Hardly a week goes by without the newspapers reporting on the skyrocketing costs, the fraud and waste of the health care industry. Long-time physicians and nurses bewail the hyper-commercialism and greed which drive so much of this marketplace.
That is why it is good sometimes to reflect on the practice of medicine, as if people mattered. The University of Oklahoma Press (Norman, OK) has recently performed a public service in republishing Dr. Michael A. Shadid’s autobiography, titled Crusading Doctor: My Fight for Cooperative Medicine. If Hollywood is looking for both drama and historical significance in the life of one immigrant to this country, the saga of this rural physician in the shortgrass country of western Oklahoma has to be a leading candidate. His family in Mount Lebanon, where he was born in 1882, was so poor that nine of his infant brothers and sisters died from poor sanitation and malnutrition.
Yet, before he completed his remarkable career in the nineteen sixties, he went from a teenage peddler in the mid-west to college and then medical school at Washington University. As a physician, he braved dust storms and snow drifts, delivering babies and attending to the illnesses of farm families; he organized the first prepaid medical institution in the United States — the farmer owned cooperative hospital in Elk City, Oklahoma. In retirement, he founded a charity hospital in the Lebanese village of his birth. He also helped establish in 1946 the Co-operative Health Federation of America and was elected its first president.
All the while, during these decades, he wrote seven books, numerous medical journal articles, started the first consumer-health publication, crusaded all over the United States and Canada for pre-paid medicine and group practice that stressed accessibility, affordability and disease prevention. He fought off aggressive attempts by organized medicine to take away his license, harass his co-physicians, undermine his hospital, and smear him. He fought them in the state legislature, at the Governor’s office and in the courts.
Dr. Shadid’s battles and his ultimate victories against the associations of doctors, who viewed prepaid health plans, not to mention cooperative medicine, as a threat to their fee-for-service medicine, paved the way for the large Kaiser Permanente and Puget Sound Plans. He was the indomitable pioneer with the unshakable integrity who ran all gauntlets.
His son Fred, now a retired physician, described a daily routine in the early Thirties; “At age fourteen and fifteen I was driving as his chauffeur [to farmland speaking engagements where Dr. Shadid would spread the seditious doctrine of prepaid medical care], and due to threats, many occasions I sat on the back seat with my 12-gauge shotgun across my knees (I admit my knees were shaky).”
Dr. Shadid persuaded these farmers to start their own Community Hospital in 1929, with a group practice of physicians on salary. Dismayed by poor rural families unable to afford health care, he made hundreds of speeches showing farmers the benefits of banding together.
In 1932, a prepayment plan was developed entitling families to unlimited medical examinations, treatments, surgical operations, and laboratory work at the hospital for the following prepaid rates: one person, twelve dollars per year; two persons, eighteen dollars per year; three persons, twenty-two dollars per year; and four or more persons in the family, twenty-five dollars per year. Home visits were one dollar in town, plus ten cents a mile each way in the country. Drugs, anesthetics and ancillaries were extra.
All this sounds quaint in an era when a single Bic razor can cost $8.00 on a hospital computerized billing sheet. But Dr. Shadid was a physician for all seasons — versatile, focused and self-renewing as a doctor, communicator, organizer and practical visionary.
For this generation of young physicians and medical students, Crusading Doctor is a needed prescription for an historical perspective on what a profession and professional standards should mean today.