Mr. HERSEY. What is suggested to be put in place of section 7? The CHAIRMAN. There is nothing suggested here. Mr. FRITZ. No, sir. Mr. HERSEY. Paragraphs (b) and (c) of section 7 are crossed out, 'both in black and red? The CHAIRMAN. They are crossed out, with one exception: Lines 17, 18, 19, and part of line 20, are to remain in; and I suppose that is conceded by both sides. That provides: Where the employer has knowledge of the injury and the necessity for treatment, his failure to tender the same shall constitute such neglect or refusal. Mr. FRITZ. My understanding of our suggestion with respect to that is this: That subdivisions (b) and (c) we believe should go out; and I think my friends on the other side think they should both remain in toto. Subdivision (d), I believe, we are agreed, should remain in. Subdivision (e) is to go out, by agreement. The CHAIRMAN. Subdivision (d) stays in. The CHAIRMAN. And subdivision (e) goes out, by agreement? The CHAIRMAN. Now, before we go from that, the gentleman from Maine (Mr. Hersey) made an inquiry as to what was to be substituted in lieu of subdivisions (b) and (c). Is there any suggestion as to that? Mr. FRITZ. The suggestion is that the New York act be incorporated-section 13 of the New York act be incorporated. Mr. TUCKER. With the addition of a penalty? Mr. FRITZ. Yes, sir; that section 13 of the New York compensation act be substituted, with the addition of a penalty for failure to comply with those provisions. The CHAIRMAN. Those lines that I have quoted, however, that "where the employ has knowledge of the injury and the necessity for treatment, his failure to tender the same shall constitute such neglect or refusal," I have not been able to see to what that phrase such neglect or refusal" applies; there is nothing antecedent that I have seen to which that has reference. Mr. FRITZ. I think that refers back to subdivision (a), which provides that the employer shall furnish medical, surgical, and other attendance, etc., as the nature of the injury or the process of recovery may require. The CHAIRMAN. Yes; but it does not say anything about neglect, does it? Mr. FRITZ. No; it does not. The CHAIRMAN. That is what I referred to. If that phrase were to stand in as you suggest, it has no relation to any other part of the bill. Mr. FRITZ. No; I appreciate that, sir. Well, I think that is a matter of phraseology upon which both sides could readily agree. The CHAIRMAN. Yes; that is easily cured. Then it will go on. You say paragraph (d) goes in and paragraph (e) goes out? Mr. FRITZ. Yes; paragraph (d), we are agreed, stays in. Mr. BOWLING. Mr. Chairman, before we go any further, I did not get the preliminary statement of this gentleman. May I ask if you are a physician? Mr. FRITZ. No, sir; I am not a physician. Mr. BOWLING. Are you an attorney? Mr. FRITZ. Yes, sir. Mr. BOWLING. Being an attorney, you recognize that section (b), page 6, imposes a legal liability under a certain state of facts, with respect to the furnishing of medical, surgical, and other attendance? Mr. FRITZ. Yes, sir; I think that is true. Mr. BOWLING. Now, may I ask you this: If from your viewpoint there is an unnecessary burden imposed by this bill as drafted, in furnishing to the employees a list of five physicians to whom they may refer, or upon whom they may call in times of illness or emergency. Mr. FRITZ. I do feel, sir, that that provision does throw a burden on employers generally, and particularly on those who have heretofore adopted a method of providing medical treatment for the men, pursuant to the various State laws under which they may be operating. As I explained, a good many of the larger industries in New York-and I think my friends recognize that have provided rather elaborate methods of medical service for their men. And I think, sir, that under that provision those organizations are gradually bound to be eliminated, from the economic standpoint, namely, that they will become so little used as not to warrant their further carrying, because there will be three or four other doctors to whom these injured men may have recourse, and it seems to me that ultimately the necessity of dispensing with these organizations will be very obvious to the employer. Mr. BOWLING. Well, I recognize, of course, as all lawyers would, that in emergency cases anything that is done for the benefit of the injured man would raise an equitable question in any suit for damages or any claim for compensation. If you did what you could under the circumstances that existed, why, you should have full credit therefor, both in law and in morals. But I do not see-and you will pardon me for saying so Mr. FRITZ (interposing). Certainly. Mr. BOWLING. I do not see any good reason that you have yet advanced why any substantial employer should not have at least physicians on his panel to whom his employees might be referred, in avoidance of any legal liability that would arise under subdivision (b) of section 7. Now, that is my point exactly. Do I make myself clear? Mr. FRITZ. Yes, sir; I think I get the point. I think in answer to that, in addition to what I have already said, which I think is a substantial partial answer, at least, there is this to be said: In my experience I have seen that the number of experienced medical men along these particular lines, even in a place like the city of New York is not so great. Industrial surgery is carried on, in most parts, by one or two very large clinics in the city of New York, and of course, by various attendant physicians that are engaged by insurance companies, or by self-insuring employers, like ourselves. And it seems to me that, for each employer to name a panel of five physicians will impose the necessity of putting on this board certain practitioners who will not be able to accomplish medically what a specialist would, ultimately increasing the burden of compensation to be carried by the employer, in the event that the man exercises his choice to go to one of these particular men who may not be a specialist in this line. Mr. BOWLING. Is there anything in the bill that would prevent any two, or any half a dozen employers or corporations or associations from maintaining some joint panel? For instance, suppose you are an employer, and I am an employer. Mr. FRITZ. Yes, sir. Mr. BOWLING. And Mr. X is another employer. Is there anything in this bill that would prevent you from naming five physicians, and me naming the same five, and Mr. X naming the same five? Mr. FRITZ. I think there would be nothing in the bill to prevent that, but I think there is something in the practical situation which makes that impossible, and that is this: This is simply a matter of physical distance. Employers in Brooklyn, employers in Staten Island, employers in the Bronx, and employers in the Borough of Manhattan agreeing upon a board of doctors would necessarily want a representative in each place; and you would have these medical clinics sticking out all over the Borough of Manhattan, which would be a very great hardship upon the injured man in the case of an emergency treatment being required in Brooklyn, for example. And I might point out at this particular moment that longshore accidents, when they amount to anything, or when they are at all serious, are emergency cases; a man in that occupation I find will either have a trivial injury, or will be quite badly injured; the mean ground is not so usual in that occupation. Mr. STOBBS. May I ask you a question at this point? I realize the force of your contention very clearly that the effect of having to provide a panel of five physicians might possibly be to eliminate the use of your own medical clinic. Mr. FRITZ. Yes, sir. Mr. STOBBS. But has it ever been tried out, as a practical matter, to see whether or not the employee will go to the clinic, with all its advantageous conditions, etc., to have his wound or injury taken care of? Would he simply leave that and pass that to one side and go to an outside physician if the benefit of the other were furnished to him? Mr. FRITZ. As a matter of experience, I can not answer that question. But as a matter of opinion, I should say that practically it would probably make little difference. Mr. STOBBS. I should think as a practical matter it would make very little difference. Mr. FRITZ. But at this juncture, where we are endeavoring to put on the statute books legislation covering a given situation, I should be very loath, if I had anything to say about it, to leave the matter to probabilities, even though that is what I might think they might turn out to be. Mr. STOBBS. I am somewhat familiar with the Massachusetts law, coming, as I do, from Massachusetts; and there, of course, we have a somewhat similar situation-not exactly the same. It is sometimes true that the employer does retain a physician who is not always acceptable to the employees-and it is perfectly reasonable that he should not be acceptable to him. I know of cases, for instance, where a man gets more or less callous; he has been doing this insurance work so long-or something of that kind-that it is more or less a cut and dried affair with him; and the employee feels that he does not get that sympathetic treatment that he ought to get from that physician. That is true, is it not? Mr. FRITZ. I think that is true. Mr. STOBBS. It is pretty hard to be confined to that one man; and the employer says to the employee, "You have got to go out and hire this one man.' There are arguments on both sides, of 'course. Mr. FRITZ. Yes. May I interrupt you at this point? Mr. STOBBS. Yes. Mr. FRITZ. It seems to me, taking such a situation as this-where there are two doctors in attendance, one in the morning and one in the afternoon, and where those men are in constant association with the workingmen who go to them for treatment-it seems to me that you more or less meet the objection as to lack of sympathetic treatment there, because you have got this esprit de corps on the part of the doctors, and the men who are provided there are reasonably able men, and are accustomed to rendering this service, and will be of much more benefit to the employer and the men themselves than if the employee went out to one of the doctors on a panel, which doctor would simply be paid $3 or $4 a visit, or whatever the rate happened to be. Of course, I do not want to be misunderstood by my friends on the committee, or on the other side, as wanting to do anything except to put forth a reasonable project which would be mutually beneficial both to the men and to ourselves. That is the position I am in. Mr. STOBBS. As a practical matter, you do not think it would make very much difference, do you? Mr. FRITZ. Well, sir; I am afraid it may. I have the men come to see me, for example, quite frequently; and I discuss things fully with them; and while I think that, in my particular case, I am fortunate, I can see where in other cases, the men, if they had the choice of four or five doctors, would simply try them out, rather as a matter of experiment than as a matter of knowledge or expediency on their part. I do not think it is really feasible, either from the standpoint of the employer or the standpoint of the employee; and I think it comes more or less within the inhibition of the case of the New York Central R. R. Co. v. White, pertaining to the reasonableness of the compensation bill. After all, I think what both sides want is a reasonable bill; and I am afraid that the medical provisions as inserted in this bill do not make it reasonable, either from the standpoint of the employee or that of the employer. Mr. BOWLING. Mr. Chairman, if I may, I would like to ask one more question. In your colloquy with my colleague, Mr. Stobbs, a member of the committee, a question as to the pay of these physicians was injected. I want to ask you this question: How much annually salary do the pay these medical experts who are regularly on their pay roll? Mr. FRITZ. Speaking generally, I am unable to answer that. For myself, I can say that, in straight salaries and I hope my friends will not use this against me at any time I pay in the neighborhood of $6,000 a year. Now, that represents the work of two doctors, one in the morning, from 8 o'clock until 12, and one in the afternoon, from 1 o'clock until 5. The rest of the time the doctors give to their hospital work and their clinical work, postgraduate work, etc. Mr. BOWLING. I think that is all. ADDITIONAL STATEMENT OF ANTHONY J. CHLOPEK, PRESIDENT OF INTERNATIONAL LONGSHOREMEN'S ASSOCIATION, BUFFALO, N. Y. Mr. CHLOPEK. Mr. Chairman, may we have the privilege, as the proponents of this bill, at this time, of giving our reasons why we favor subdivision (b) and (c) just as they are drawn? The CHAIRMAN. I think that will be all right, as we will then have the discussion on all that together. Mr. CHLOPEK. Mr. Chairman and gentlemen of the committee, there is not a provision in this bill that we have given the care and attention to that we have given to these subdivisions (b) and (c). We think that is one of the best drawn provisions that could be drawn, fully protecting the employee as well as the employer. The gentleman who just spoke referred to his particular company-that, so far as his company is concerned, they are confined to a specific location or district within two or three blocks, you may say. The system that they have in mind does not in any way interfere with this proposal. But, on the other hand, gentlemen, take this into consideration: There are employers in practically every big port in the United States, where they are doing work 10, 15, or 30 miles away from their offices. Let me refer to quite a number of instances in the Port of New York last year: In one case in Brooklyn a longshoreman had both of his legsfractured in six places. The employer in that case had a contract with the Scandinavian Hospital to take care of his injured employes. The ambulance was sent for, and that man lay on that pier for 45 minutes, and no ambulance showed up-and if you please, the Scandinavian Hospital was six miles away from the scene of the accident. After that the patrol wagon was called, and that injured man was taken to the hospital within the five minutes the patrol was called. And that hospital refused to accept that man. And there are hundreds of cases of that kind, gentlemen The CHAIRMAN (interposing). Will you permit me to interrupt you at this point? Mr. CHLOPEK. Yes, sir, certainly. |