1955-1964: ACP becomes cosmopolitan
ACP's fourth decade was a time of internationalism and glamour.
The College's fifth decade was a time of internationalism and glamour. Things started off right with the 1956 annual meeting in Los Angeles, which featured a banquet where Bob Hope served as master of ceremonies and “stars of the stage and screen, scattered at tables through the audience, contributed to the entertainment and gave an opportunity for guests to meet those of whom they had long heard,” according to historian George Morris Piersol, MD, MACP.
Current meeting attendees shouldn't be too jealous, though, since the event was so popular that some College members had to be seated in a neighboring ballroom and watch the fun on closed-circuit television. Two years later, when the annual meeting was held in Atlantic City, everyone in attendance got to see Miss America, who “spoke briefly of her experiences in that role.”
Other College practices that have since gone by the wayside include the plan, announced in 1955, for every article published in Annals of Internal Medicine to include an abstract in Interlingua. “Interlingua is a scientifically constructed language that aims to play the same role in overcoming language barriers, especially among scientists, as did Latin until the end of the seventeenth century,” Dr. Piersol explained.
ACP leaders were making an intensive effort in these years to engage with physicians in other countries. Annals also looked into obtaining and publishing translations of the current Russian medical literature. Speakers at the annual meeting were often from other English-speaking countries, including a London doctor who spoke on Oscar Wilde and “Constitutional Insensitivity to Pain” in 1956 and a New Zealander who spoke on “Post-diphtheritic Myocarditis” in 1957.
The College struggled with how to fund the visits of these foreign speakers. In 1956, the Regents voted down a proposal to let pharmaceutical companies pay for the lectures, and then in 1957, they reversed that decision.
Over the decade, there were many debates held and fine lines drawn regarding accepting money from pharma. In planning the 1959 annual meeting, the Regents decided that it was unacceptable to have corporate sponsorship of the cocktails at the President's reception, questionable to allow it for the cocktails before the banquet, but not a problem for a pharmaceutical company to provide the banquet's entertainment.
The FDA was also working to restrict the pharmaceutical industry's role in medicine during this time. The agency made pharmaceutical companies, rather than the publications carrying the ads, responsible for providing truthful information about the safety and effectiveness of drugs and also proposed that drugs should be advertised by their generic names, rather than by trade names.
The Kefauver Act, signed by President John F. Kennedy in 1961, added some additional restrictions that were “onerous to many physicians,” according to Dr. Piersol. Doctors would have to get informed consent from patients before prescribing an unapproved or experimental drug, and researchers had to keep records of their drug research and submit them to the study's sponsor.
Although College leaders did get involved in these issues, the role of the organization in political matters was still under debate. The American Society of Internal Medicine (ASIM) was organized in 1956 with the intent to focus on the political and economic matters that ACP generally did not address.
However, in 1957, some College leaders were expressing fears that ASIM would become a rival organization. “The problem of the interrelationship of the two organizations was so perplexing that even the Regents' Executive Committee was unable to arrive at a definite solution,” Dr. Piersol wrote.
The organizations did collaborate in some ways. In 1960, ACP launched a new publication, the Bulletin of the American College of Physicians, which contained the meeting announcements, obituaries, and fiscal notices that had formerly run in Annals “News Notes” section. This new publication also had a special section devoted to the ASIM news.
The College also continued to work with organizations on the accreditation of hospitals. A report to the Regents from 1955 noted that hospitals could automatically lose accreditation for a number of transgressions, including “fire hazards, ghost surgery, excessive removal of normal tissue, lack of graduate nursing supervision, presence of irregulars on the staff, etc.”
Hospitals at the other end of the quality spectrum were collaborating on a big-data project, of which ACP was one of the sponsoring organizations. In 1957, leaders of the project were working on “abstracting and using data from the clinical record of every patient for the preparation of routine reports for each hospital and for special studies including all member hospitals,” with a goal of including over a million discharges per year by 1959.
In another example of the continuity of issues in medicine, ACP's Medical Services Committee was concerned about “how expensive the prolongation of life had become, even when it had lost its meaning” and “that the technical aspects of medicine, procedures and laboratory tests, were paid by third parties, regardless of expense, whereas the cost of medical judgment, knowledge, and skill were not reimbursed realistically,” according to former College CEO Edward C. Rosenow Jr., MD, MACP.
And finally, in a choice that may also seem familiar, in 1965, ACP celebrated 50 years of existence with a Golden Anniversary Session in Boston.