Medicine in Milford

Medicine may be viewed as a profession with component parts embodying art, science, skill, communication and business.  It provides an avenue of access where those needing care may meet those who provide it.  This need exists both within and outside of a hospital setting. 

The avenue of care in the 1950s was a two-lane highway where a patient could find a doctor of his or her choice.  Healthcare was then a cottage industry.  The two-lane highway has broadened considerably into a multi-laned boulevard, with access controlled by insurance companies.  And the cottage industry has developed into a 1.3 trillion dollar business annually, consuming over 14% of the G.N.P. 

The manner in which care is dispensed by the medical doctor has changed dramatically.  Perhaps the only constant in our lives is change (K=D).  To start with, the doctor is now renamed the caregiver or health provider, alongside others not possessing the medical degree.  The broadened boulevard is now traversed by other vendors providing alternative or complementary measures. 

Of all the component parts constituting the armamentarium in “the doctor’s bag,” not all are required in equal parts on any given day.  The business component has assumed a front and center position however, even though loathed by both patient and doctor.  This is one of the by-products of managed care. 

Along with these changes was a contemporaneous development in the profession of the law, which would impact unfavorably upon medicine.  The legal profession was actively seeking new sources of revenue and doctors were fair game.  It was common to hear advertisements on the radio and on television inviting potential clients to seek monetary redress if they had been injured, or if there were any reason to suspect malpractice.  There were lots of new lawyers to develop this thesis. 

As if to aid this cause, both the medical and lay press have drawn attention recently to the fact that doctors themselves are to blame for at least part of the existing medical miasma; that doctors are part of the problem, not the solution required in mainstream medicine.  The March 16^th, 2003 New York Times Magazine illustrates the point.  On the cover page, in one half inch letters is the statement that “Half Of What Doctors Know Is Wrong.”  Reflecting a study in 1999 by the Institute of Medicine, more than 30 pages are devoted to impugning the practice of medicine, and the statement is made that: “In 2003, as many as 98,000 people in the United States will die as a result of medical errors.”  It may raise the question as to why doctors should let mere facts stand in the way of conventional medical practice. 

A concomitant development was a crisis in obtaining malpractice insurance for doctors.  Premiums increased dramatically; it was common in mid century America to have premiums less than one thousand dollars annually.  Toward the end of the same century, the same coverage cost tens of thousand of dollars, and in some areas, insurance was not even available.  While the focus of this story is not on the legal aspect, the component is being mentioned to point out one of the factors bearing upon the change that has occurred.  The country as a whole was becoming increasingly litigious, and it was sometimes difficult to ascertain whether a given patient on a given day would first seek help from his attorney or from his doctor. 

This is a story about medicine in Milford Connecticut about a medical stage and about some of those who traversed it.  Milford could well be considered a microcosm of evolving events, part of a larger picture:  the macrocosm of medicine throughout the land.  What unfolded on the Milford stage may well have commonality with other communities.  Let us recall three l