The Making of a President

When the American Medical Association held its semiannual meeting in Miami Beach last week, high on the docket was the election of a president to take office next June. Not surprisingly, the delegates chose a small-town general practitioner, a man who projects just the sort of image that the A.M.A. prefers: Dr. James Ziegler Appel, 57, of Lancaster, Pa. (pop. 60,000).

Dr. Appel's ancestors immigrated from the Palatinate in 1732. He is the son of a doctor who delivered his own baby in the family quarters above his office. Today, Dr. Appel (pronounced apple) still practices in the house where he was born. He wears a hearing aid and is enough of a gadgeteer to have adapted it to serve as a stethoscope. "A lot handier than a regular stethoscope," he says, "for getting inside a man's shirt."

Up the Ladder. Though he is qualified as a surgeon, Dr. Appel insists that he is still a G.P. "A general practitioner," he says, "can be a very contented person because he becomes infused with a feeling of devotion and humanism; he and his patients get to know one another as persons; the rewards are soul-satisfying. I'm doing general practice and I love it." The house of delegates loved him for it too. They chose him, 131 to 94, over Dr. Donald E. Wood, an Indianapolis specialist in internal medicine.

Though small-town doctors are in a minority in the A.M.A., they get the Association presidency disproportionately often. This is not so much the result of rural overrepresentation as of the facts of medico-political life. The small-town doctor has fewer professional societies to occupy him than his big-city colleagues have; he devotes relatively more time to his county medical society. Dr. Appel, during most of his professional life, has been methodically working his way up the ladder of medical-society office holding, first at the county level, then the state, and for 19 years as a member (and in many cases, chairman) of innumerable A.M.A. councils and committees.

Needs of the Elderly. With its current president, Iowa's Dr. Donovan F. Ward, and President-elect Appel as its chief spokesmen, the A.M.A. will continue to oppose, with one voice, President Johnson's plan to finance medical care for the aged under social security. Knowing that the medicare fight will come to a climax in the next Congress, the A.M.A. decided to hold a 50-state war council next week in Chicago and to appropriate a multimillion dollar campaign fund.

Dr. Appel stated the A.M.A.'s position succinctly: "There is no reason for a tax-supported program. We have a much better program in Kerr-Mills. If the states would enact good Kerr-Mills laws the medical needs of the elderly would be met better and at less expense than through medicare. But if it passes, the A.M.A. will obey the Constitution and the laws."

On another issue the A.M.A. did an extraordinary turnabout last week. Having taken a studiously neutral position on birth control for more than 25 years, it decided that "the prescription of child-spacing measures should be made available to all who require them, consistent with their creed and mores." Having jealously opposed any intrusion into the doctor's domain or infringement of his right to collect fees in the Depression 1930s, the A.M.A. now decided that birth-control guidance should be equally available to private and clinic patients, regardless of whether they "obtain their medical care through private physicians or community-supported health services."

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