Old and Sick in America: The Journey through the Health Care System

By Muriel R. Gillick | Go to book overview

CHAPTER FOUR
The March of Time, 1965–2015

When the residents of Markle, Indiana, lost their only physician in a tragic accident in the early 1960s, they set out to find a replacement. They knew what they were looking for, and after scouting out some possibilities at the nearest medical school (one hundred miles away in Indianapolis), they found just what they wanted. In fact, they found a pair of new doctors. Gerald Miller and Lee Kinzer were young, eager, idealistic, and fresh out of internship. They were a perfect fit for Markle, a town of just under 1,000 located twentyfive miles from Fort Wayne, the closest urban center.1

The two physicians proceeded to set up what they considered a dream practice and the community, by all accounts, shared their view. Sporting the slightly grandiose name of “Markle Medical Center,” the practice cared for every one in town and, as its reputation grew, in neighboring towns as well. Miller and Kinzer worked hard seeing patients six days a week, with evening hours once a week—at least for a time—and rarely got home to their wives and children before seven on the remaining days. They saw patients in the office, they visited patients in their homes, and they made rounds on patients in three nearby community hospitals, until they finally consolidated their hospital work in the thirty-three-bed Welles County Hospital, twelve miles down the road from Markle.

Markle Medical Center was for children and old people and every one in between; its physicians delivered babies, diagnosed and treated pneumonia, referred patients with heart attacks or cancer to specialists, and patched up local farmers when they came in with an injury. They relied on their wives to serve as nurse, bookkeeper, and receptionist until they earned enough income and had sufficient volume to hire a full-time staff. In their first years, they charged four dollars for an office visit, adding another dollar for a urinalysis. They dispensed Medications themselves, billing at cost. The two doctors lived, worked, and participated in the life of their community. Dr. Miller joined the local Lions Club, volunteered as team doctor for high school sports teams, and attended the school’s football and basketball games. His wife was active in their church and the local chamber of commerce, and wrote for the town newspaper.2

When Drs. Miller and Kinzer made house calls, toting the black bags universally supplied by Eli Lilly Company to medical students in that era, they

-61-

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Old and Sick in America: The Journey through the Health Care System
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Prelude ix
  • Abbreviations in the Text xxi
  • Part I - The Office 1
  • Chapter One - Going to the Doctor 3
  • Chapter Two - The Lay of the Land 23
  • Chapter Three - From the outside in 41
  • Chapter Four - The March of Time, 1965–2015 61
  • Part II - The Hospital 79
  • Chapter Five - Entering the Palace of Technology 81
  • Chapter Six - The Varieties of Hospital Experience 97
  • Chapter Seven - The Hospital through Other Eyes 113
  • Chapter Eight - The Transformation of the American Hospital, 1965–2015 133
  • Part III - The Skilled Nursing Facility 151
  • Chapter Nine - Going to Rehab 153
  • Chapter Ten - Different Snfs, Different Miffs 169
  • Chapter Eleven - Movers and Shapers 184
  • Chapter Twelve - Now and Then 202
  • Finale 223
  • Acknowledgments 245
  • Notes 247
  • Bibliography 267
  • Index 293
  • Studies in Social Medicine 301
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