Practicing Medicine in the 1940s
A doctor practicing medicine in the 1940s would most probably have been born in the years 1880 to 1918, which meant that he had experienced WW1 and would experience WW2. Some of these doctors would serve in one or both wars. He had experienced one or two major depressions. Training was a six year course at Sydney University or Monash University. Typically the young doctors would spend some time in hospitals as RMOs and might work as locums in general practice in order to gain some capital and experience. As general practitioners they would be expected to be able to give anaesthetics and be able to do most surgery (appendicectomies, cholecystectomies, Caesarian sections) as well as be able to do most trauma work (fractures, surgical repair of injuries, pinning femurs and hips, etc).
It was a costly matter to purchase the godowill of a practice as practices sold on a pound for pound basis, eg if a practice earned £2000 per year then purchase price would be £2000. This might be more than the value of the premises.
Many doctors worked on a capitation basis. This was run by various "lodges" or "clubs". Patients paid a regular amount to be part of the scheme. This then guaranteed them free medical care. Some workplaces (eg some mines) arranged to compulsarily take the fees directly from the worker's pay. An amount might be 1s 10p per fortnight. The care of patients was essentially on an honorary basis (ie the GP could not charge the patient for care). There was no such thing as a private patient in the public hospitals. An exception might be for compensation cases (eg work related injuries). Obstetric patients were at times looked after in small cottage hospitals. These patiets migh be charged a guinea for their care. It was uncommon for antenatal care to be given in the early 40s. A patient would go to the hospital when in labour, have her baby and would be looked after for a week in the hospital.
It was a time when patients were told what they had to do by the doctor and they were expected to do what they were told.
Most doctors were very busy. Ward ounds at the hospital could start at 7am. Following this would be a busy time seeing patients at the surgery. Following this the many house calls. The doctor would have a car and would need to drive out to many patients. Few patients hada car and few had access to a telephone. The more remote hous calls would be by kerosene lamp.
Vaccinations were available for diphtheria but not tetanus. Penicillin use was from about 1945, but it was initailly hard to get, and expensive. Practices would supply some medications eg for cough (mist. pot. cit. and mist. pot, brom), although the patients would have to bring their own bottles to the surgery. There were some pahrmacies in larger urban areas. Patients who had myocardial infarcts were given pain relief (pettidine or morphea) and admitted to hospital. There they would either survive or die (no definitive treatment). The most common form of heart disease was rheumatic in origin. Hypertension was treated with diet as no effective forms of treatment were available.
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