During the last quarter of a century there has taken place in this country a remarkable growth in the hospitals, medical schools, laboratories, special clinics and other health agencies of the larger cities. During the same period not only have the rural communities suffered from a lack of these opportunities, but even the ranks of their practicing physicians have been rapidly thinned, so that many small towns are without the service of a single physician. In 1927, the National Grange, representing 800,000 members engaged in agricultural pursuits, called formally on the American Medical Association to consider seriously the problem of adequate rural medical service.
The grange reported: "There were approximately 33,000 physicians in places of 1,000 or less in the United States in 1906. In 1924, this number had been reduced to 27,000, showing an actual loss of 6,000 rural physicians in eighteen years. More recent investigation shows that almost
GORHAM LW. MEDICAL EDUCATION AND ITS RELATION TO RURAL MEDICINE: CHAIRMAN'S ADDRESS. JAMA. 1931;97(12):821–824. doi:10.1001/jama.1931.02730120001001
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