1. The plan must safeguard the quality of medical service and preserve the personal relationship between patient and physician.
2. It must provide for the future development of preventive and curative services in such kinds and amounts as will meet the actual needs of all the people, not merely their effective demands.
3. It must provide services on financial terms which the people can and will meet, either through individual or through collective resources.
4. There should be a full application of existing knowledge to the prevention of disease, so that all medical practice will be permeated with the concept of prevention. The programme must include, therefore, not only medical care of the individual and the family, but also a well-organized and adequately supported public-health programme.
5. The basic plan should include provisions for assisting and guiding patients in the selection of competent practitioners and suitable facilities for medical care.
6. Adequate and assured payment must be provided to the individuals and agencies which furnish the care.
Having spent five years in factfinding, and having agreed upon these six essentials, the committee was forced to recommend, as the only ultimate solution for the great majority of our people, group practice of medicine and group payment of medical services.3
The committee recommends that medical service, both preventive and therapeutic, should be furnished largely by organized groups of physicians, dentists, nurses, pharmacists, and other associated personnel. Such groups should be organized—and preferably around a hospital—for rendering complete borne, office, and hospital care. The form of organization should encourage the maintenance of high standards and the development or preservation of a personal relation between patient and physician.
The major recommendations envisage groups providing all the needed therapeutic and preventive medical and dental services, except care for tuberculosis, mental disease, or other conditions which have been accepted as governmental responsibilities. Thus, complete groups would contain physicians, — both general practitioners and specialists, — dentists, nurses, pharmacists, medical social workers, and all the needed technicians and assisting personnel.
It is clear that many groups in smaller cities and towns cannot afford the full-time services of specialists in each branch of medical practice. To obtain the less common specialized services, these groups should affiliate with larger centres, particularly with teaching hospitals and medical schools.
The committee recommends, further, the extension of all basic public health services, — whether provided by governmental or non-governmental agencies, — so that they will be available to the entire population. Primarily this extension requires increased financial support for official health departments and full-time trained health officers and members of their staffs, whose tenure is dependent wholly upon professional and administrative competence.