A national medical service / by F. Lawson Dodd.

  • Dodd, F. Lawson (Frederick Lawson), 1868-
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: A national medical service / by F. Lawson Dodd. Source: Wellcome Collection.

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    competitive commercialism has attached in the form of day and night work to the practice of medicine, and there is just as good a case for legal interference in this matter as in any of those instances in which Acts of Parliament have regulated the hours of labour. The medical men do not like the arrangement ; it is injurious to the public interest in that it may lead to individual disaster just as surely as the over- employment of a signalman or engine-driver may lead to a collision, and yet nothing is done because we regard commercialism as in- evitable. : Other Hardships of the Competitive System. Slowly the evils of competition are revealing themselves to the profession, but there are certain other hardships which are more obvious. The first of these to be noted is the constant tendency on the part of the public to impose on the physician or surgeon in the matter of gratuitous work. A well-known surgeon* has said: ‘‘ The well-to-do philanthropist is so moved by the sight of suffering that he is impelled to ask the doctor to cure it gratis.” Practically all hospital appointments (except those under the control of the State) are unpaid, and although the ec/at of a position on the staff of a large city hospital is in some ways its own reward, yet there are endless posts held in connection with small provincial hospitals, orphanages, epileptic colonies, etc., etc., which bring to the holder of them neither the reward of education nor any professional distinction, and which are filled without fee by the long-suffering profession. Then, again, there are countless reports and certificates (some of which, such as the death certificates, are matters of com- pulsion), which the doctor is asked to sign, and for which he is unpaid ; and there are those who, regarding his calling as a noble one, consider that it would be demeaned by the settlement of their quarterly or half-yearly accounts, which for social reasons it is almost impossible for the creditor to recover in the legal manner. No body of men is more imposed upon in these ways, and if ever a doctor asks for his fee in advance, or refuses to get up at night to attend a case without the assurance that it will be forthcoming, he is regarded by the public almost in the light of a criminal. Hospital Competition (‘‘ Abuse.’’) There is another factor that tells heavily against the average medical man, especially in the poor and populous localities, that is hospital competition—or ‘abuse,’ as it is called. The immense increase in free hospital, or assisted dispensary treatment 'is making this more and more serious. Although some hospitals—notably the London—are trying to carry out a selective process with regard to their patients, the temptation for statistical and educational reasons is all in the direction of encouraging them to come. It is hard for a democratically minded doctor to refuse hospital treatment to an interesting case whose income is £5 a week, and take under his care * J. F. Fuller, M.A., M.B., F.R.C.S. Paper read at Southampton, 1893.
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