Heilbrigðisskýrslur - 01.12.1938, Page 166

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II. Sanitary Officers, Conditions and Work.
District Physicians.
The district physicians are at the same time health officers and
medical practitioners. Arrangements are, however, now in the course
of preparation in Reykjavík and the larger towns to limit the medical
practice of the district physicians so that in the future they shall be
more, or rather solely, concerned with administrative work, i. e. general
inspection of public health, or guidance regarding protection of health.
The medical districts vary a great deal in size, both as regards popula-
tion and area, ranging from about 38.000 inhabitants (Reykjavík) down
to 4—500. The population of the whole country is about 120.000,
which gives an average of something inore than one persons per
square km. About one half of the districts have a population of 1.000
to 2.000. Outside of Reykjavík and a few of the larger towns the district
physicians are almost without exception the only doctors each in his
own district. The area of the districts is more often than not in an in-
verse proportion to the number of the population. In some of the most
extensive and most sparsely populated districts the distance from the
doctor’s residence to the remotest farms may range from 60 to 70 miles,
over which the doctor must make his way, often across mountains
and uninhabited areas, or over desert sands and unbridged big rivers.
At the best such journeys are made on horseback, but in winter when
even this method of travelling is impossible the doctor has often to go
on foot, or on skis; in other places the journeys are made by motor
boat across fjords and bays or even round promontories which project
right out into the open ocean. At such times it may take the doctor
the whole of a long day or even days to reach his patient and cost him
and those who come to fetch him unbelievable difficulty. But all this
may now he said to be of rare occurrence and most of the inhabitants
of the country are now in a position to reach a doctor within a few
hours at least. All district physicians are now within the reach of the
telegraph and almost without exception within a telephone call of all
the inhabited parts of their respective districts. The construction of
bridges and roads makes rapid progress and the doctors have to an
ever increasing extent taken motor cars into their service both when
travelling themselves and for the conveyance of the sick; this may,
however, be of limited use in winter because of snow. Even aeroplanes
have been used in urgent cases for conveyance of sick persons.
The district physicians are salaried in accordance with their two-
fold activities, partly permanent salary from the Treasury, these salaries
being highest in the most sparsely populated districts, and partly
they charge fees like all other inedical practitioners according to a
tariff fixed by the public health authorities. We may assume that
the total annual income of district physicians ranges from kr.1)
1) Icelandic króna approximately equal to one shilling.