SCHOOL MEDICAL SERVICE IN PERSPECTIVE

Abstract

THE PROBLEM of quantity and quality of school medical service has concerned some leaders in public health and education in this country for more than 50 years. To achieve a balance between quantity and quality within budget limits is a problem of great difficulty. The growth of population and increasing demands for service may at any time upset the best laid budget plans. In what follows, I shall deal with the progress of school medical service and consider those policies which have had a bearing upon the quality of services. Emphasis on Quantity About 1905, when physicians in schools began to give attention to non-contagious conditions of school children, many physical defects were noted. This was the beginning of a new type of official action in behalf of the health of school children. By 1923 many states had laws requiring annual school medical inspection. However, as there had been no specific standards of quantity or quality, those responsible for the service were troubled by the dilemma of deciding how much of each they should plan for. How much medical service was needed? Nearly every school medical and nursing service was reporting enormous numbers of defects found and this kept the focus upon a concern for more examinations and coverage to find them all. During the 1920's communicable disease epidemics encroached so heavily upon the time of doctors and nurses in the schools as to stop all examinations and follow-up work. In between epidemic periods the demand for inspections of suspected cases of communicable disease caused interference with the search for defects.