, which
could be made up at once. For the past two or three years, the Fund has not received
my money from the College, as the annual levy was discontinued. Now, of course,
he Fund is under the control of the whole College, and its financing is greatly simplified
:hereby.
This Benevolent Fund is one of our greatest assets—its work is of the greatest
mportance. Its administration reflects very great credit on the Committees that have
panelled it. We can all be very proud of the work that this Fund has done, without
Iny publicity, with the greatest of tact and kindliness and consideration: and we know
Page 249
I that there are many who have great reason to be thankful for its existence, and who,
in their time of need, have been helped over a rough place in the road, not by organised
charity, or by public funds, but by the good-will of their own folk—the friends and
colleagues who most gladly contribute of their own plenty to those who need it. It is
not an insurance fund, and nobody has any claim on it—but while it exists, no medical
man, and no medical man's family, who may have fallen on evil times, need want for
the necessities of life. It is a family affair—and the family of medicine, through this
fund, will take care of its own members.
Monday to Friday - - 9:00 a.m. - 9:30 p.m.
Saturday 9:00 a.m. - 1:00 p.m.
Recent Accessions
Transactions of the Ophthalmological Society of the United Kingdom, volume LXXII,
The Spread of Tumors in the Human Body by R. A. Willis.
An Atlas of Anatomy by J. C. B. Grant.  Third Edition.
Textbook of Surgery edited by H. F. Mosely.
Connective Tissue, Transactions of the Second Conference  1951,  edited by Charles
Ragon.
The Metabolic Response to Surgery by F. D. Moore and M. R. Ball.
Tumors of the Eye by A. B. Reese.
Clinical Pathology of the Eye by B. Samuels and A. Fuchs.
The Significance of Heredity in Ophthalmology by J. B. Hamilton.
The journals listed below are those received in the Library in the fields of Obstetrics
and Gynecology.
The American Journal of Obstetrics and Gynecology.
Journal of Obstetrics and Gynecology of the British Empire.
Surgery, Gynecology and Obstetrics.
Obstetrics and Gynecology.
"Truth in medicine is an unattainable goal, and the art as described in books is far
beneath the knowledge of an experienced and thoughtful physician."
Rhazes (850-932)
FOR SALE
Portable X-Ray machine, fluoroscopy shadow-box, developing tank,
all in good condition.    Telephone CEdar 4214.
Page 250 Vancouver  Medical  Association
President _ Dr. E. C. McCoy
Vice-President: Dr. D. S. Munroe
Honorary Treasurer ! Dr. G. E. Langley
Honorary Secretary \ Dr. J. H. Black
Editor Dr. J. H. MacDermot
SUMMER SCHOOL
June 1st to June 5th (inclusive)
Hotel Vancouver
Speakers:
Surgery—
DR. JOEL BAKER, Mason Clinic, Seattle, Washington.
Orthopaedic Surgery—
DR. R. GRAHAM HUCKELL, Professor of Orthopaedic Surgery, University of
Alberta, Edmonton, Alberta.
Obstetrics and Gynaecology—
DR. HOWARD STEARNS, Clinical Professor of Obstetrics and Gynaecology,
University of Oregon, Portland, Oregon.
Medicine—
DR.  MARTIN  M.  HOFFMAN,  Professor  of  Medicine,  Dalhousie  University,
Halifax, Nova Scotia.
Urology—
DR. CARL ABERHART, Toronto, Ontario.
Tickets for the five day session will be $10.00.
An Opening Day LUNCHEON will be held in the Georgia Hotel, and a GOLF
TOURNAMENT followed by a GOLF DINNER and DANCE held on Thursday,
June 4th, in connection with the School. For those who wish to participate in these
functions as well as to attend the Sessions, a total price of $20.00 will be charged.
(This may be deducted from income tax.)
Further information may be obtained from:
Dr. John A. Elliot,
Secretary of the Summer School Committee,
1807 West Tenth Avenue,
x Vancouver 9, B.C.
Phone: BAyview 4158.
R§. DOCTOR WANTED
For an area in Northern British Columbia on main line of
Canadian National Railways. Doctor's practice would include two
farming communities as well as two Indian reserves and an Indian
residential school. Full particulars as to. grants available from
government departments and available living quarters on request.
Enquiries should be directed to the Secretary, Fraser Lake Women's
Institute, Fraser Lake, B.C.
Page 251 In a letter addressed to the Bulletin, Dr. Naden promises to send further letters
dealing with problems that arise in relations between the profession and the Workmen's
Compensation Board. This seems to us to be an excellent and constructive idea—and
we shall be glad indeed to publish these letters.
An observance by all of us of the point made by Dr. Naden at the end of this
letter, viz., more complete and accurate reports on cases, would in itself probably do
a great deal to remove misunderstanding and lessen any possible friction. —Ed.
WORKMEN'S COMPENSATION BOARD
VANCOUVER
March 9th, 1953.
To the Members,
College of Physicians and Surgeons of British Columbia.
Dear Fellow Members:
The sincere hope is hereby expressed that this series of letters will lead to a much
greater understanding of our common needs.
The Medical Officers of the Workmen's Compensation Board Head Office and Clinic
wish they, individually, could have an opportunity of meeting the members of the
College. Sitting across a table or desk face to face, outlining the day-to-day problems
encountered in the handling of Workmen's Compensation claims has, in our experience,
been a most useful means of ironing our difficulties. We are always glad to have you
come to see us for any discussion about contentious cases.
Our Compensation Board has been in operation since 1917. During that period
tremendous changes have taken place in medical practice and in all phases of activity
in our Province. The Compensation Act has been expanded in all its phases and in
most respects is one of the finest Acts in Canada.
It is not generally known that the powers of the Chairman and the other Commissioners of the Workmen's Compensation Board are very definitely governed by the
limitations and controls outlined for the protection of all parties in the original Act and
subsequent amendments.
As the new Chief Medical Officer I am encountering a great many intricacies of
administration apparently unknown to the outside practicing physicians. Almost
twenty-five years experience with the British Columbia Workmen's Compensation Board,
from without, has only given me a very superficial knowledge of the complexities of
management from within.
The answering of one of your greatest causes of complaint in relation to accounts,
would, I am sure, be an excellent beginning. Discussion of the point had better wait
until a later date.
Many of the members of the College have been annoyed and I am certain will,
upon occasion, continue to be annoyed, by the seemingly petty requests for more information about the history and examination of a workman in relation to his injury.
The first request the Medical Staff would like to make, is for your cooperation in
the complete and accurate submission of all reports. The powers of expression, by the
writings of a pen, seem so inadequate in my hands in an attempt to convey the importance of this appeal. Your participation in this initial venture will eventually lead
to a more enduring association for the mutual benefit of all.
With the deepest respect for arid admiration of the practicing physicians of British
Columbia, on behalf of the Workmen's Compensation Board, and particularly the
Medical Staff, I remain
Sincerely yours,
J. R. NADEN, M.D.,
Chief Medical Officer.
Page 252 TRANS-CANADA MEDICAL PLANS
By Dr. E. C. McCoy*
Ladies and Gentlemen:
In discussing with you Trans-Canada Medical Plans—and the part it could play
in a national plan of health insurance, one should first outline for you what Trans-
Canada Medical Plans mean—it is not a new super-plan on a national basis—it is a
co-ordinating body set up to co-operate the activities of the various provincial schemes.
That is why the name was recently changed from the original name of Trans-Canada
Medical Services. Many people were interpreting this as a new plan and it is not. For
any of you who know of Blue Shield in the U.S.A.—I might say that this is the
Canadian coutnerpart. It is administered by a Commission consisting of one representative from each member plan plus one representative from C.M.A.—to date the Chairman
of Economics Committee of C.M.A.
In my remarks, I shall attempt briefly to do four things—much of which is a
repetition of a speech made in Montreal recently and with headlines so ably misinterpreted by some of the local papers.
(1) Give you a summary of T.C.M.P. to date.
(2) Outline to you what T.C.M.P. consists of to-day and show why service plans
provide the best type of prepaid medical care.
(3) Try to show you where we believe T.C.M.P. could play a large part in a
national health insurance plan in Canada.
(4) Outline decisions made in T.C.M.P. meeting in Montreal.
Trans-Canada Medical Plans were conceived in Montreal in June, 1951, after a
two day conference of representatives from several prepaid medical care plans across
Canada, under the Chairmanship of Dr. C. C. White. Discussions had gone on for four
years prior to this at annual meetings of representatives—but until 1951 an apparent
sterility had been the result and in reviewing these meetings, the apparent cause of the
sterility was a constant failure to be able to produce a plan which would have
uniform benefits and uniform rates across Canada.
In 1951 the thinking changed somewhat and it was decided to form Trans-Canada
Medical Services to co-ordinate the activities of the various provincial schemes—but to
retain provincial autonomy—and not create a new super-scheme.
Since June, 1951, there have been four Commission Meetings and a Meeting of
the Executive Committee. These have been held in Montreal, Toronto, Edmonton,
I Banff and Saskatoon, respectively.
A full time Director—Mr. Howard Shillington—has been engaged.
The present coverage across Canada and the needs—have been studied at considerable length—and much spade work has been done in attempting to get a more universal
coverage across Canada.
A Constitution and By-laws have been worked out and revised with many
revisions already made as need became evident.
A "Dependents of servicemen Prepaid Care Plan" has been studied at length—
| and negotiations are in the preliminary stages.
T.C.M.P. to-day consists of nine Prepaid Care Plans across Canada—other applications are pending. The total membership of the plans in T.C.M.P. at present is
over a million. During the past year, these plans paid out $15,394,075.68 for medical
accounts, so you can see that we are already pretty 'big business'.
These plans are all service plans, except one, and this is a point we wish to
[ emphasize. To the best of my knowledge there are only five ways that medicine may
be practised and paid for:
(1) Private contract
(2) Indemnity plans j%|l
'Address given before Vancouver Medical Association, February 3, 1953.
Page 253 (3) Government sponsored plans
(4) Service contract
(5) Private practice
In looking these over, I think we already know most of their advantages and
disadvantages. The private contract denies the free choice of doctor which is one
basic principle in which we believe—but it does work adequately in some small isolated
communities.
Indemnity plans certainly have a place but do not answer the people's demand for
complete coverage. Also, doctors don't particularly favor indemnity plans on a
large basis unless the doctors are adequately represented on the governing board because
if over 50% of the people in any area become covered, the doctors tend to lose control
of the fee schedule. The schedule the company pays comes more and more to be
accepted as the schedule. On a small basis this is not an important factor. They
have a place—but certainly are not the full answer from either patient or doctor
point of view.
Government sponsored plans have many advantages and disadvantages and I need
not outline many of these for you. However, in most places where the government
sponsored plans have been introduced, the free choice of doctor has been lost—or at best
there remains a restricted choice. Also the doctor tends to get involved in a lot of 'red
tape' and spends too much time filling in papers instead of practising medicine. Also
it seems very hard to retain the proper doctor-patient relationship. Again, it usually
becomes expensive.
The service contract where the patient's full bill is paid for—on as full a service
basis as possible—seems to approach more nearly what both patients and doctors
desire. In working out such a scheme, the service as I mentioned should be as complete
as possible—getting rid of all exclusions, if possible, and paying the bills in full. If
doctors believe what they say when they say people should be able to prepay for their
medical care, then it would seem realistic that this type of plan should be the objective.
The 5 th method is that of private practice with the patient paying his own bill.
I'm sure many doctors would desire that this method remain—as it had been in Canada
for many years. However, medical care is becoming very expensive with newer methods
of investigation and treatment, etc. Also I believe one must face the fact that the
world is changing with resultant changing philosophies and changing standards of
living—with a greater emphasis on security and collectivism—and making as much of
everything available to as many people as possible, with the cost spread over groups
as a whole—in other words some socialistic trend. Hence, people want to prepay for
medical care and not suddenly be faced with a financial catastrophe. I think the doctor
who can't see this or understand this, must just have his head buried in the sand—and
he had better get it out—and realize that prepayment for medical care is coming whether
he likes it or not—and perhaps it would be better if he used his knowledge and ability
to help plan some way so that people could prepay.
In other words, I think that private practice where the patient pays his own
medical bill—much and all as it has many desirable features that are very difficult to
achieve under any plan—is on the decline—and we might as well face it and help
mould the new method.
I have attempted to point out to you why the service plan is the best plan available
—and that is why, under T.C.M.P., we are primarily co-ordinating service plans. We
believe this will give what the people want—and at the same time retain the patient-
doctor relationship on a proper level.
In trying to point out to you where we believe T.C.M.P. could play a large
part in a national health insurance plan in Canada, one must attempt first of all to
answer several questions that must be answered and one must outline what one means
by health insurance. Certainly, many of those who to-day are discussing this problem
across Canada know very little about it—but are attempting to play politics with health
Page 254 insurance—and one cannot help but feel that the provision of medical care is too
personal a service to be brought into the realm of politics. Health insurance not only
enables individuals to prepay their medical costs, but does this in such a way as to
secure a wide pooling of risks and distribution of costs in much the same manner as any
other form of insurance. Such questions as, "Should such a plan be voluntary or
compulsory?" "Should it be run by government or by doctors?" "Should it be provincial or national?" "How should it be paid for?"—are all important questions that
we should be prepared to answer before we can intelligently deal with the problem.
I believe there are two main aspects to the provision of medical care. The first
is the field of public health and preventive medicine on a community basis—the other is
the field of curative medicine which also involves preventive medicine on an individual
basis and to have a proper health insurance plan, we must consider both of these fields.
Curative medicine is the more expensive part while public health and preventive medicine
is much less costly. On the other hand, public health and preventive medicine on a
community basis must be compulsory. From a public health point of view, there is
not much sense in your being immunized against diphtheria if your neighbours aren't
also. The only place where such a compulsory scheme properly fits into our way of
life is under government sponsorship, therefore, this part of medicine could properly
be provided by the government out of the tax dollar—personal contribution here is not
necessary. Prevention cannot be properly done by individuals—it must be done by all.
Individuals as individuals just aren't sufficiently interested in prevention.
On the other hand, individuals should be vitally interested in curative medicine.
It is high-priced as stated before and the individual must share part of that cost at
least. This should be done on a voluntary basis—if we are to retain two of the basic
principles which we believe to be essential—those are (1) free choice of doctor by the
patient and (2) free choice of doctor to refuse any patient. I know of no compulsory
scheme that does not interfere with one or both of these principles to a greater or lesser
degree. However, if any individual small group wished this to be compulsory for their
group, they could have it so without interfering with the desires of the people as a
whole to keep it on a voluntary basis—as a matter of fact under some plans at present,
compulsion is in effect—as it is a condition of employment in certain groups—agreed
upon by management and unions.
One frequently hears it remarked that doctors are against health insurance. They
are not—they want health insurance—the C.M.A. has gone on record as being in favor
of it—they realize the need of it perhaps more than most laymen as they are dealing
with sickness continually. Quite rightly they do not want to become government
employees as they believe a personal service like medical care must retain the above
mentioned two basic principles—and as government employees it becomes very difficult
if not impossible, to retain these two basic principles.
If one accepts the above, one next comes to whether such a scheme should be
administered by the Government or by doctors. I don't believe it should be by either
one. I don't believe the Government could administer it even on a voluntary basis
without getting too much politics and red tape mixed up in it. I don't believe the
doctors alone can administer it adequately because it is most important that the
subscriber have a choice in the provision of his care.
I believe the plan should be administered by a board composed of representatives
of the two groups of people primarily involved—the consumer and the provider of the
care. That is, the subscribers and the doctors both—such a board to be elected and
selected from the two groups. Several plans in Canada now operate under such a system
and operate very well.
Next, we should consider whether such a plan should be provincial or national.
I believe that it should be no greater than provincial at outside. Centralization of such
a scheme leads to more red tape and book work—and certainly doctors in Nova Scotia
or B.C. are not going to take the certain amount of regimentation that must go with
Page 255
P such a scheme, from someone sitting at a desk in Ottawa in the same way that they)
would from someone in Halifax or Vancouver. By the same token, the patient isn'ti
going to accept rulings, etc., from one central office in the same way that he would]
from a provincial office and more important he isn't going to remain so much interested
in keeping down the costs as he would if the scheme is on a more local basis. As a
matter of fact, the more local it is the more interested he is in keeping down thej
costs—but there is a limit to how local the scheme can become and remain economical.
I believe that provincial plans or plans of about that size are best. Another point herei
is that conditions vary tremendously across Canada as we have seen in our deliberations
to date in T.C.M.P. Costs of living vary—diffierent provinces have different types of
government—some of which provide more medical care than others—also doctor's fees
vary as costs of living varies— -thus it is most difficult if not impossible to set a fee
schedule for all of Canada that is fair. That is one place that indemnity schemes do
have an advantage. They can do national coverage fairly readily because they pay only
a certain amount toward a bill and the patient pays the rest which varies from province
to province. Thus, I'm sure we are on the right track when we say these plans must
be no larger than provincial.
This now brings us up to where T.C.M.P. fits into this plan. Provincial schemes
alone are not enough—people frequently move from one province to another—usually
from any one of nine, provinces to British Columbia—and they should not have^ to lose
coverage or undergo new waiting periods, etc. This is where T.C.M.P. fits in. It will
co-ordinate these various provincial plans—fallow subscribers to move from one to
another, without loss of waiting periods and without loss of coverage. Also it provides
a means whereby national employers can arrange coverage for employees in several
provinces—and at the same time it will be working towards getting as nearly as possible
a uniform type of coverage—at possible fairly similar rates.
At the present time, the various provincial plans do not cover enough people—
some will only take employed groups—some will not take individuals. T.C.M.P., if it
functions efficiently, will have to have all of its member plans enlarging their scope
and making prepaid medical care available to all. This applies to our own plan in this
province—M-S-A which is our representative in T.C.M.P. It does not cover enough
people. If all those were covered who are eligible under present regulations—we should
only cover about 35-40% of the people in the province. We must begin relaxing our
strict regulations a bit—and make the service available to more people if it is to answer
to the demand for health insurance. Of the various members of T.C.M.P., our enrolment increased by the smallest percentage last year, At the same time, I must admit
that we have the second largest enrolment—but we must keep enlarging—and quite
rapidly—as our experience grows.
You may now well ask—who will pay for this? There is no doubt that the subscriber should pay if able—it might be done in conjunction with employers in some
cases—if desired. However, the subscriber must pay at least part—or it becomes too
expensive. You do not get anything in life for nothing and if the subscriber is not
vitally interested in the cost, he will tend to abuse it. Even when he is interested in
the cost, he tends to use it more than he would if he were paying the doctor's bill in
full and this is why no government can estimate the cost of medical care in advance—
regardless of estimates they may produce. Utilization is a big factor and we are just
beginning to realize what it means. In B.C., for instance, under M-S-A, in 1945 one
in 20 subscribers used the service each month-—in 1952, one in 8 used it each month.
This is one of the main reasons why such Plans must grow gradually. The human
element in such a personal service is impossible to estimate—and the human element is
what makes or breaks the plan.
For those who cannot pay at all, the government must pay—as I'm sure all of us
agree that we must look after our indigents. However, I believe the government
should comribute these costs—but should not administer the plan.   As Raoul Poulin—
Page 256 a very able parliamentarian from Quebec said in November, speaking in the House.at
Ottawa in referring to the problem of medical care which should be given to the
needy:
"I believe, speaking in all sincerity, that governments can strive to attain this
goal without intruding into the field of medicine."
Canada is not a poor country—we can afford good medical care—we can afford
the best medical care—but we must make sure that what we get is good medical care
without too much waste of money.
This, ladies and gentlemen, is where I believe T.C.M.P. could fit into a plan for
national health insurance for Canada. I believe it would give up better medical care—
better from both patient's and doctor's point of view—than any other plan in existence
to-day—although I must admit that the U.S.A., after a lot of investigation and research,
is now coming to strive for something that is not too unlike what we are trying to
do in Canada.
Now,coming to the fourth part of my remarks—telling you what we did in
Montreal. There was much discussion about development in Quebec and I must say
that as yet the doctors in Quebec have not agreed to sponsor any plan to represent them
in T.C.M.P. The two medical associations there—English and French—complicate
considerably the matter of arriving at decisions.
It was decided that the Head Office of T.C.M.P. will be in Toronto and it is
hoped that it will be established by this summer.
Maritime Hospital Service Association—A Blue Shield Plan—which also provides
hospitalization benefits but is not a service plan was accepted as an Associate Member,
after much discussion—and after being named by New Brunswick Division of C.M.A.
as their representative. One quite agrees that as yet they do not meet the standards set
up for membership in T.C.M.P. but they have the approval of the medical profession
there and that is one of the chief points we insist on—that the doctors must approve
the plan and apparently the doctors like this plan in New Brunswick, although I doubt
that either doctors or subscribers would go for it here—to any extent.
I believe we aroused much interest on the part of the doctors in Quebec in the
i matter of service plans and it is hard to tell what may develop.
Many other matters were discussed which would be of no particular interest to
you so I shall not waste your time with them.
However, we had a good round table discussion on national health insurance.    We-
also had a very excellent representative from Blue Shield in the U.S.A., who participated  in  discussions.     As   a   result,  partly  of   this   and  partly  of  other   general
observations, I believe it is fair to assume that we have probably about two years to
; provide health insurance for the people of Canada—or it will be provided for them
otherwise. We may have less time than this and we may have as much as four years.
The Americans figure they have four years and I don't believe we will be too much
different from them.
The important thing is that we, as a profession, must at least help to arrange
provision of this care and must have a voice in its operation.    As individuals or as
j groups, we may not like some of the regimentation—or other things that go with
this—but at least we should keep our dislikes and disagreements within our own pro-
I fession, and if we do not like some particular treatment we have received over for
! example same case, we should not take it out on the patients or express our dislike of
the scheme to patients—we should get together with the other members of the profession and make the needed corrections and make prepayment work. Also we must
remember that it is our effort, and if we abuse it we are only working against ourselves.
If doctors and subscribers aren't both vitally interested in making prepayment work and
in keeping down costs, then it won't work, and I'm sure we will all end up with
much more regimentation and red tape than we would ourselves arrange.
Page 257 In conclusion, I have attempted to outline to you what type of child T.C.M.P. is
at present time—and to reveal to you some of our feeding problems and why we are
being kept awake at night a bit. However, I am sure that it is a good healthy child—
and I believe it should grow up to fulfill a very useful manhood—and to play a very
useful part in the future of Canada.
E. C. McCOY, M.D.,
President, Vancouver Medical Association,
and Chairman, Trans-Canada Medical Plans.
THE PRESENT STATUS OF STATE MEDICINE*
By G. GORDON FERGUSON, M.D.
When invited to speak to this Society, the suggested title was "The Present
Status of 'the threat of State Medicine." This will continue to be the theme of the
talk, but for the first time in my experience I find myself cast in the role of a crystal
gazer.
O wad some Pow'r the gif tie gie us
To see oursels as others see us!
It wad frae mony a blunder free us,
And foolish notion:
What airs in dress an' gait wad lea'e us,
And ev'n devotion!
Burns—"To a Louse"
Before giving any prognostications it will be worthwhile to give a little time to
examine the two important words in the suggested title:
1. The State
2. The Threat
If we are intelligently to understand our present position, we must be clear on
the implications of both. The word "state" is used throughout in the broadest sense
of being the opposite to the citizen as an individual. It may mean the local community,
the national community or the agent of the community—which is the Government.
The State is interested in two ways.
1. As a consequence of world wide social change. This is inevitable in the
twentieth century with its unparalleled industrial and scientific development plus the
convulsions of two world wide wars.
The State believes it a proper function of government to be interested in the well-
being of individuals. This varies only in degree within different countries. On the
one extreme, the state has busied itself so much in the affair that it has supplanted the
individuals' responsibility and even stolen his freedom. This latter catastrophe is a
natural result when too many individuals live by that common and lazy rule "Let
George do it."
However, since in all nations today the question of survival has moved from the
individual to the national level, I accept that we must recognize that the state has a
right to show interest in the wellbeing of individuals.
There are many indications of this acceptance in Canada today. The Old Age
Pension—Child Welfare Allowance—Social Aid—Workmen's Compensation and probably many others I cannot recall at the moment. What must be apparent to you is
that most of these innovations more or less intimately involve the work of the medical
profession.
*Address given before Vancouver Medical Association February 3rd, 1953.
Page 258 Our general responsibility as citizens and not just as physicians is that we must
not be so enamoured of the "something for nothing" philosophy in respect to government beneficence that we surrender our individual freedom to the state.
However, it is because of the effect of a highly organized industrial society that
some family units are in distress and are suffering a lack of essential things. Such a
lack weakens the whole community.    Here the state should extend a helping hand.
The family able to care for itself must do so, as in doing for itself it becomes
more self reliant. We can strengthen the family and the individual by showing them
how to assume their own responsibilities, that is, be more conscious of their own
behaviour in particular respect to health.
However, it is important that we do recognize that some people need help and
we should be prepared to act with the State to see they are not denied essential medical
care. The S.A.M.S. is an example of the state picking up its responsibility and working
it out? through us. I think many of the seemingly irksome personal features of S.A.M.S
will become more tolerable when the ultimate group objective is more clear.
These remarks indicate to me why the state is interested in health and in general
what I hope is our considered and responsible attitude toward the general weal.
2. The Practical Application of Medical Knowledge in Health Affairs. As
illustration I will consider the disease Tuberculosis—a subject familiar to all of you.
At the outset I can find no indication that the state is interested in tuberculosis
because they believe they have a better treatment to offer. We practise as individuals,
and given an individual tuberculosis patient, most of us can handle it with credit.
However, that is not the point at issue.
What is the point at issue is that uncontrolled tuberculosis is a menace to the
state. Undiagnosed disease leaves many healthy people in danger. Segregation of the
family is not enough. It must be segregation of the individual. The long period of
recovery is more than most individuals can afford and if it is the breadwinner who is
affected then women and children are destitute.
The move to diagnose and segregate early in the disease, check contacts and extend
a helping hand to the dependent of the patient as well as assure treatment over a
sufficiently long period of time is a problem in which the profession needs the help of the
community. The community is anxious to give its help, and in this province operates
as a division of the Department of Health.
I have only discussed the medical aspect of the problem as it affects the community.
Just for the record I will mention that the community has the added task of being
interested in sanitation, housing and nutrition if it is to successfully attack this disease.
Sometimes in this respect the State is slow and must be prodded.
Feeling a Threat
The use of the words "threat of State medicine" is interesting. Recognition of a
threat against anything is an awareness of a possible danger, but degrees of apprehension
against a threat can be measured all the way down the scale to absolute, fear. I have
no doubt that in the minds of individual physicians it does run from mild apprehension
to fear, depending on the knowledge and understanding, that the individual has of the
problem.
In war time an army commander will recognize a threat to his position from certain
directions but is not apprehensive unless he is either unprepared or has no knowledge
of the situation. In other words, if we are concerned about the threat of State medicine
and are apprehensive about it, our first task is to remove ignorance of the problems
involved from among ourselves and develop our own strength through knowledge.
We must make certain that we understand clearly whether the threat is against
ourselves and involves something personal with us or whether it is a threat to our
concept of good medical care.    Are we concerned because we feel that the position we
Page 259 hold, either for ourselves or for a good medical service, is unjustifiable and cannot
be maintained?
The Threat to Ourselves
If any of us are apprehensive about the threat to ourselves, then that apprehension
also stems from a lack of knowledge of the situation or full knowledge of the situation
but realizing that the position we hold is indefensible.
"No good doctor remains cold, hungry or unliquored for long."
Fischerism.
Granting we must have some self interest, it seems to me that if we adequately
demonstrate that as a group we are ready to lead in health affairs, and are good doctors,
we do not have to blow our own trumpet too loud to win adequate attention.
It has not been my experience that patients complain about the cost of medical
care, or envy their doctor some of the luxuries of life, when they have received good
attentive service.
We believe our system of practice to be the best for today. It would be foolish
to think it must necessarily be best for tomorrow. Our professional minds must be
alert and receptive to improve methods of distribution as well as improved technical
methods.
Knowledge is strength and there is strength in unity. Knowledge and unity will
overcome the threat to ourselves.
The Threat to the Service
We believe that free choice of patient and doctor, and individual responsibility in
health matters are essential for a good health service. These are things we must always
defend. Threat to these beliefs come from opportunist politicians and uninformed
people. We can do much to remove the threat to our service by educating the people,
which in turn will nullify the politician.
Education of the citizens (who are our patients), comes about in several ways, not
the least of which is how the doctor acts in relation to his patient. Does he help the
patient get the best for his medical dollar? Think twice before ordering the diagnostic
tests? Think twice before ordering fancy and expensive medications? Be a friend and
counsellor with patience and tact?
The cost of a good medical service is high and growing higher. Not because our
fees are so much higher, but because there are so many more ways of helping, a person.
We believe that some system or planning is necessary if the great bulk of our people are
to benefit from these advances. We believe that the Insurance Principle is the one
to be applied.
What are our people to think when we publicly endorse the insurance principal:
while some members privately still Yefuse to cooperate with those who are trying to
work it out through voluntary prepaid care plans?
Judging from some correspondence I receive too many doctors think of S.A.M.S.
and M.S.A. in the terms of the teenage song "Somebody else - not me." These are
professional commitments through the Association and require to be honoured by every
member.
The threat to the service is entirely one of ignorance on the part of the people
generally, which can be dispelled only by intelligent and united action by a well
informed and disciplined profession. If we cannot unite and act by our own free will,
then certainly the threat becomes a reality vand we may expect to have someone try
to force compliance on us from outside the profession.
I believe no other body of citizens has such a potential to influence the course of
history than the medical profession. Should all the doctors of the world manage to
work together, I am sure we could stop the Four Horsemen of the Apocalypse in
their tracks.
Page 260 What is Our Present Position?
The State is interested in health now,  and always will be.    Their responsibilities
| however need not be antagonistic to ours.
Every political party promises to do something about Health Insurance.   The type
and amount of 'State Health' will depend on the political party in power, which in
turn is a measure of the mood of the voters.    There is today a swing away from the
strong left position which followed the war.   This swing is in Canada the same as over
I the world.
More people are realizing there is no such thing as 'free medical care'. They are
skeptical about "Pie in the sky", and are reckoning cost. Most people realize that if
they want medical care they cannot dragoon the medical profession into some unjust
and unsatisfactory system. In Canada our slower development toward Health Insurance
is likely to result in a more universally acceptable change. Socialized medicine as such
is receding.
However anything can happen in the event of another world war when our
whole medical man power will have to be mobilized for the big task of protecting the
nation in its civil and military committments. What comes out of a war may not be
recognizable to the system we took into it.
Summary
I have reviewed the position of the "State" in medical affairs, but wish to say
that knowledgeable action on our part can remove the "threat". What counts is
participation in the group discussions and honouring in every action these group
decisions. Failure to belong to the Medical Association and failure to honour its work
is the surest way I know for the medical profession to destroy itself and its place in
society.
Look up and not down,
Look out and not in,
Look forward and not back,
And lend a hand.
PREPAID   PLANS
The work of Medical Directors and Assessment committees as well as
the Reference Committee of the Association, will be greatly eased, and
most misunderstandings between individual doctors and all approved
plans, including M.S.A. and S.A.M.S., will be reduced, if the following
points are noted:
1. The Schedule of Fees forms the basis of understanding in
accounting between the profession and plan.
2. Accounts varying from the Schedule should be accompanied
by an explanation. The back of most account forms has a place for
this.
Page 261
P DOMINION INCOME TAX RETURNS BY MEMBERS OF THE
MEDICAL PROFESSION W^£r
As a matter of guidance to the medical profession and to bring about a greater
uniformity in the data to be furnished to the Taxation Division of the Department of
National Revenue in the annual Income Tax Returns to be filed, the following matters
are set out:
Income
1. There should be maintained by the doctor an accurate record of income
received, both as fees from his profession and by way of investment income. The
record should be clear and capable of being readily checked against the return filed.
It may be maintained on cards or in books kept for the purpose.
Expenses
2. Under the heading of expenses and following accounts should be maintained
and records supported by vouchers kept available for checking purposes:
(a) Medical, surgical and like supplies;
(b) Office help, nurse, maid and bookkeeper; laundry and malpractice insurance
premiums. (It is to be noted that the Income Tax Act does not allow as a deduction
a salary paid by a husband to a wife or vice versa. Such an amount, if paid, is to be
added back to the income);
(c) Telephone expenses;
(d) Assistants' fees; The names and addresses of the assistants to whom fees are
paid should be furnished. This information is to be given each year on Income Tax
form known as Form T.4, obtainable from your District Income Tax Office;
(e) Rentals paid; The name and address of the owner (preferably) or agent of
the rented premises should be furnished (see (i)  );
(f) Postage and stationery;
(g) Depreciation; A description of the treatment of depreciation may be found
on page four of the Income Tax Return form T.l General under the Part XI Method.
The method of computing depreciation for tax purposes is the same as that used
last year and you should have no difficulty if you have a copy of last year's return
available.
Simply carry forward the balance remaining in each class after deducting last
year's allowance. Add to this figure the cost of any new equipment purchased and
deduct the proceeds from any disposal of property in eachdass. The rate you wish to
use not exceeding the maximum rate (see below) is applied to this new balance for
each class to obtain the depreciation you may claim this year.
The maximum rates for the classes of equipment most used by doctors follow:
Capital item
Medical equipment Annual maximum
(a) Instruments costing over $50 each and medical Class depreciation
apparatus of every type            8 20%
(b) Instruments under $50 each  ... 12 100%
Office furniture and equipment  8 20%
Motor car  j  10 30%
Building (Residence used both as dwelling and office) 3 5%
Instruments costing less than $50.00 each belong in class 12 and have a maximum
allowance rate of 100%. They should not be included in expenses but should be
recorded as additions in column 3 of the schedule.
Where a doctor practises from a house which he owns and resides in, the allowance
may be claimed as above on a portion of the cost of the residence, including land. For
example if the residence were a brick building costing $12,000 and one-third of the
space were used for the office, the doctor would use $4,000 as the business portion of
Page 262 the cost and apply the building rate of 5% to determine the maximum depreciation
allowable in the first year.
For further information on the subject you may refer to the Regulations or you
may consult your District Income Tax Office.
(h) Automobile expense; (One Car). This account will include cost of license,
oil, gasoline, grease, insurance, garage charges and repairs;
The capital cost allowance is restricted to the car used in professional practice
and does not apply to cars for personal use.
Only that portion of the total automobile expense incurred in earning the income
from the practice may be claimed as an expense and therefore the total expense must
be reduced by the portion applicable to your personal use.
The mileage rate permitted in years prior to 1950 may no longer be used to
estimate the automobile expenses.
(i) Proportional expenses of doctors practising from their residence: (a) Owned
by the doctor: Where a doctor practises from a house which he owns and as well
resides in, a proportionate allowance of house expenses will be given for the study,
laboratory, office and waiting room space, on the basis that this space bears to the
total space of the residence. The charges cover taxes, light, heat, insurance, repairs,
capital cost allowance, and interest on mortgage (name and address of mortgagee to
be stated); (b) Rented by the doctor: Only the rent and other expenses borne by the
such as heat and light will be apportioned inasmuch as the owner takes care of other
expenses.
The above allowances will not exceed one-third of the total house expenses or rental
unless it can be shown that a greater allowance should be made for professional purposes.
(j) Sundry expenses (not otherwise classified).—The expenses charged to this
account should be capable of analysis and supported by records.
Claims for donations paid to charitable organizations will be allowed up to 10%
of the net income upon submission of receipts to your Income Tax Office. This is
. provided for in the Act.
The annual dues paid to governing bodies under which authority to practice is
issued and membership association fees, to be recorded on the return, will be admitted
as a charge. Initiation fees and the cost of attending postgraduate courses will not
be allowed.
(k) Carrying charges: The charges for interest paid on money borrowed against
securities pledged as collateral security may be charged against the income from
investments and not against professional income.
(1) Business tax will be allowed as an expense, but Dominion, Provincial or
Municipal income tax will not be allowed.
Convention Expenses
"Effective January 1, 1948, the reasonable expenses incurred by members of the
medical profession in attending the following Medical Conventions will be admitted for
Income Tax purposes against income from professional fees:
1. One Convention per year of the Canadian Medical Association.
2. One Convention per year of either a Provincial Medical Association or a
Provincial Division of the Canadian Medical Association.
3. One Convention per year of a Medical Society or Association of Specialists in
Canada or the United States of America.
The expenses to be allowed must be reasonable and must be properly substantiated;
e.g., the taxpayer should show (1) dates of the Convention; (2) the number of days
present, with proof of claim supported by a certificate of attendance issued by the
organization sponsoring the meetings;   (3)   the expenses incurred, segregating between
(a)   transportation expenses,   (b)   meals and   (c)   hotel expenses, for which vouchers
* ould be obtained and kept available for inspection.
Page 263 None of the above expenses will be allowed against income received by way of
salary since such deductions are expressly disallowed by statute."
Professional Men Under Salary Contract
The employees' annual contribution to an approved Pension Plan and alimony payments may be deducted from salary income.
Amendments to the Income Tax Act, introduced in 1951 and made retroactive to
the beginning of the calendar year 1951, provide for the deduction of certain expenses
from salary income.
The allowable expenses include travelling expenses, annual professional membership
dues, office rent, salary to an assistant or substitute and supplies consumed directly
in the performance of the duties of employment.
The annual registration fee of the Provincial medical licensing authority would
be allowable if paid by the doctor himself.
Certain conditions are attached to the allowance of the expenses and without
trying to recite the exact provisions of the law the main points are:
(a) That the expenses must have been incurred in the performance of the duties
of the office or employment.
(b) That the employee is required, under the contract of employment, to pay
the expenses.
(c) To claim travelling expenses the employee must be ordinarily required to
carry on the duties of his employment away from his employer's place of business.
Travelling between the doctor's home and his office is not included. *
Where the travelling expenses are allowable under these provisions, depreciation
may be claimed on the automobile used for this purpose but no other claim for
depreciation may be made.
Income from a Partnership
Additional expenses incurred by a partner, but not charged to the partnership, may
be claimed as a deduction from the partner's share of income. However, the partner
must be in a position to substantiate these expenses, to show why they were not charged
directly to the partnership and that they were necessarily laid out to earn the partnership income.
FOR THE BUSY DOCTOR
A GENERAL BOOKKEEPING SERVICE, COST AND
PROFIT ANALYSIS,  INCOME TAX ESTIMATES
PHYSICIAN'S ACCOUNTING SERVICE LTD.
503 - 535 W. Georgia St.
W. C. Wolfe—Manager
Page 264 British Columbia Btutsftttt
Canadian Mthxtai Asanctatum
1807 West 10th Ave., Vancouver, B.C.      Dr. G. Gordon Ferguson, Exec. Secy
OFFICERS—1952-1952
President—Dr. J. A. Ganshorn.
President-elect—Dr. R. G. Large.
Vice-President and Chairman of General Assembly—Dr. F. A. Turnbull
Hon.  Secretary-Treasurer—Dr. W. R. Brewster	
Members of the
Victoria
Dr. G. Chisholm
Dr. E. W. Boak
Nanaimo    %«
Dr. C. C. Browne
Prince Rupert and Cariboo
Dr. R. G. Large
New Westminster
Dr. J. A. Sinclair
Dr. W. R. Brewster
Yale
Dr. A. S. Underhill
Dr. C. J. M. Willoughby
Standing Committees
Constitution and By-Laws.
Finance	
Legislation jj	
Medical Economics	
Medical Education	
Nominations	
Programme and Arrangements.
Public Health	
Special Committees
Arthritis and Rheumatism.
Cancer	
Civil Defence _	
Hospital Service ; — Dr. J. C. Moscovich, Vancouver
Industrial Medicine  Dr. J. S. Daly, Trail
Maternal Welfare Dr. A. M. Agnew, Vancouver
Membership - Dr. E. C. McCoy, Vancouver
Pharmacy j Dr.  D.  M.  Whitelaw, Vancouver
Public Relations : Dr. G. C. Johnston, Vancouver
THE B.C. DIVISION AND PREPAID MEDICAL CARE
A review of the articles in this Bulletin will indicate to the members of the
Association the great extent to which the insurance principle has already been applied
in the provision of medical care in British Columbia. It is important that we recognize
that social change and advance in medical sciences have made it imperative that this
insurance principle be applied. Indeed, the application of the insurance principle is
the only solution to the present day problem. Our task has been to see that it is done
on a voluntary basis and not by compulsion or government direction. The question
arises: "Is it enough simply to understand or must we bend our energies to develop
that which we believe is proper?"   In other words, lip service or action.
Page 265
Board of Directors
Vancouver
Dr. F. A. Turnbull
Dr. A. W. Bagnall
Dr. F. P. Patterson
Dr. P. O. Lehmann
Dr. G. C. Johnston
Dr. Ross Robertson
Dr. R. A. Gilchrist
Dr. J. Ross Davidson
Dr. R. A. Palmer
Kootenay
Dr. J. McMurchy
Chairmen
 Dr. R. A. Stanley, Vancouver
 Dr.  W.  R.  Brewster, New Westminster
 Dr. J. C  Thomas,  Vancouver
 Dr. P. O. Lehman, Vancouver
 Dr. T. R. Sarjeant, Vancouver
_.Dr. J. A. Ganshorn, Vancouver
 Dr. Harold Taylor, Vancouver
 Dr. G. F. Kincade, Vancouver
 Dr. F. W- Hurlburt, Vancouver
 Dr. Roger Wilson, Vancouver
.Dr. John Sturdy, Vancouver Recently the Prepaid Plans Sub-committee of the Association had the opportunity
of again meeting with representatives of all the Approved Plans. Approval means that
the plans are fair to the subscriber, fair to the doctor and administered soundly.
Approval is given so that their work might be better integrated with the individual
members of the profession who bill directly to the plan. There has been give and take
on both sides in order to make a working plan feasible. The Association will continue
to work with these Plans toward a method of standard adjudication. Our Reference
Committee will seriously study problems submitted by any doctor or plan and will
recommend considered opinions that might be acceptable to both parties to a dispute.
The Association once more takes this opportunity of advising all its members
that in giving approval to these Plans we are in fact recommending them and are
prepared to work with them. And that payment of the account at the schedule of
fees less 10% administrative discount will be accepted. It is clearly recognized that
at times errors in adjudicating will occur, but if we are to advance the idea of voluntary
health insurance, it is necessary for us to recognize that problems might exist and that
they can be solved in a friendly manner.
It is also to the advantage of the profession to advise our patients who might be
unaware that coverage is available to them, that they can obtain such coverage through
the Approved Plans. We hope in British Columbia to make it possible to fulfil one of
the tenets of the C.M.A. national policy that voluntary medical care will be available
to every citizen.
The following is a list of Approved Plans in British Columbia:
Medical Services Association (M.S.A.)
B.C. Government Employees' Medical Services Association
B.C. Telephone Employees' Medical Services Association
B.C. Teachers' Federation Medical Services Association
Vancouver School Teachers' Medical Services Association
CU. & C. Health Services Society
Cunningham Drug Sick Benefit Association
In order to further complete your understanding some of these Plans have been
good enough to forward a short resume of their history, the persons they serve, the
numbers of people covered, their benefits under the plan, and any information which
it is thought advisable for you to have at the present moment.    The space available
is limited but we are glad to do this at this time and hope you will keep this copy of
the Bulletin for reference.   Through this information it is hoped you will have a broad
understanding of what is being done in voluntary health insurance and that you, along
with all your colleagues, will put your shoulder to the wheel and see that it proceeds
fairly and rapidly as possible.
GORDON FERGUSON^ Executive Secretary.
C. U. & C. HEALTH SERVICES SOCIETY
The Credit Union & Co-operative Health Services Society was formed the 1st of
November, 1946, to provide medical and surgical services at cost to credit union and
co-operative members and employees. For those of you who are not familiar with
credit unions, the following is a brief outline:
Credit Unions have no connection with Labour Unions and are not concerned
with labor problems or conditions; neither are Credit Unions concerned with
political, religious or racial activities, as such, but keep a strictly neutral attitude
on all controversial subjects. A Credit Union, as its name implies, is a union of
credit.ilHt is an association of persons, united by some common bond in a
co-operative effort to assist its members in saving through sound investment and
Page 266 to borrow at cost.   Through its associate organizations it supplies life, fire, casualty,
savings and loan and health insurance at cost to its members.
The Society was approved by the College of Physicians and Surgeons of British
Columbia on November 1st, 1949.
MEMBERSHIP
Approximately 7,500 heads of families, that is, about 18,000 people in B.C. are
covered, under either the individual plan or the group plan. For individuals there is a
three month waiting period for illness only; under the group plan there is no waiting
period.
MEDICAL REFEREE
Dr. T. Dalrymple is employed on a part time basis as medical referee. This
appointment was approved by the College of Physicians and Surgeons.
RESTRICTIONS
For individual members the CU. & C collects a first call for any new illness from
the member. The Doctor is paid in full for all services subject to the following
limitations:
(1) The Society will pay a maximum of $350.00 for any one illness or accident in
any one membership year. The total amount payable for or on behalf of any one
member and, or, his dependents for each membership year shall not exceed $1400/00.
(2) No benefits will be payable in respect of gall stones, thyroid, varicose veins,
hernia, dilation and curettage, stomach ulcer, hysterectomy, tonsillectomy, adenoid-
ectomy or appendectomy, emergencies excepted, unless such operation is performed, or
treatment necessary originates at least one year after the date of acceptance of the
person on whom the operation is performed or to ^whorn the treatment is given as a
member or a dependent.
Under the group plan, the above restrictions do not apply, but the treatment of
any accident or illness is limited to one year's duration.
TERMS OF SERVICE
(1) All members are supplied with a membership card stating the date coverage
commences.
(2) CU. & C provides a billing form available to all doctors upon request. It is
important that a separate billing form be used for each new illness.
(3) Payment is made direct to the doctor on the basis of the 1952 minimum schedule
of fees, less 10%. The CU. & C will pay all accounts received up to the last day of
each month by the end of the month following with ten days grace.
It is requested that the doctor not collect the first call by individual members,
as this only leads to confusion in the CU. & C office.
Any doctor who has difficulty and does not understand the CU. & C set up,
please communicate in the first instance directly with:
CU. & C Health Services Society F. G.- Greenway,
96 East Broadway, OR 706 Courtenay Street,
Vancouver 10, B.C Victoria, B.C
Phone: EMerald 2021 Phone:  Empire  7722
B.C. TELEPHONE EMPLOYEES
HISTORY: The Telephone Employees' Medical Services Association of B.C. is a
non-subsidized organization adrninistered by the employees of the B.C. Telephone and
Associated Companies in B.C. It was founded in 1936, reorganized in 1937, and after
negotiations with the Medical Profession throughout the Province, became the first
"Approved Plan" on the basis of 75% payment of fees, in full, on a fee for service
basis, and free choice of doctors registered in B.C. A Medical Reference Committee
was set up to study the affairs of the Association and, after three years, the accumulated
Page 267 data was used in formulating plans for M.S.A.    The Association served as a model for
a number of private and commercial organizations. f|||
BENEFITS for members and dependents cover necessary office, home and hospital
calls and surgery in accordance with the Schedule of Fees; necessary diagnostic services
(including laboratory and X-ray); half cost of drugs on prescription (within limits)
and the services of a specialist on referral by the family physician. In unreferred cases
the specialist fee is paid and the member refunds the difference over the general
practitioner rate. Medical costs in accident cases are paid up to a limit of $100.00 and
Anaesthetic Services in cases covered by benefits.
EXCLUSIONS: Treatment of congenital and pre-existing conditions; mental and
venereal diseases; for cosmetic effect; conditions arising out of the use of alcohol or
narcotics; maternity fees; services connected with, dental work; refraction for glasses;
physiotherapy and X-ray treatment; services that may be obtained free or at nominal
cost through public institutions and injection treatments, or inoculations series, over
the amount of three office visits.
MISCELLANEOUS: Members and adult dependents give written permission to
ascertain details necessary for payment of accounts in accordance with the By-laws.
Coverage is given outside the Province (emergency only) at rates payable in B.C.
There are 4,112 members or approximately 7,000 total persons covered.
The Association is an approved plan under B.C. Hospital Insurance Service and
pays hospital costs for Association members in accordance with the Act.
Inquiries should be directed to Miss M. H. Harris, R.N., Administrator.
B.C. GOVERNMENT EMPLOYEES
HISTORY:
The B.C. Government Employees' Medical Services Association, established in
August, 1944, under the name of the B.C. Provincial Government Employees' Benefit
Society, with an original membership of 400. The Society received the "Approval" of
the College of Physicians and Surgeons some eighteen months later. The present
membership of the Society is 5,700, and is serving some 14,200 persons. Membership
in the Society is open to all employees of the Provincial Government, whether employed
on a full or part-time basis. Membership is also extended to Superannuated employees
who were members of the Society two years prior to retirement.
BENEFITS:
Medical and surgical services, home, office, and hospital calls on a general
practitioner basis and specialist when referred. Members and/or their dependents
obtaining the services of a specialist in the first instance may be held responsible for the
difference between the general practitioner's fee and the specialist's fee. The foregoing
benefits are subject to the limitations as set forth in these Regulations. These services
shall be rendered by a physician or surgeon registered by the College of Physicians and
Surgeons of B.C.   Maximum liability $500 in any one membership year.
Anaesthetic and laboratory services; X-ray for diagnostic services (except dental
services) up to a maximum of $25.00 for any one illness or accident in any one
membership year; Blood transfusions and blood plasma up to and not exceeding $25.00
for any one illness or accident in any one membership year; Treatment for preexisting or chronic conditions after a member has been enrolled for a period of one
year, but such treatment shall not exceed the sum of $250.00, payment for any further
treatment shall be at the discretion of the Board of Directors.
The sum of $67.50 will be paid the attending physician for obstetrical services,
to include pre-natal, confinement, and post-natal care, when a female member has been
enrolled as i\ member or when the wife of a member has been enrolled for a period of
ten (10) months. Cesarean operations will be paid for by the Socity, providing that
the same ten (10) months waiting'period has elapsed.
Page 268 Injections that follow accepted therapeutic practice, up to the sum of $35.00 in
any one membership year, providing that the Medical Director shall approve such
treatment.
Out-Patient services in accordance with established hospital rates.
Members and their dependents shall be entitled to Physiotherapy when prescribed
by the attending physician, up to a maximum of $25.00 in any one membership year.
EXCLUSIONS:
Diagnosis and treatment for injury for which the member or dependent is entitled
to benefits provided by the Workmen's Compensation Board; Diagnosis and treatment
for cosmetic effect; Diagnosis and treatment for functional or structural abnormalities
which are not the result of illness or disease unless such treatment is approved by the
Medical Director as necessary for the health of the individual concerned.
Refractions or treatment in connection with optical glasses.
Treatment for mental disorders, venereal diseases, voluntary abortions, rest cures,
alcoholism or drug addiction, any disease or injury occurring during military, naval or
air services, self-inflicted diseases or injuries, any illness, injury of riot or war, plastic
surgery except of an emergency nature, tuberculosis, or- any other illness or diseases
that are provided for by the Government or Municipal authorities at a nominal or no
cost.
Serums, vaccines, spirituous liquors, artificial eyes, artificial limbs, braces and
appliances, or proprietary drugs or biological or endocrine products.
Radium treatment, X-ray or treatment by any electrical appliance or hydrotherapy.
Periodical medical examinations or examinations for the purpose of obtaining a
certificate of health.
LIMITATIONS:
Members are not entitled to services during the first sixty (60) days of membership
in the case of illness, and 14 days in the case of accident.
Enquiries should be directed to 902 Helmcken Street, Vancouver 1, B.C, TAtlow
8361-62.
Medical Director—Dr. G. L. Smith.
Secretary-Treasurer—Mr. J. P. Swansborough.
VANCOUVER SCHOOL TEACHERS
Vancouver School Teachers' Medical Services Association was organized in January,
1940. Membership and coverage is restricted to teachers in the employ of the Vancouver School Board and dependents; members of the Vancouver School Board office
staff and their dependents. Retired teachers and widowed spouses of teachers may
continue coverage.
Present coverage, members 932, dependents 878—Total 1,810.
Benefits: Ordinary medical and surgical costs and specialist when referred by
general practitioner.
Limitations of Benefits:
Any one illness covered for 12 months.
One person—$500 per year.
Two persons—$800 per year.
Three or more, $1,000 per year.
Member pays to the Association the first $10.00 of medical or surgical costs
incurred by him in any fiscal year.
- Total Claims Paid
Association has paid in claims a total of $105,773.29 during the past five years.
Enquiries should be directed to Mr. E. E. Barnes, Secretary-Treasurer, 1642 West
Broadway, Vancouver, B.C
Page 269 B.C. TEACHERS
The British Columbia Teachers' Federation Medical Services Association was
organized with the co-operation of the College of Physicians and Surgeons of B.C., in
1942. Its purpose is to provide prepaid medical care for school teachers and their
dependents.
It operates with the paid help of one full-time stenographer-bookkeeper and part
times services of another. It is adniinistered by an elected board of trustees. The
services of a medical referee, Dr. J. H. MacDermot, of Vancouver, are used by this
Association.
The Teachers' Medical Services Plan offers free choice of doctor. Reference to
use of specialist services are made through the general practitioner. A maximum of
$500 for single members and $750 for those with dependents is allowable in any one
year. Physio-therapy, X-ray, laboratory and other diagnostic services are also paid
for by this Association. A maternity grant of $25 is payable to the member after ten
months of membership. Pre-existing ailments are not covered under the by-laws. A
sixty day waiting period applies to new members.
Account forms are provided and are forwarded to doctors upon request. Payment
of medical accounts are made upon the basis of the schedule of niinimum fees of the
B.C. Division, C.M.A., less 10% administrative discount. In settlement of doctors'
accounts, to date the Association has paid out approximately $150,000 in benefits..
Our present total membership is 1,454 members plus 1,75^5 dependents, being a
total of 3,209.
Enquiries may be addressed to:
The Secretary,
B.C. Teachers' Federation M.S.A.,
1644 West Broadway,
Vancouver 9, B.C
SOCIAL ASSISTANCE MEDICAL SERVICES
Social Assistance Medical Service was first established in March, 1949, and since
that time over three nrillion dollars has been received from the Provincial Department
of Health and Welfare and distributed to the Profession. The cost of administering
this amount in the first three years has averaged 4.4% of this total sum.
One occasionally hears some criticism about various groups in the Profession
receiving more than their share so for that reason the following figures are presented
for your information and are self explanatory.
TABLE i.
Percentage of monies paid in one quarter to various categories of practice.
Classification
General   Practice   	
General Surgery 	
Orthopaedic  Surgery  —
Ophthalmology	
Otolaryngology
Ophthalmology and Otolaryngology.
Internal   Medicine	
Urology  1	
Anaesthesia   	
Radiology	
Obstetrics   and   Gynaecology	
Paediatrics  ;	
Neurology  and Psychiatry	
Neurology   and   Neurosurgery	
Psvchiatry j	
Page 270
Number of
Doctors
563
:   l°l \
:    I
18    /
53
17
47
_ 17
22
16
Percentage
of money
62.1
12.5
7.4
5.1
4.8
2.8
1.9
i.i
.8
i Dermatology
Osteopathy
Pathology   _
6
3
1
923
Total Number of Doctors .	
In addition to above, 45 Hospitals submitted accounts.
Who receives Medical Benefits under S.A.M.S.?
Two new acts were established on January 1st, 1952, namely the "Old Age
Assistance Act" (65-69), and the "Old Age Security Act" (70 years and over). In
order to qualify for Medical Benefits under the above two acts the pensioner must pass
a Provincial Government Means Test. For a single pensioner the annual income including pension must not exceed $720 and for a married pensioner $1,200 per annum.
The pensioner is also required to have one year continuous residence in the Province
before he can apply for Medical Benefits.
Table 2 shows the variations in the different categories covered over the first three
and a half years of operation of S.A.M.S. It will be noted that the overall increase of
almost nineteen thousand is made up chiefly of the 65-69 group and the seventy and
over group.
TABLE 2.
Number of persons covered including dependents:—
Inception of Plan—March 1, 1949
Category
Japanese	
M. A	
S. A. 	
C. W. D	
O. A. P.	
No. Covered
        312
 2,235
  13,763
 515
  28,672
September 30th, 1952.
Category No. Covered
M.   A. 1,575
S.  A. 14,515
C. W. D 2,952
O. A. P. and Blind 37,714
O. A. A.   (65-69) 7,691
Total  per month j— 45,497 Total  per month ___ 64,447
Medical Identity cards are issued by the Provincial Government Department of
Health and Welfare and not by S.A.M.S Prior to the 1st of January, 1952, only a
spot check was made on account cards for correct medical identity numbers. Since
then however it has been found necessary to check all accounts rendered for the correct
medical identity number in order to establish eligibility. When at all possible we supply
the correct medical identity number, but when this is not possible the card is returned
to the Doctor's office and it is his responsibility to supply the correct number. Sample
cards have been sent to all Doctors for their guidance.
This may seem like a rather bureaucratic rule, but it was only put into force to
protect the profession at large, as many of the Old Age Security group felt they were
entitled to free medical care and there appeared to be some confusion in the minds of
some Doctors as to who was entitled to medical benefits under S.A.M.S.
H. SCOTT,
Medical Director.
E. L. DEIGHTON,
Administrator.
4?04   y044/1 9nfojUH&Uo44
Fraser Valley Medical Dental Society
In the Fall of 1952 officers of this Plan again met with the Prepaid Plans Subcommittee in an endeavour to see if approval could be given. The plan, its benefits, its
administration and the financial structure came under critical review.
After a very thorough study, the Economics Committee recommended to the
Board of Directors that the Fraser Valley Medical Dental Society be not approved at
Page 271 this time.   This recommendation was accepted by the Board of Directors and the plan
so notified.
Recently a considerable number of physicians have phoned the Association office
or have forwarded letters that have been received from the Fraser Valley indicating
that Fraser Valley has been asking certain specialists to do work at general practitioner
rates, has suggested that patients might be referred to doctors if they do so, and has
sent as payment of account in full the account less 10%. Moreover, a printed letter
has been sent out to all physicians suggesting that recognition has been sought rather
than approval and that the plan has amended itself in such a way that it would now be
possible for physicians to accept a 10% deduction.
This opportunity is taken to assure you that this is not an approved plan, there
is no understanding between our Association and Fraser Valley Medical Dental Society
for a 10% administrative discount, and that physicians in their relationship to patients
who are insured in Fraser Valley should deal with the patient, recognizing that any
contract lies between patient and Fraser Valley.
POSITION WANTED
Toronto graduate (1951), with rotating internship, married, now
in general practice desires immediate position in general practice in
B.C., preferably in Lower Mainland, Okanagan or southern part Vancouver Island. Write: The Bulletin of the Vancouver Medical Association, 675 Davie Street.
FOR SALE
Beautiful privately-owned island for sale. 65 enchanting acres. 1 V_-
hour drive from Victoria. Country farm estate. Abundant water.
Splendid yacht harbor and lovely white beach. Wooded trails connect
many hidden bays and coves inviting exploration. Oysters. Good
salmon fishing. Close to shopping districts. 15 minutes by air from
either Victoria or Vancouver.   Write owner for full particulars.
David B. Conover Ganges, B.C.
NOTICE
Mr. F. J. FISH, having retired on superannuation after more
than 20 years service to the Medical Profession through the Medical
Records Department of the Vancouver General Hospital, wishes it
to be known that his services are available on a part time basis to
any doctor or group of doctors desirous of having their office medical
records reliably collated. Occupation of greater consideration than
emolument. Phone CHerry 2068 or write 3416 West Fifth Avenue,
Vancouver 8.
Page 272 PUBLIC HEALTH AND MENTAL HEALTH NEWS
G. F. AMYOT, M.D., D.P.H.,
Deputy Minister of Health, Province of British Columbia
A. M. GEE, M.D.,
Director, Mental Health Services, Province of British Columbia
INFORMATION REGARDING THE ADMISSION OF
MENTAL DEFECTIVES TO THE MENTAL HOSPITAL
The Woodlands School in New Westminster where the mental defectives are cared
for is at present^administered under the Mental Hospitals Act. It is hoped to have this
school operating under a separate act for the mentally deficient.
At present all admissions must.be regularly certified under the Mental Hospitals
Act; that is the regular certificates are necessary, an "A" form, two "B" forms or
medical certificates and a "C" form signed by a magistrate or justice of the peace.
These patients are then admitted in the usual way to the Provincial Mental Hospital
at Essondale and are transferred to The Woodlands School as soon as accommodation
can be proveded.
In regard to the mental defectives under the age of six, an order-in-council was
passed in 1951 making it necessary to make application to the Medical Superintndent
requesting admission of the child in order to determine whether or not accommodation
existed. At the present time such application should be made through Dr. L. E. Sauriol,
the Medical Superintndnt of The Woodlands School, who may authorize, when he has
available accommodation, the admission of such child direct to The Woodlands School,
providing of course that the regular certificates mentioned above are properly completed.
This thus eliminates for the under-six child the necessity of being admitted to the
Mental Hospital at Essondale and then later being transferred to The Woodlands
School. ||gg|
STAFF NOTES
Dr. Bruce Bryson was recently appointed Medical Superintendent of the Provincial
Home for the Aged, Port Coquitlam, B.C. In this position he supervises the Geriatric
Division of the Provincial Mental Health Services including the Homes for^ the Aged
at Vernon and Terrace. Dr. Bryson's new appointment is made possible by the recent
promotion of Dr. T. G. B. Caunt to the position of Medical Superintendent, Provincial
Mental Hospital, Essondale, B.C.
Dr. F. E. McNair, for some years Assistant Clinical Director at the Crease Clinic
and Provincial Mental Hospital, Essondale, B.C., was recently promoted to the position
of Clinical Director of these units upon the appointment of the former incumbent, Dr.
A. E. Davidson, to the position of Deputy Director of Provincial Mental Health
Services.
Dr. N. L. Richardson of the Crease Clinic staff commenced a year of post graduate
study in Psychiatry at the Allan Memorial Institute, Montreal, in January. Dr.
Richardson has received a Federal Mental Health Grant Bursary for this training period.
The following is worthy of reading by all medical practitioners in this Province:
"Preventive medicine as practised by the general practitioner is not limited to
his office, it is found wherever he goes—in his daily practice, in his postgraduate studies,
Page 273 and in his civic activities through his community health council.    Each decade preventive medicine occupies more of the general practitioner's time.
Without the cooperation of the general practitioners of America any preventive
medical program, whether national, State, or local in character, is doomed to failure.
Practicing physicians look to public health officials for leadership. The general practitioner, however, should be led, not pushed.    Continuous education is the key.
Public health is a specialty. Few general practitioners have the time or the
training to do a good job in part-time public health work. Organized public health
units with full-time personnel constitute the essence of good health protection."
J. S. DeTar, M.D., Milan, Mich., speaker, House of
Delegates, American Academy of General Practice;
President, Michigan Health Council.
n
ew5 an
d I/oted
Dr. B. W. Cannon of New Westminster has retired from practice.
Dr. E. C. H. Lehmann is now certified in orthopedic surgery.
Dr. Helen B. Zeman is now resident in pediatrics at the Rosedale Hospital in New
York.
Dr. A. S. McPhillips has opened a practice in endocrinology in the Broadway Medical
district of Vancouver.
Dr. Paul Kepkay has been with the Leahey Clinic in Boston and is shortly returning
to Vancouver to practice internal medicine.
BIRTHS-
To Dr. and Mrs. C. G. McNeill of North Vancouver—a son.
To Dr. and Mrs. D. E. McKerricher of Vancouver—a daughter.
To Dr. and Mrs. J. J. Eakins of Nanaimo—a son.
To Dr. and Mrs. J. C. Rife of Cloverdale—a son.
GROUP  LIFE  INSURANCE
All members of the Canadian Medical Association, B.C. Division,
under age 60 have received an invitation to join the Group Life Insurance Plan. The Board of Directors believes this is a good Plan and
recommends your particiption in it. A reply one way or another
would be appreciated.
Page 274

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