Refugee Physicians

Before the reign of Hitler there were 50,000 physicians in Germany, of whom 6,500 were Jewish or part-Jewish. Since 1933 "non-Aryan" doctors have been gradually pushed out of practice. Crowning blow came last October, when licenses of all Jewish physicians were revoked, and only a few special temporary permits were granted for practice in Jewish communities. Although Germany now faces a shortage of trained physicians and has been compelled to reduce the period of medical education by two full years, more than one-half of the ostracized Jewish physicians still remain in Germany, helpless and impoverished. Many of them committed suicide, and about 60 are now practicing in Britain. Most of those physicians lucky enough to escape have come to the U. S.

"Refugees Unlimited." Contrary to popular opinion, there are not 25,000 emigre physicians in the U. S. According to the American Medical Association there are only about 1,180. These have trickled in over a period of six years. In a country which boasts 170,000 licensed medical men, 1,180 is an inconsiderable number. Yet a tremendous hue & cry has been raised by American physicians against the hospitality the U. S. has extended to foreign "competitors." Last week Medical Economics which reaches the office of almost every doctor in the U. S., issued a loud blast against "Refugees Unlimited."

Asserting baldly that 1,000 European physicians, mostly Germans, are entering the U. S. every year, Medical Economics stated that foreign doctors are "coming in droves" to the U. S., painted a gloomy picture of unrestricted immigration, unfair competition of emigres with American doctors and low standards of medical treatment.

Against Medical Economics stands the opinion of several hundred of the most eminent physicians in the U. S., who have formed committees in several large cities to help their unfortunate colleagues. During the next three years, say these physicians, no more than 2,500 European physicians will come to settle in the U. S. and the U. S. is certainly large enough to absorb them. Many of these men are outstanding scientists, and will contribute greatly to the progress of American medicine.

A few famed researchers such as Dermatologist Wilhelm Frei, Dr. Carl Lange, inventor of the Lange test for syphilis, and Biochemist Rudolf Schoenheimer have found little difficulty in securing hospital and university appointments. Other valuable medical scientists, some of whom have not yet achieved medical prominence, are helped by the 77 well-known members of Manhattan's Emergency Committee in Aid of Displaced Foreign Medical Scientists, including Drs. Bernard Sachs, Ernst Philip Boas, John Augustus Hartwell, William Hallock Park, and headed by famed Clinician Emanuel Libman. The Committee, which is nondenominational, administers funds received from the National Coordinating Committee Fund, Inc. in Manhattan, and provides fellowships at U. S. medical schools and hospital laboratories for well-qualified physicians who apply to the schools. In the last five years the Emergency Committee has placed some 80 promising scientists in research positions all over the U. S.

Far more gloomy is the prospect facing practicing physicians and specialists, who leave Germany with only ten marks. Some of them receive financial aid from the National Coordinating Committee or its affiliates, but most of them settle down in the Manhattan area, try desperately to eke out a precarious living.

Manhattan Competition. Most German physicians remain near New York City because it is the port of entry, and New York State requires only a passing mark in the regular State Board examinations for the practice of medicine. Since the licensing laws of 30 States demand from an immigrant doctor full citizenship, and others insist on a period of U.S. training, it is difficult for penniless aliens to spread over the Union. Their way has not been smoothed by the American Medical Association, which offers emigres only sympathy.

About 600 German doctors are practicing in the Manhattan area, struggling hopelessly to compete with established American practitioners. Their business methods are sometimes far from ethical. Some of them are said to have distributed handbills advertising office visits for 50-c-, fluoroscopic examinations for $1, maternity service for $10. But these stratagems, say sympathetic physicians, are not exclusively used by German doctors. Many U. S. practitioners are guilty of more flagrant abuses, such as fee-splitting. In answer to the argument that immigrants give inferior service, sympathizers say that German medical schools are different from U. S. medical schools, for they emphasize research and specialization rather than broad clinical experience. Many German specialists who are masters in their field have been driven into general practice in the U. S. through sheer necessity.

Solution. Most practical solution to the problem has been offered by the Boston Committee on Medical Emigres, headed by Dr. David Linn Edsall, Dean Emeritus of Harvard Medical School and top-flight Neurologists Stanley Cobb and Tracy Jackson Putnam. There are hundreds of small towns throughout the U. S., says the Boston Committee, where physicians are badly needed.* American doctors are usually not attracted to small towns or agricultural communities because they offer only a bare living and meagre hospital facilities. WPA officials have agreed to make a comprehensive survey of such communities, and when a list of opportunities is published the Committee will help to place German physicians. Medical rules in many States, claims the Committee, can be leniently interpreted. Absorption of emigre physicians, stated Dr. Putnam last week, should really be a minor problem. "We look at the emigre problem realistically." he said. 'There will be no placing of emigres in competition with American doctors."

* Last month, Omaha's station WOW interviewed a young physician looking for a place to settle. When Announcer Foster May asked WOW's radio audience to send in names of towns which needed doctors, he was "amazed" to receive requests for physicians from 64 towns in seven Midwestern States.

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