BRADENTON - The economy had hit bottom. Millions of Americans were jobless. So, as Dr. Edward Kallins assisted patients in his new family practice in Baltimore, he knew they had no insurance and little, if any, money.
How Kallins, now 100, and other doctors provided patient care during the Great Depression reveals just how much medicine has changed in the past 75 years -- for good and bad -- and offers a distant window into today's debate on health care reform.
When Kallins started his family practice in 1934, there also were no government health care programs for the needy and elderly.
So he and other doctors were willing to barter.
"A lot of people brought you things like cakes and chickens or food from their backyard gardens," Kallins said.
Those who could afford to pay often negotiated a lower rate. Kallins charged $5 a visit, but got $2 -- if that.
Kallins accepted whatever they could provide as payment because he knew what could happen if they did not get proper care.
"They went to quacks" or relied on useless potions or homemade remedies, causing their conditions to worsen.
His wife, Marie, remembers well the late-night phone calls.
"He'd always go out on those calls," Marie Kallins said. "He always answered the phone. He would not rely on me to answer it. ... He was a real doctor. When a real doctor gets a call, he feels he must go out and see the patient."
Kallins' commitment inspired the younger generations in his family. His son, Mark Kallins of Bradenton, and grandsons, Brian Bloom of Boston and Ian Bloom of Washington, D.C., have medical practices.
When he retired to Bradenton 25 years ago, Kallins knew his profession was drastically changing.
The nation was becoming divided into haves and have-nots -- those with medical insurance and those without.
He marvels at the advances in drugs, therapies and technology since he last wore a stethoscope. Yet he believes reform in how that system delivers health care is overdue.
He favors President Barack Obama's plan to make insurance coverage more affordable and reliable, including a public option for those who still cannot get private coverage.
The proponent of Medicare disagrees with those who think the plan smacks of socialism.
Yet he wonders whether genuine reform is possible.
America's health care system has made big strides since he first practiced medicine, Kallins said. "But the ability to bring it to a person is prevented by politics."