Editorials

IRVINE H. PAGE, M.D., Editor

More on a National Academy of Medicine

Last year | wrote of the need
for a National Academy of Medicine. It has become increas-
ingly apparent that a large gap exists between the thinking
and operations of the American Medical Association on the
one hand and the various governmental medical agencies on
the other. For example, there seems to be little middle ground
between the AMA and the President's Science Advisory Com-
mittee with its minimum of physician representation. The
recent Commission on Heart Disease, Cancer and Stroke again
illustrates how wide is the gap, and yet no serious-minded
person denies the great role that medicine must play if we
plan to have a “Great Society.”

So what has happened since
the original editorial (Needed—National Academy of Medi-
cine, MM, July 20, 1964, p. 77)? Hundreds of letters have
arrived expressing all manner of opinions, and many of them
have been fram present members of the National Academy of
Science. | am deeply impressed by their thoughtfulness and
desire to find the right answer. A summary of all these letters
is impossible because of their great variety. One trend, how-
ever, is readily discernible, and it is that there is the need.
On a less urgent note is the feeling that formation of an
Academy will not be easy. This, in short, is the distillate of
the thinking of many highly intelligent scientists and physi-
cians. While all this was under way, the engineers, for a
variety of not wholly dissimilar reasons, have formed a Na-
tional Academy of Engineers. Thus, change seems to be in
the air.

Let me add a series of miscel-
laneous views and suggestions | have gleaned from the corre-
spondence, especially from present members of the NAS.
Clearly medicine is wholly inadequately represented in the

Reprinted from MODERN MEDICINE, March 15, 1965, pp. 89-90

Copyright 1965, Modern Medicine Publications, Inc.
PRINTED [IN U.S. A.
Editorials

NAS, although other disciplines feel it is they who are inade-
quately represented. Oddly enough, biochemistry feels slight-
ed! Some feel a NAM should be closely affiliated with the
NAS; others feel strongly against it, and yet only four sug-
gested that the problem be explored in collaboration with the
NAS! Many express the hope that a NAM would comprehend
social issues which seem to find no reflection in the NAS.
The fear is often expressed that academies in general “are
no more than self-perpetuating bodies to serve our own
glory”; and more, “It is a great honor to be a member of ....
and the main function of it is to decide who deserves the
honor.” Isn't it good to see that our brethren have not lost
their delightful sense of humor! Another fear is that it would
fall into the hands of cliques of medical politicians. With de-
light | read the following: “The multiplicity of organizations
has already done almost infinite harm so that on first blush
| shuddered at a NAM.... 1 wish now to approve completely
your suggestion.” Clearly, we are not lacking in spirit, and
{| am pleased to report to you that this gem comes from one
over 80.

Many express apprehension
about the basis for selection of members for a new Academy.
Nineteen letters expressed the fear that members would be
selected who would do nothing more than follow AMA policy.
Some feel that no organization really speaks for its member-
ship; 5 or 10 elected officers or full-time employees give
their views. A number want to be sure that some people who
are scientists and not physicians be included.

On one thing everyone agreed:
They themselves were on the go so much there was little time
to give to a painstaking analysis of thé problem. This is cer-
tainly true, but | have evidence in the form of their letters
that those who have written me not only are very superior
men—tolerant, articulate, thoughtful with charming wit—but
have given the problem the attention it deserves. Whether
a NAM is formed or not, the materia! is certainly there to
form it. | can tell you that preliminary discussions are now
under way. Let us proceed slowly and thoughtfully, but Jet
us proceed.

IRVINE H. PAGE

90 Modern Medicine, March 15, 1965