The Protection of Student Health

RESPONDING to urgent requests from undergraduates, President Hopkins last year appointed a committee to study the organization of the various agencies administering to the health of the undergraduate body; to appraise their effectiveness; and to compare the health service at Dartmouth with that of other colleges. This committee consisted of undergraduates, doctors, and administrative officers of the College.

Under the chairmanship of Dean Robert C. Strong '24, the committee spent five months in pursuing its investigations and evaluating the information obtained. They found that the health service of the College had developed from a natural growth without having followed any well coordinated plan. The result was that six virtually independent administrative units in the community were concerned with student health. These units were the Medical Director's Office, the Department of Physical Education, the Dartmouth Medical School, Dick Hall's House, the Mary Hitchcock Memorial Hospital, and the Hitchcock Clinic, a professional partnership of the ten leading doctors in Hanover.

The medical services available to students at Dartmouth were quite complete and of exceptional quality. The committee reported to the President that "although the service as it is now organized has doubtless resulted in some duplication of effort and, at times, some friction, we wish to emphasize that the devotion of all parties concerned to the common good has given us a health service of excellent quality as well as extensive in its scope." The committee studied the health services at a number of leading universities in both the East and West. Using the published report of the Committee on Cost of Medical Care of the American Medical Association on the university student services at Yale, Cornell, Michigan, Minnesota, California, and Oregon State, and, following the form of this report, the committee compiled a comprehensive survey of college health services with which the service at Dartmouth compared favorably. The committee was somewhat surprised to find that the cost of maintaining the health of the student body at Dartmouth amounted to 186,500.00 annually. Of this amount students paid 37% in direct charges for hospitalization and professional services, and the balance represented the cost to the College of free services and the maintenance of Dick's House and other buildings used in the health service.

The committee recognized that the greatest problem in maintaining the health of an undergraduate body is to bring the student to the physician as soon as the symtoms of physical disability are evident. It seemed quite clear that this was not being accomplished at Dartmouth under the conditions which existed. The returns from a questionnaire distributed among students indicated that very frequently students were sick without seeking medical advice, and that during a recent epidemic of German measles a large number of students had deliberately avoided medical treatment in order to escape the expense of enforced hospitalization and isolation. The average student was obviously unwilling to part with money from his allowance for medical examination until his sickness had advanced to a stage where even youthful optimism recognized that it was dangerous.

Dean Strong's committee recommended to the President that the Board of Trustees establish a Council on Student Health with power, to supervise the health service of the College, including health education, sanitary control, physical examinations, and care of the sick both by out-patient service and hospitalization. It also recommended that the cost of the services pro- vided by the new Council be apportioned between the students and the College, and that the charge to students be included in tuition. In order that the medical care and hospitalization might be available to all students and so far as possible be dissociated from immediate expense, the committee strongly favored increasing the tuition to cover the costs rather than establishing a special health fee such as that charged at most colleges.

The report of this survey committee was considered by the Trustees at their April meeting. The recommendations having been accepted, the President was authorized to appoint a special committee to make detailed plans for the reorganization of the College Health Service and to prepare an estimate of the expense involved. This committee, under the chairmanship of Prof. Francis J. A. Neef, prepared the plan for the new College Health Service which has been established. The plan recommended was accepted by the Trustees at their Commencement meeting in June. The Council on Student Health was appointed by the President and during the summer perfected its organization. Agreements were established with the Hitchcock Clinic and Mary Hitchcock Memorial Hospital which enabled the College to establish a new out-patient service, to improve the entrance physical examinations, and to secure medical and surgical care for all undergraduates hospitalization at Dick's House.

The Council on Student Health accepted as its objective: to provide facilities which will make available to every student the advice and professional services of a competent medical staff; to operate these facilities under conditions which will insure their unrestricted use; and to train students to recognize the first signs of endangered health and to seek immediate medical examination and treatment.

The Trustees of the College announced an increase in tuition charges, long contemplated to meet other needs, but fixed at a figure that would provide the funds needed for the new health program. These funds will enable the Council on Student Health to meet the cost of both medical care and hospitalization required by students, and to offer, without charge, physical examinations, out-patient service, and hospitalization. Whether the service required is the treatment of a common cold, the reduction of a fracture, or an emergency operation for appendicitis, any student of the College may secure at Dick's House the best available medical care without incidental expense. That students will freely use the medical services of the College has been made a practical certainty. The result of securing prompt attention during the early stages of illness should decrease the incidence of serious sickness in the undergraduate body and the development of a very desirable habit of relying upon a doctor instead of avoiding him.

Dartmouth has gone far beyond its sister colleges in the east in providing for the care of students who succumb to illness or injury. It should be a source of gratification to alumni and particularly to those who are parents of undergraduates, to know that the College is meeting so completely the obligations and responsibilities imposed upon the institution by its guardianship of students' welfare.