MEMBERSHIP IN A NATIONAL ACADEMY OF MEDICINE
| Irvine H. Page, M. D. |

No problem has caused more trouble to scientists and physicians
than methods for selecting members of societies with limited membership.
Most medical societies should not have any but the simplest limitations.
But an organization devoted to service to the nation, especially as
regards policy, needs to draw from the upper, relatively thin layer
of the best medical, scientific and lay talent. In this case limi-
tation is mt undemocratic but a matter of making decision-making
feasible. Further, such a limited membership organization should be
given no governmental authority to enforce any of its recommendations.
If limitation means status alone, then Limitationoula have no place.
| I have discussed before (M. M. Aug. 5, 1963, P. 69) my views
on the various kinds of societies we now have, with their merits and
demerits. My suggestion of a National Academy of Medicine has brought
us face to face with this old problem.

How limited should a membership be? Should membership be one
of the highest honors a scientist or Physician can achieve? Should
continuing original research be a criterion? Should political power
be a determinant of election? Should campaigns among the other
members be obligate to assure election of a candidate? Who should
propose the candidate? Should the candidate be aware of his
nomination? Obviously, I don't know the answers but to start the

discussion, let me introduce some suggestions for debate.

 
-2—

1. There should be no definite number of members simply
because medicine is a constantly growing subject. I suppose the
chief criterion of size is whether the organization effectively does
the job it is supposed to do. Specific limitation makes for an
exclusive status and may deprive the organization of some of the best
and, further, it creates serious opposition, especially by those
who are good enough for membership but are not elected.

2. I do not think membership should be so sharply defined that
flexibility is not maintained. The membership should fit the worthy
purposes of the Academy and not satisfy human vanity. As an example,
I am far from convinced that research scientists always have the
greatest political and social wisdom and it follows that a medical
academy must not limit its membership wholly to research workers.

3. Political power alone should not be a determinant but
power with wisdom make a most acceptable criterion for membership.

4. Representatives from other organizations should not be
elected as such. The man's capabilities alone should be the guide.

I would wt limit membership in an academy of medicine to physicians--
degrees and titles should make no difference.

5. Only those who have exhibited a willingness and desire to
serve above and beyond their immediate work should be elected. This
should not be only an honorary society for the greater glory of the
individual, but an organization for service to the nation.

6. I would hope that an academy could find a genuine use for

physicians with the wisdom and maturity which usually come with age.
This country needs to learn respect for mature judgment.

7. Election could be safeguarded to some degree from pressure
groups and selfish interests by the "study-section council system."
Proposals for membership would come from the membership but the
proposal itself would be kept confidential. It could be categorized
and evaluated by study sections, their recommendations passed on to
a council that would make the final decisions. But before becoming
final, the board of trustees should also approve, having the benefit
of comparing those proposed for election and those rejected. The
pattern appears complicated but this is deliberate to cancel out
petty animosities and partisan interests which can become so destructive.
Hopefully, this system would avoid the campaigning of members for the
election of their especial candidate, an unwholesome procedure for
any first rate organization.

I am sure that many of you will have better plans but until
we pone to grips with them we are not likely to get very far with
the organization of an Academy of Medicine. fhere never has been a
time when one was more needed to fill the yawning gaps between the
American Medical Association and the government on the one hand and
the sciences on the other. I know you can be trusted to let me hear

from you!