One of the most serious handicaps in maintaining the health of the rural community is its frequent lack of medical service. The number of doctors practising in the open country was always inadequate, but in recent years it has decreased until now many large sections are without any resident physician. The influenza epidemic of 1918, following the shortage of doctors during the war, revealed the plight of many a rural community without medical service. The higher standards now required by medical colleges and state licensing boards has resulted in a real shortage of physicians and the young men are not going into the country to practise. A recent study made by the New York State Department of Health showed that in 20 rural counties 88 percent of the physicians had been practising over 25 years and only 3 percent less than ten years. This means that most of the rural doctors in these counties have less than ten years more to practise and that there is no indication that their places will be filled by younger men. In Manitoba one rural municipality has employed a physician on full time, and a recent act of the New York legislature makes it possible for towns to employ physicians. It seems probable that country people will be forced to employ physicians on a salaried basis if they are to secure adequate medical service. This does not necessarily mean, however, that the physician will be employed by the local government. Industrial workers are now employing physicians on a salary and farmers' organizations are employing salaried veterinarians. Why cannot a local health association be formed to employ a physician, whose job it will be to keep its people well? Two factors prevent the larger use of physicians now available. Chief of these is the cost. Farmers handle relatively less actual money than townsmen, and their income is less frequent so that they have less on hand, while the cost of medical attendance is necessarily higher in the country. Fear of running up a bill deters many a farm woman from calling a doctor, when one call might prevent many more later on. The farm home tends to employ a physician only for serious sickness, rather than as a medical adviser who may forestall illness. Another difficulty is one of the physician's own making. The experience is far too common that in cases of immediate need when the family doctor cannot be located, doctors will refuse to attend a case on account of so-called "professional courtesy." It is time that public opinion be aroused so that such cases be brought to the attention of county medical societies with sufficient public opinion to force them to take suitable action. The ethics of every profession must be shaped to meet the needs of those it serves as well as the pocketbooks of its members.