Federal Writers' Project – Life Histories/2019/Fall/Section 1/Floyd L. Abernathy

Overview
Dr. Floyd Abernathy was a doctor in Foley, Alabama during The Great Depression. This interview was conducted by Lawrence Evans in 1939, as part of the Federal Writers’ Project.

Biographical Information
Dr. Floyd Abernathy was a physician in Foley, Alabama during the Great Depression. He was born around 1892 in Alabama. For generations, his ancestors drifted between ministry and medicine, but he was definite in his decision to pursue medicine. Dr. Abernathy conducted pre-medical studies at Southern University, and after a brief hiatus, attended the University of Alabama, finishing school in 1916. In World War I, he was drafted and served multiple military camps, earning full credit for an internship/residency at the time. After the war, he returned home to Alabama and served as the Assistant State Health Officer of Alabama for two years. After this, he married Lucile Abernathy and had two children. At the time of the interview, conducted on February 16, 1939, by Lawrence Evans, as part of the Federal Writers' Project, Dr. Abernathy had been practicing medicine for sixteen years. He continued serving the small community of mostly farmers and townspeople for many years after this.

Medicine in the Mid-20th Century
Medicine in the early to mid-1900’s would be considered crude by today’s standards. During this time, there was less regulation, poorer infrastructure, and far fewer medical advancements than there are today.

Currently, there are numerous laws and regulations concerning the medical industry, ranging from privacy concerns to health and safety. During the mid-1900’s, patient records were not strictly kept, whereas everything is documented in more modern medicine. Over time, sophistication has grown, and processes are more official and streamlined than in the past. In 1996, HIPAA was enacted, introducing an array of patient records, privacy, and insurance regulation

An important, and often overlooked, factor of quality of healthcare is infrastructure. In small, rural towns, poor roads and conditions would make travel inefficient and dangerous, ultimately degrading the quality of healthcare. In the past, doctors would often respond to house-calls, and the roads could make the trip potentially dangerous. Over time, small towns have become more developed, and better roads and buildings have been constructed, which indirectly improves the quality of healthcare

One of the most obvious and influential factors of healthcare quality in the present compared to the mid-1900’s is the advancements in knowledge and medical understanding. Many new vaccines have been created to prevent deadly, communicable diseases, and new ways to treat disease and illness have emerged, resulting in more effective healthcare. The rise of telemedicine has allowed doctors to give patients care in their own home without wasting time to travel. The discovery of new bacteria and pathogens have helped evolve sterilization of medical equipment; from the use of boiling water to antiseptic cleaners or even ionizing radiation. Overall, there have been countless important medical advancements since the mid-1900’s that have ultimately resulted in the quality of present-day medicine

The Impact of the Great Depression on the Medical Field
The Great Depression was undoubtedly the worst economic situation since America’s founding. A massive stock market crash in 1929 resulted in a decade of economic hardship across the country, impacting everyone; from farmers and blue-collar workers, to professionals, including doctors, lawyers, etc. Because of the massive drop in consumerism during this period, as well as a sharp increase in unemployment, people could not afford basic healthcare. As a result of this, a large amount of medical care was conducted for free.

A study, published in The Milbank Quarterly, analyzed the medical industry’s earnings during The Great Depression. Despite much of the general population being unable to afford healthcare, hospitals and doctors had to continue to work, even due to a sharp drop in payments. This study focused on a survey conducted by the United States Public Health Service in 1933, which surveyed about 7,000 families across seven major U.S. cities. The study concludes that between 25 and 75 percent of physician's calls were free. Essentially, a significant amount of medical care during The Great Depression went uncharged, and many patients paid little to no monetary amount; however, during the time, other methods were often used instead of money. Patients would often pay their debts with food, goods, or labor, and in some cases, they would make multiple, incremental payments.