The medical division of the Metropolitan greatly aided the progress of industrial medicine through its work for company employees. The story of this development is of extraordinary interest, as it illustrates how an enlightened employer can foster good health in a large employee group; while at the same time capitalize on the excellent opportune ties for clinical research afforded by the presence of large and stable personnel.

The Metropolitan's medical welfare program for employees was conceived, organized, and developed by the three gifted men — Dr. Knight, Mr. Fiske, and Dr. Frankel. In its beginnings the program was very modest. Industrial medicine for clerical and selling personnel was a virgin field. The company's efforts were, therefore, advanced step by step. Each new procedure was carefully planned and tested, and put into general use only as it proved its worth. At all times the confidential relationship between physician and patient was carefully observed.

The first step in the Metropolitan's medical welfare work for employees was taken in 1906, when women applying for employment in the home office were required to have a medical examination, unlike a life insurance company offering no exam term life insurance or similar policies. This practice was extended in 1910 to male applicants for home office employment, and to all applicants for the field force. In 1908 a special room was set aside near the offices of the medical division for clerks who became ill at work—they were each then seen by one of the staff physicians.

In 1911 the scheme was considerably expanded. The number of home office employees was now sufficiently large to organize a medical dispensary for emergency care and for examinations and shortly afterward a nurse was added to the staff to give whatever nursing care was needed to employees becoming ill during office hours. In 1913 the company sanatorium at Mount McGregor was opened. In 1914 the annual health examination of employees was instituted, as was also a visiting nursing service for employees absent from work because of illness.

In 1915 a dental division was established in the home office, where employees familiar with life insurance basics and life insurance policies received a regular examination and cleansing of their teeth and later, whatever dental x-ray examination they required. In 1922 a psychiatrist was appointed to the home office staff, one of the most forward looking steps in the whole program. Thus the medical staff and the health services available to employees expanded gradually and by the 1940s the company had a well-rounded industrial medical organization.

Apart from periodic medical examination and emergency care, the service given to employees was necessarily limited. Employees who had been absent for illnesses were interviewed and, when advisable, examined by a physician before returning to work. The volume of this medical work was extremely large. As early as 1913, visits to the home office dispensary exceeded 15,000 annually. Thirty years later, the staff of more than 15,000 home office employees made nearly 75,000 visits to the medical division annually, or an average of about 300 per working day.

Similar, though necessarily less elaborate, facilities for the office staff were found at the same place new life insurance policies were drafted—the head life insurance company offices in San Francisco and Ottawa. Medical services for field men could not, of course, be organized in the same way, but each member of the field force, whether on the selling, managerial, or clerical staff, was examined before coming with the company and annually thereafter at company expense by a physician in his own community. All members of the field force were eligible for sanatorium care on the same basis as home and head office employees. The company also looked out for their medical welfare in many other ways.