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The Physicians Forum for the Study of Medical Care was an organization of liberal doctors based in New York City. It began in 1939 as the Progressive Group of the New York County Medical Society, a group of members of the New York County Medical Society who called for the county medical society to make greater efforts to improve health conditions in New York City. The group quickly came to favor more liberal leadership of the county medical society and also nationally organized health insurance. It became the Physicians Forum in 1941 and achieved non-profit status as a corporation in New York state in 1944.
From the late 1940s through the 1960s the Forum came to play a significant role in the national conflict over the direction of health care in the United States. On the liberal side of the debate were several successive White House administrations, organizers of health insurance and group practice plans, and individual liberal doctors and organizations such as the Forum. These groups were opposed to the American Medication Association's more conservative views of health care, which favored independence for physicians and long-lasting personal relationships between doctors and their patients. The central issue was whether the U.S. should adopt federally-controlled national health insurance, similar to the systems that were being introduced in the United Kingdom and other countries. Throughout the debate, other health measures such as pre-paid plans, group plans, clinics, Social Security, medicare, etc., were cast in terms of being precursors to national health insurance. The AMA explicitly warned that the successful implementation of such plans would lead to national health insurance, while the Forum celebrated the same. In later years, when it became clear that national health insurance would not be successfully implemented, the Forum downplayed the intended connection between it and other programs while still supporting all of them.
The debate over national health insurance was primarily a long, multifaceted, publicity campaign soliciting the support of the general public, and of doctors in particular. The AMA lobbied congress, ran ad campaigns, raised funds from membership dues, and attempted to force members of county and state medical societies to join the AMA and pay dues to support it. The Forum protested such practices while running counter-ads and lobbying as best it could. At various points opponents directed a considerable amount of Red-baiting and anti-socialist rhetoric at the Forum.
Throughout, the Forum also continued to work in New York City. In most years the Forum ran a slate of doctors for the board and committee minor positions of the New York County Medical Society, and although their candidates were nearly all defeated, they consistently polled about 30% and elicited a considerable amount of campaigning and debating. The county medical society was also the venue for many Forum programs. The Forum worked on a variety of issues of local interest, such as discrimination in health care, reproductive rights for women, and the rights of doctors serving in the U.S. military. Especially when the issue related to health care, the Forum focused these campaigns on New York City, which often led to discussions and sometimes conflict with the county medical society.
Structurally, the Forum organized itself in several different ways. Although concentrated in New York, the organization considered itself national in scope and had members in many different cities. At various times there were chapters in several cities, primarily on the East Coast. In addition, as the Forum grew in New York it established separate chapters to advocate for the Forum program in the county medical societies of Brooklyn, Queens, and the Bronx. The Forum also organized a variety of national committees to tackle issues such as health care, Social Security, and the dangers of radioactive fallout from nuclear tests. Finally, the Forum spun off independent organizations, such as the Physicians Committee on Research, and was part of national coalitions, including the Council of Health Organizations.
The work of the Forum was largely the result of the leadership of Ernst P. Boas, who founded the organization and was its chairman until his death in 1955. The son of anthropologist Franz Boas, Dr. Boas was a successful heart specialist with his father's interest in activism. During Dr. Boas' life, the national Forum focused on issues such as discrimination in medical training and practices, hospital construction, and most importantly compulsory health insurance, as it was known in the 1940s. It is difficult to gauge from the collection the relative importance of the Physicians Forum in the debate over compulsory health insurance. Certainly the Forum was a small organization, and less important than many other advocates of compulsory health insurance, but it was large enough to be noticed.
The early health insurance debate centered around the comprehensive Wagner-Murray-Dingell Bill. The Forum was involved in debates, sent members to appear before congressional committees, and organized mailings, coalitions, and conferences. The AMA's responses included disputing the fiscal viability and stability of compulsory health insurance, suggesting that it would inevitably lead to inferior standards of health care, arguing that doctors would be unwilling to work under it, and supporting a variety of other bills that were less comprehensive in scope. These bills tended to gave more oversight to the AMA and were intended to appease the supporters of compulsory health insurance without ceding any of the control over fees and services that the AMA enjoyed. The AMA-controlled National Physicians Committee became involved in the controversy in 1941, when it was created, ostensibly to study medical care. The Forum and other liberal groups charged that it funneled AMA funds into a propaganda campaign designed to discredit the supporters of national health insurance by associating them with Communism. In the late 1940s these objections grew more common, and in 1949 the AMA disbanded the National Physicians Committee under pressure, while declaring victory in the battle over national health insurance.
The late 1940s were an increasingly tense time, and it was during the same period that medical McCarthyism became a major issue on the Forum's agenda. A related issue was that of loyalty oaths, which were required by an increasing number of organizations in many areas of American life. Starting in 1949 the Forum worked against the imposition of loyalty oaths, and this increased its prominence in the broader battle against anti-socialist reactionaries. This larger role led to testimony before many congressional investigations of alleged communists and involvement in coalitions protesting the same throughout the 1950s. As part of this, the Forum reached out to individual doctors accused of Communism or disloyalty, and forged links with men such as John P. Peters, who would later become an important member of the Forum. In the late 1940s and early 1950s the federal Social Security program was broadened so that it included more Americans than ever before, but not self-employed professionals such as doctors and lawyers. Seeing Social Security as similar to national health insurance, the Forum began to campaign for the inclusion of physicians in Social Security. As Congress gradually extended the Social Security program to professional groups, it looked to professional organizations such as the AMA for guidance. This allowed the AMA to delay the inclusion of physicians in Social Security, setting Social Security up as another battleground between the AMA and the Forum.
The Forum went through its first major organizational shift in 1955, with the death of Dr. Boas. To a large extent, it was Dr. Boas' energy and convictions that had given the organization its direction. When funds needed to be raised on an emergency basis, he would lend the Forum money or write to his friends asking them to do the same. When the Forum's often haphazard operations threatened to break down, he would devote his time to writing letters and sorting the office out in a way that few (although some) of his fellow Forum members were willing or able to do. During the decade and a half that he led it, the Forum was truly his organization. Without Dr. Boas, the Forum began to change its operations.
Dr. Boas was succeeded as chairman by Edmund Braun, a longtime member and secretary of the Board of Directors of the Forum and another dedicated volunteer, as well as the president of the New York Chapter of the Forum. During this period, the Forum became more involved in promoting voluntary health insurance plans. The Forum's position had always been that voluntary plans could never be as effective as national health insurance, because only the payees and not the payers would want to subscribe. But it viewed voluntary plans as useful to establish the principle that health insurance was viable and acceptable to Americans. As the years went by and national health insurance looked less and less likely, the Forum increased its enthusiasm and support for voluntary plans, especially the Health Insurance Plan of Greater New York.
During this period the Forum also created an Administrative Committee to address issues of fund-raising, office management, and member recruitment on an institutional level rather than leaving these tasks solely on the shoulders of the chairman and the executive secretary. Dr. Braun served for only two years before the Forum decided in 1957 to make the chairmanship a position that rotated on an annual basis.
This new structure led to further changes. The Forum's work, especially its work with other groups fighting medical McCarthyism, had diversified its membership around the country. The new rotating chairmanship began with Paul Levietes of Connecticut, followed by Katherine Dodd of Arkansas, and the scattered nature of the Forum's leadership reinforced the idea that the organization would not be dependent on the willingness and ability of individual leaders to sacrifice tremendous amounts of their time. This led to an increase in the responsibilities of the Forum's various committees, which essentially took over the operation of the Forum.
In the early 1960s, the conflict over health insurance and Social Security entered another phase, with the proposal of Medicare legislation to extend Social Security to provide greater health benefits to the elderly. The Forum appears to have entered this campaign with a renewed vigor, as the collection suggests that the national office once again took the lead on this issue, with several successive chairmen being heavily involved in letter-writing and campaigning. With the emergence of the civil rights movement into the mainstream, the national office also re-engaged the issue of discrimination in medicine.
After Medicare became law in the mid-1960s, there is a significant drop in the volume of the collection, although work on discrimination continued and it was joined by reproductive rights and other new issues through the late 1960s and into the 1970s. There is less information about these later years, but in 1985 the Forum also became incorporated in the state of Illinois, and a discussion of the constitution and by-laws of the corporation in 1992 suggests that operations were moved from New York to Chicago. The latest dated item in the collection is an invitation to a 2002 dinner that suggests that the Forum's office operations, or possibly just name, were then being looked after by the AFSCME International office in Chicago.
Physicians Forum Collection came to the University of Pennsylvania from Walter J. Lear's Institute of Social Medicine and Community Health at two times; the bulk of the collection in 2005, and a smaller, related collection in 2008. The collection comprises 64 boxes of material, including administrative records, correspondence of members, work of committees, subject files on major issues, events, publications, publicity, news clippings, and a reference file on other organizations. The collection primarily contains minutes, notes, and correspondence but also includes printed materials such as publications and a few audio tapes. The volume of the collection is variable, as the Forum's level of activity was not constant. It peaked between 1945, when the Forum was fully organized behind national health insurance, and 1965, when Medicare was passed.
The Organization and Administration series contains records pertaining to the organization and history of the Forum. The constitution and statement of principles address the organization's establishment and several important transitions such as incorporation and the move to Chicago. The Board of Directors' files contain a chronological record of the meetings and correspondence of the Forum's directors in their official capacities, giving a sense of the national office's work, including the volume of work done by the Forum's executive secretaries.
The Papers of Forum Members series illustrates this further, with a considerable portion of the series comprising the papers of the executive secretaries and chairmen of the Forum. Including personal, non-Forum, and official Forum correspondence that does not fall under any specific committee or issue, the series suggests the large role the Forum played in its members lives. The papers of Dr. Boas form a large part of the series, and contain many documents concerning the Forum's founding and organization. The correspondence files of executive secretaries Jocelyn Wagner and Pat Lievow include useful summaries of the Forum's history.
Rounding out the basics of the Forum's operations, the Committees series and the Regional Activities series contain information about the Forum's efforts to diversity itself with respect to both issues and geography. The committees varied widely in scope, and some of their files contain just a few pages of minutes while others have several folders and chronicle entire campaigns. Some key examples of the latter type of committee are the Committee on Social Security for Physicians, the Radiation Hazard Committee, and the Women's Committee, a group of doctor's wives who helped with fund-raising and event planning. Similarly, the regional files vary from those of well organized and long-lasting groups such as the Boston chapter to groups that never had a chapter, such as Los Angeles, and groups that appear to have been a chapter in name only, such as the Philadelphia chapter.
The series of records from the New York County Medical Society is one of the more complex and important parts of the collection. The Forum began as a group of doctors who felt that they needed to provide a liberal voice in the New York County Medical Society, and so the county medical society comprises one of the oldest, longest, and most complete series in the collection. The Forum's relationship with the county medical society, antagonistic as it often was, included many of the Forum's most important projects. The series contains materials pertaining to the planning of the Forum's "independent slate" of candidates for county medical society office each year, including correspondence detailing the planning the campaigns, advertising, election monitoring, and the results and reactions to the elections, which often included an exchange of letters with the county medical society's nominating committee protesting the manner in which the election was run. The county medical society records also contain an important archive of Forum actions in the file of resolutions introduced by members of the Forum from the chronological file of the county medical society's general records. In addition to the relevant portions of the Forum's program, the county medical society files also include materials generated by the county medical society for a variety of purposes.
The Issues series contains the majority of the documentation of the Forum's activities, filed by subject, with each folder including materials such as meeting minutes, correspondence, activity planning, and coalition-building around specific issues. Note that in cases where the Forum had a committee working on a given issue, all papers that originated with the committee are filed in the committees series. The largest portion of the Issues series is devoted to national health insurance, and there are also substantial files on hospitals, Social Security, doctors in the military, and Forum responses to anti-socialism and Red-baiting. There are also files for a wide variety of smaller Forum concerns, ranging from abortion to food costs to nuclear weapons. Taken together, these files show an organization with wide interests but limited resources, working to balance its priorities.
The remainder of the Forum's work consists of its events and publications. The events files contain documentation of major events such as conferences, annual meetings and dinners, and other events such as informal parties and public meetings around specific issues. These events show another angle of the Forum's interactions with the public, while the annual meetings and dinners, especially the Tenth Annual Dinner (1953), Twentieth Anniversary Dinner (1959), Fortieth Anniversary Dinner (1979), and the Ernst B. Boas Memorial Dinner (1955), provide many interesting retrospectives of Forum history. Similarly, the Forum's publications, especially the Bulletin, provide a considerable amount of historical content as well as an idea of the Forum's message to the general public. The scattered nature of some of the publications and the correspondence around the publishing process also provide another window into the Forum's day-to-day operations.
The Publicity and Papers of Other Organizations series contain material not generated by the Forum but kept by the Forum because it was relevant to their work. Publicity includes sub-series with coverage of the Forum and Forum members in news sources and also a substantial sub-series consisting of news clippings filed under the same subject scheme as the issues series. The Papers of Other Organizations series consists of papers of other organizations that were of interest to the Forum. Finally, the collection includes one set of reel-to-reel audio tapes and a small amount of memorabilia.
Gift of Walter J. Lear Institute of Social Medicine and Community Health, 2005 and 2008.
The creation of the electronic guide for this collection was made possible through a grant from The Andrew W. Mellon Foundation, administered through the Council on Library and Information Resources' "Cataloging Hidden Special Collections and Archives" Project. Finding aid entered into the Archivists' Toolkit by Garrett Boos.
- University of Pennsylvania: Kislak Center for Special Collections, Rare Books and Manuscripts
- Finding Aid Author
- Christopher Segal and Heather Isbell Schumacher
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