Medical history of Taylor County as seen by Walther Meyer MD, CMD - a native son.

Medford is the county seat of Taylor County. I was born across the street from the Taylor County Courthouse in May 1922.

My father came to Taylor County to teach a Lutheran parochial school in Stetsonville. My mother was the youngest of 7 children, 5 of whom were immigrants from Switzerland. My grade school and high school education took place in Medford Public School buildings, which no longer exist. I was graduated from 'Medford High' in 1940 and went on to the University of Wisconsin for pre-medical school. My parents, especially my mother, had expressed their desire that I either be a minister or a doctor - in that order. I can remember the exact spot in the old high school building when my high school football coach said, "Wally you should go to medical school to be a doctor". That encouragement at the beginning of my senior year in high school set the direction for the rest of my life.

In 1943 I enlisted in the Navy under the V-12 Program. The Navy sent me to Northwestern University to finish my premedical courses and to the University of Chicago Medical School to which I had been accepted before enlisting. When my father was going through some of his old records, he showed me the total expenditure that he made for my entire education. It was under $900! Knowing the hundreds of thousands that present doctors end up owing in this day and age, it is may be the record for the least expensive medical education ever. It has troubled me some not knowing if I should feel fortunate or guilty about it.

In our class of about 90 medical students at the University of Chicago, I was one of two medical school graduates that ended up as general practitioners. The 1ate 1940's was the dawn of medical specialties and everyone who wanted to amount to something was urged to specialize in their chosen medical field. I had chosen to become an internist and had a contract for Internal Medicine Residency training at the Marshfield Clinic after my internship at Wisconsin General Hospital in Madison.

Throughout my life, I have been impressed by how, what seem to be, casual decisions are life changing. While I was an intern at Wisconsin General, another intern asked me to take his student infirmary call one night. One of the patients I admitted was Dolores Haering, who turned out to be my wife. It took a number of years before my mother saw the humor of "Wally, where did you meet your wife?" "In bed." We had 4 children in four years. I have another memory picture of visiting a high school friend whose oldest sister was a doctor. Walking up to her lounge chair on the shore of Lake Esadore, with 2 boys and 2 girls from 1 to 4 years old, her comment was "My God Wally, you must have missed a medical school lecture somewhere along the way!"

About half way through my Internship, I had a phone call from my father, who had been the business manager of the Medford Clinic Hospital saying, "Walther, Dr. Norton died and doctors Ray and Les are going to need help. I would like you to come up here for a year or so to help them out - until they can find someone". I protested that I was under contract to go to Marshfield. Doctor Carl Doege was the president of the Marshfield clinic at that time. He and my father were business associates as my father had successfully built WIGM radio station in Medford and Dr. Doege was part of an investor group building radio station WDLB in Marshfield. They had employed my father, who had learned how to build and develop small town radio stations from his Medford experience. At any rate voiding the contract that I had for the internal medicine training was no longer an argument that I had.

If I felt somewhat bullied at the time that I 'came up for a year or so', coming to Medford turned out to be a great decision for me and has let me contribute to the community and to feel it's warm response. After WWII ended, I took an honorable discharge from the navy. With the Korean War starting, there was talk of calling me back into service. A group of citizens somehow certified that the community would be adversely affected if I was called up, and it never happened. To this day I do not know the particulars of that effort. In 1989 I received The Chambers Life-time Achievement Award, and in 1993 Physician-Citizen of the Year award in central Wisconsin.

One of my most cherished experiences was a retirement party for me put on by the Medford Clinic and Memorial Hospital of Taylor County (MHTC) when I retired from clinical practice in June of 1998, after 51 years of general clinical practice. During that time I had delivered 6,719 babies, many of which showed up for the event. The party was held at the Simek Recreation center. Even though the refreshments and Hors d'oeuvres were free, a lot of people took the time to come and express their memories and warm feelings. What a wonderful night!

Early medical history

My early remembrances of medical practice in Medford were in the old clinic building on the west end of State Street. As a young boy visiting my father in his business office, I can remember the clinic waiting room and the scene of an unconscious man, smelling of ether, carried through the waiting room on a stretcher, up the stairs to a room on the second floor to recover from an operation. My father, who was business manager of the clinic at that time, was pressed into service as one of four stretcher-bearers.

Dr. Conrad Nystrum, the father of Doctors Ray and Les built that clinic building in 1919. Doctor Conrad was the first person educated in Medford schools that went on to be a doctor, graduating in1882. He taught school for a couple of years before leaving for Hahneman medical college in Chicago, September 1989. He was one of eleven children. His father had a tannery that was located in the area of our new Medford Post Office. Dr. S.B. Hubbard, who was the first physician in Medford, built a log medical office adjacent to the tannery. Conrad Nystrum may have been influenced in his career choice by Dr. Hubbard's office location. (Dr. Hubbard's career ended with a suicide after a scandal unrelated to his medical practice.)

There seemed to be some community pride taken in a Medford boy, taught in Medford schools, leaving town for such a high calling. There was a statement in the newspaper that he had been studying for this career for sometime, but that the time had come for him to have medical lectures. There was a newspaper article telling of his leaving for medical school in September, 1989, and an ad in the paper announcing his practice and office hours in April of 1894. Office hours of 9 to 11 am and 2 to 4 pm probably reflect the amount of time-consuming home calls.

After Dr.Hubbard's death in 1885, Dr. T.M. Miller moved to Medford from Chelsea, where he had been practicing for 3 years. He was born in Canada in 1850, trained at the Royal College of Physicians in Edinburgh, Scotland, and was a fellow at the Obstetrical Society of Dublin Ireland. He was active in the community and had a great interest in trotting horses and horse racing. He did this on land that was eventually sold to the county for the fair grounds. He was the first doctor that I heard of, who had a yearly family rate for health care. In 1896 both he and doctor Nystrum observed the first appendectomy performed in Medford by an itinerant surgeon. The operation was done at a house on 3rd street.

In 1890 the first woman physician in Medford was Emma Olson. She was an associate of Dr. Nystrum

Dr. Miller and Dr. Nystrum were apparently close colleagues. In 1905 they both were references for Mrs. Grace Luther who built the Maple Grove Hospital 1/2 mile west of the city depot. She advertised "Board, nursing and room $7 to $15 per week in advance. Laundry extra. Physician and medicine $5 per week. Special nurse $1 per day extra. Surgical operations extra. Patient has choice of his physician and surgeon; and Medford has first-class physicians and surgeons whom we can recommend. No contagious diseases, taken"

The last reference was probably because Medford had small pox, diphtheria, and typhoid epidemics since the turn of the century. Newspaper accounts of death were frequent and a 19 year old from Goodrich "had typhoid for two months and it turned into pneumonia" This was the outcome of many illnesses before the time of antibiotics.

Quarantining to control the spread of diseases was a problem and in 1901 the city purchased land just north of the city limits 'To take care of any patients who may be sent there by authorities". The owners of the house had recovered from small pox and did not have a concern about caring for the quarantined patients. The residence became known as the "Pest House". The house is still being lived in and contains great history.

Dr. Conrad was active in the community. He was president of a social club, had the village of Murat platted, and was an incorporator of the Medford Pea Canning factory and the Medford to Perkinstown Telephone Company. He also had the first rubber- tired buggy in the county and had a patent on the 'first sanitary spittoon'. The spittoon had a paper liner that could be removed and burned. After a few fires started in them from still lit cigars, the paper linings were made fire resistant, but then they no longer burned and the patent never did pay off.

The first auto came to Medford in1902. By 1904 there were apparently enough to have an auto show at which Dr. Nystrum took fourth prize with his Oldsmobile.

Hospital facilities

By the time that I came back to Medford as a physician a new hospital was operational. My father had been in charge of building a proprietary hospital for doctors Ray and Les Nystrum and doctor Don Norton. It was attached to the back of the old clinic building. It is my understanding that this was probably the first medical practice in the state that was incorporated. The old hospital rooms above the original clinic were turned into nurse's quarters.

The new hospital had an operating room, a delivery (OB) room, a couple of ward rooms for postpartum mothers with basinets for newborn babes, and a number of private rooms. In the basement was a 'state of the art' x-ray machine with a fluoroscope, which we used to set bone fractures. I can recall that doctors Ray and Les often worked under the unit without using lead gloves. Dr. Les spent the last years of his life having a number of skin cancers removed from his fingers, hands and forearms, because of radiation injury.

The hospital had an elevator serving its 3 floors. Having interned at Wisconsin General Hospital, I really felt happy with the facilities in Medford. These facilities worked well for the three of us who were practicing at the Medford Clinic. As time passed, more and more hospital facilities were becoming non-profit. Having a proprietary facility was less common and not as well accepted in the community. Theoretically this could keep other doctors from coming to the area.

Around this time a group of men from the Knights of Columbus approached me to see what we would think about having a hospital run by the "Nuns from Merrill". I suspect that they had already run this past doctors Ray and Les Nystrum who were both members of Medford's Holy Rosary parish. Even though I had no problem with this, it did not come about because the nuns decided not to build in Medford. Even though this proposal did not develop, an alternate proposal of building a non-profit community hospital did, and the concept became a reality with a great community effort.

Medford Memorial Hospital became a reality in 1962 and our old proprietary hospital became a nursing home. This change was done with full cooperation of the doctors of the Medford Clinic Hospital with me serving in numerous committees to facilitate the transfer and building of the new community hospital. With this change came the necessity to build a new clinic building. This was done by the hospital corporation and allowed facilities for other doctors not associated with the Medford Clinic. For many years, we had a pharmacy in our clinic, but new construction allowed for an independent pharmacy that would serve all clinic physicians.

Even thought the old hospital patient records, each one was only about 3 or 4 pages and information was hand written. Clinic records were very casual. I started the formal clinic record system on large recipe cards in a long box with divider card for each letter of the alphabet. Doctors Ray, Les and I were assisted by one RN. She also did urine and blood counts for the three of us. Each physician had a single office. There were no appointment times and the daily clinics ended when the waiting room was empty. At the present time there are about 530 employees to support 35 caregivers.

Another important person in the care of patients was Frank Perkins. He was hired as a handy man and a driver taking the doctors on home calls, especially at night. Along the way, he learned many other skills like taking x-rays, being an orderly, and - by the time I arrived - had been taught to give analgesia on home deliveries. I have no recollection of any incidents that occurred related to his informal training. He was such an important individual in the clinic and hospital, that the new Medford Clinic Hospital had built a shower room in the basement for him, because his apartment didn't have one.

Before my arrival on the scene home deliveries were common and I also did them until Dr. Les Nystrum got into a severe postpartum bleed necessitating the patients trip to the hospital in the hearse, which was our ambulance service at the time. That was my cue to stop doing home deliveries, especially since our hospital facility was up to date and very adequate to handle these emergencies. We had a list of individuals who we could call on if we needed their blood- type in an emergency.

In 1954 the Sheriff Department was authorized by the Taylor County Board to provide ambulance service for the county. Initially the ambulance was a panel truck with a red cross painted on it. In 1961 it was traded in for a station wagon with two cots anchored to the floor. In 1968 the first real ambulance was a big Oldsmobile that had 4 cots, two anchored on the floor and two under the ceiling. In 1974 Memorial Hospital took over the ambulance service. At this time the State of Wisconsin had mandated that each ambulance was to have two trained EMTs. A course was devised and I participated in the initial training of the voluntary members of the team. The first EMT Course had 60 students. The first full time EMT and ambulance coordinator person in the county was hired in 1999. There are now (2005) 5 full-time EMT positions.

The business office had a business manager and another helper who doubled as a receptionist. When my father was the business manager I can remember him telling of getting chickens, eggs or produce for bill payments. The nurse and nurse assistants had quarters on the floor above the clinic and their lodging and food were provided. These were the years of the great depression.

The Price/Taylor County Medical Association

There are medical records of the Price-Taylor County Medical Society meetings dating back to 1907. The early Taylor and Price County association was based on travel by train with meetings documented at Medford, Ogema, Phillips, and Park Falls. (The first train came through Medford in 1873.two years before there was a Taylor County established by Governor Taylor) At first the meetings were annual or biannual and must have taken up a day of travel back and forth. Initially it seemed as if these meetings were a kind of a networking between the physicians.

The first documented meeting was after the death of Dr. T. M. Miller and contained a copy of the published formal resolution expressing deep feeling of loss of this "Esteemed Colleague". After a few years, physician deaths no longer resulted in formal public resolutions. They became letters of regret to the family, and with flowers and finally deaths of medical colleagues were not formally recognized, at least, in the societies meeting minutes.

By 1909 Price and Taylor counties had joined to become one association. By 1915 medical society meetings were held twice a year. They were usually held at the finest hotels in each community, where their meetings started with a dinner. Various physician members often read a paper of medical interests for the educational portion of their meeting. In 1925 it is recorded that Dr. Elvis read a paper on "The Smallpox Situation" at a meeting in Ogema.

In the 1940s and 50's, there were usually 10 to 12 doctors in attendance, which showed a lot of commitment, considering the travel time that was need for each meeting. Over the years the society functioned as the contact between the Heart Association and the Diabetes Association and the community and gave its blessing for immunization clinics. For many years, quarterly meetings had one or two medical leaders from medical centers in Marshfield, Madison, Milwaukee, Chicago, and Superior give excellent educational papers on their various specialties that had general interest. This provided the Price/Taylor County Society members with regular continued medical education from leaders in various specialties.

In 1914 a discussion of fees took up much of a meeting with the consensus that they were "much too low" and in 1917 a decision was made to publicly post office fees. There was no more discussion about fees until 1934. In 1936 a talk was given on "The relationship between General Practitioners and Specialists". The perception with specialists was that, often after having a patient referred to them, they frequently kept the patient and did the general care that the referring physician used to do. I got a sense that, during this time, there were almost too many doctors, but 5 years later the medical society asked the Wisconsin Medical Society for help in getting more doctors into the area.

Over the years there were society member from Lublin, Gilman, Westboro, Rib Lake, Ogema, and Catawba, besides the Medford, Phillips, and Park Falls members. Dr. Ray Nystrum was elected to membership in 1923 and Dr. Les Nystrum in 1927. Dr. Don Norton was elected to membership in 1934. The first record that I attended a society meeting was in 1949.

The Price-Taylor County location was the site chosen to set up an experimental insurance program for indigent farmers in our area in 1943-'44. It was a big deal with the president and executive secretary of Wisconsin Medical society, County Board Chairmen from Taylor and Price counties, and a representative from the Farm Home Administration. As I recall a farm family would get insurance for $47 a month. This was to include home calls and there was discussion that the mileage cost had gone from 4.3 cents a mile to 8.5 cents a mile when this new plan went into effect. Doctors were to be careful about how many house calls were made. This plan was still in effect when I became a member of the society. I served on the audit committee and found that there was no way to verify doctor's billings. The plan finally was dropped for this reason I think. I recall sitting on the audit committee when a doc from Gilman billed for 3 dislocated hips one month, (at $75 each) which he reduced by himself without any other help. Those of us who had the experience of reducing a dislocated hip, felt that this bill was highly unusual - and unlikely. The FHA/State local 'insurance' experiment was continued until October 1952 when it was discontinued at a special meeting in Phillips. Although the program lasted for almost 10 years, I think that it failed because there were no controls on billing or medical fees and the doctors only got a percentage of their costs reimbursed because the "insurance" plan never had enough money to pay 100% of the billings. It was around this time that the Blue Cross and Blue Shield insurance plans were starting.

Society minutes indicated that there was a doctor shortage in the area in the early 1940's and the Wisconsin State Medical Society was petitioned to help in a doctor search for our area. During this time the Narcotic Bureau of the State of Wisconsin had concern about two addicted physicians in our society.

In 1941 the society authorized the use of a mobile chest x-ray for tuberculosis screening in Price and Taylor counties, which cost the counties picked up, as I remember being told. In 1942 a 'minimum fee schedule' was posted in doctors offices. Office fees were beginning to be a concern and it was finally agreed to charge $4 for a home day call, and $5 for a night call. Office calls would cost $2 'with extras'. (Extras would be drugs, devices, or supplies) Deliveries would cost $50, which would be comprehensive including post-natal care and Rh and Wasserman blood tests. A tonsillectomy would cost $35, a dilatation and curettage $35, and laparotomy $100.

In the 1950's the Price/Taylor Societies were the liaison between the heart, diabetic, and cancer societies and our respective communities. In the 1960's one can see the development of political influence on the medical profession with the development of a political action committee and the development of an insurance plan by the State Medical Society. A SMS (State Medical Society) Political Action Committee became a reality and a general shift in emphasis away from medical education in favor of the politics of medicine can be noted.

A poliomyelitis epidemic in the early 1950's in Taylor County necessitated a coordinated effort for patient consultation and transfers to the University Hospital in Madison where many polio victims needed the 'iron lung' for bulbar polio. This variation of poliomyelitis resulted in a paralysis of the diaphragm muscle so people couldn't breath without assistance of the negative pressure chamber. Many times this kind of polio was associated with other areas of paralysis as well.

In the early 1950's there was also a lot of rheumatic fever associated with streptococcus throat infections, which caused a form of arthritis and heart valve disease. Regular clinics with outside heart specialist consultants saw area patients on a regular basis. A patient of mine gave me a copy of a bill from that time, which is reproduced below.

Date:	6-1-54
Laboratory	$12.50
Hospital, 11 days	$66.00
Drugs	$10.40
Professional Services,
W.W. Meyer, M.D.	$25.00
Total	$113.90

In 1966 The Heart Association gave a presentation to the medical society members about the appropriateness of Coronary Care Units in small community hospitals. Originally the Heart Association was made up of voluntary physicians, who were prominent leaders in their specialty. These independent associations soon took on a life of their own, raising their own funds, and developing their own research programs. Unfortunately funds from drug companies and special interests have had an influence on their message to the public, as the drug companies became substantial contributors to these volunteer associations.

In the 1970s fewer educational meetings were held and more and more concerns about political and insurance problems became more apparent. Fee schedules were almost always a topic of concern and there were federal attempts to limit fees to control the inflation of health care costs to 3% yearly.

In 1979 the first discussion about splitting up the Price/Taylor society were held, but put off for a while by having meetings in Phillips in order to cut down driving time to and from meetings. Periodic meetings seemed to be putting more and more strain on physicians resulting in decreasing interest and attendance as the meetings were more business and politically oriented and less attractive to the physicians compared to the educational meetings.

By the time the 1980s rolled around legislative, malpractice concerns, HMOs, PPOs, and DRGs seemed to be the most pressing items. Chart reviews were implemented and physician's charts were subject to WIPRO reviews. A few medical programs were presented, but they were actually commercials sponsored by drug companies. The physician presenters were beginning to be paid by various drug companies to sell others physicians on value of a new drug. It wasn't long before the drug representatives were visiting the doctor's offices to promote various drugs. Now most drug companies are marketing directly to the patients. Patients then ask their doctor for a specific drug that they have seen that the patient would like to try. The doctors positions of being able to evaluate drugs for their patients really is in danger of being replace by marketing to the patients who will find a doctor who will prescribe the drug that they (the patient) think they need or want.

In this latter period meetings were less frequent, and the medical society broke into separate county organizations. In an October 1889 meeting, in an attempt to revive interest in the Taylor County Society, only 3 physicians showed up. The organization existed in name only until it was formally made inactive early in 1907.

After 100 years of serving the medical profession in Taylor County, the local Medical Society has become inactive. In spring of 2002 a check for $3000 was written to enable a memorial plot for parents and family members who had lost babies through early miscarriage. As it's last official function, the Taylor County Medical Society has closed out its checking account with a $3652.89 contribution to Memorial Hospital Foundation.

The Society began in the old Medford Clinic in August of 1907. It became more valuable to the physicians and the area by combining with Price County physicians becoming the Price/Taylor County Medical Society, which had a more significant impact with the larger number of physicians. The affiliation with Price County was determined by the railroad transportation that was used to get to meetings initially. It was the main source of physician networking and continuing medical education for many years. It watched for the integrity and professionalism of the physicians. The medical society had 2 or 3 censors appointed for a kind of self-policing of area physicians. They determined if the physician had adequate training in medicine before they could be accepted as colleagues. In the early days of the society there were physicians that would come through the area whose qualifications were dubious. The area physicians had the job of policing their own profession. The minutes of the society meeting listed one episode when an unqualified doctor was removed from Lublin. Advertising was frowned on and a doctor was called to task for having an item in the weekly want ads telling of his special skills. Since he was a member of long standing, this item was too hot to handle by the group and it was referred to the State Medical Society, who have developed ethical policies and standards of qualification before physicians get a license to practice in Wisconsin. I did not notice any more mention of 'censors' in subsequent minutes of the Price/Taylor Medical Society. Apparently other societies had similar experiences and the office of 'Censor' just disappeared without ever having an official burial.

The society also was the vehicle from which information from the heart, diabetes, and cancer society information got into the communities. Immunization clinics were supported by the society and physicians volunteered their time administering these clinics. Drug Company representatives originally presented new drugs to the local medical societies, which decided about using them as a group.

Fee schedules, health and malpractice insurance programs and political action activities took over more and more of the Price/Taylor County Medical Society activities and meetings in the last 10 or more years.

As other entities took over more and more of the functions that the Price/Taylor Medical Society used to perform, this small county medical society became less relevant to practicing physicians in the area and eventually went the way of the horse and buggy - in which era it began.

The "Golden Years"

Younger colleagues have said that I was privileged to practice medicine through the 'golden years' and I readily agree with this sentiment. Most physicians can no longer practice medicine as individuals. The huge expense of running a private office with all of the regulatory paper work that is demanded, and the huge financial investments for modern laboratory and diagnostic technical facilities make a corporate type of practice inevitable.

With corporate practice came many restrictions and the amount of money (production) that a caregiver needs to make to support the corporation becomes a significant item. This limits the amount of time that each caregiver can spend on patients. This is a special problem for physicians who do not have additional income from special procedures that they do to increase their income.

Even though a family doctor is trained and is able to take care of 85% or more of patients' complaints, they frequently refer to specialists who may be more competent because they do more of certain procedures. The development of specialists, who limit themselves to certain conditions and diseases, has been a significant factor in the ever- increasing cost of medical care. Specialists usually practice in groups in order to have coverage. In spite of competition between groups, it does not result in lower competitive prices because of governmental and private insurance payers. The cost of malpractice insurance plays a major, hidden role in the costs of medical care.

The Medical Care Dilemma

During this era of expensive high tech diagnostic and emergency medicine, the preventative aspect of medicine has languished for the obvious reasons that this kind of care does not pay for itself. I have had patients that have had 2 previous heart surgeries go back for the 3rd, because we have not found how to prevent coronary heart disease. Medicine has diverged in two directions. One direction is into amazing high-tech diagnostic and emergency care, and unbelievable new surgical capabilities. The other component of health care, which is the prevention of chronic disease, has languished. Corporate medicines approach to prevention is to use high tech diagnostic and laboratory procedures to find chronic diseases at an earlier state, rather than actually preventing these diseases.

The need for corporations to have black bottom lines on their balance sheets is the main explanation for this in my opinion, and I don't see this health care dilemma changing. Unless individuals demand and take over this responsibility for self-care, things will not change, because vested interests will not change for the obvious reasons. Many students of the problem see danger in the ever-increasing costs of our current system and believe that the current course is not sustainable.

It is no longer economically practical for a general physician to listen to a patient, and advise him or her regarding dietary and lifestyle changes, which are the basic health necessities to prevent chronic disease. It is much easier to write a prescription for the disease symptoms with which the patients present themselves to their physicians. There is no caregiver mal intent when this occurs. Doctors could well be performing the 'standard of care' that is determined by research information, the research cost of which, is mainly provided by drug companies.

The present course of medical health care will not be sustainable for many more years. The future of health care does not lie in the treatment of illness, but in preventing it. In order for this to happen, the individual will need to take personal control of their own and their family's health by going back to the basics of healthy foods and life style changes. They will use their caregivers as resources to help them take personal responsibility for their health.

Hopefully physicians and caregivers will have the information to be good consultants for these individuals as they try to take personal control of their health by adopting nutritional and lifestyle changes that are known to be associated with longevity and health.

You can contact Dr. Meyer by e-mail at info@nutritionalmedicine-wm.com or call at 715-748-3197.

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