THE DOCTORS' REVOLT

Dominion, Volume 5, Issue 1365, 16 February 1912, Page 6

THE DOCTORS' REVOLT

SWEATED MEDICOS AND NEGLECTED PATIENTS.

Tin; iwrrrsH. trodui

Writing in the London "Daily Alnil" of thu position of medical men iiudr-r the new British Insunince Act, Dr. Haydn liiwu says:—lt intiat be recollected that medical men are only human and will always appreciate Ihe fad thai in order to do goud work a man must bo propc-rlv paid for it. Those practitioners who are not going to sign Ihe pledge of Ihe "I'ractilioner ' "nol to accept any s ( .,vice wlntsi.evur" under the present' National Insurance Act are in their own minds Mmii! of them, volunteering to enter a cutting-price business in tho hops ol making a profit out of mistakes in caidilation, or i( may be by placiii" a false weight in the balance, by sleight-of-hand or by mere make-believe. There should only Ik> one standard in meilicnl practice that should bo exercised over all closes alike, namely, tho best, always beariiiL' in mind that a working man's life is of as much value as his master's, each unto himself. Now the great question for oven peremptory legislators to-day, when coming to close grips with problems concerning the health of the masses, is, Can the work be of Iho best at the price- offered I- , CONTRACT WORIC IXmi-'FERENTLY DONK. It has been a commonplace in the proiessjon, long before the Insurance. Bill was thought ot. that mo?t conhr.ct work has been indifferently done, not lately, but for many ye.-irs, during which time, about -Is. per annum has been the amount paid per member, it is all vary well for a section of humanitv lo live in a fool's paradise and to accept the blandishments ot aflnblo nnd kind doctors who grow accustomed to smoothing over difficulties (who are obliged lo do so to get a living at all); but what patients miss in life who cannot, know when thev are gctlinHie best or the worst! Them has been an amount of narcotic hoodwinking nnd deception practised for many years in contract practice that has been a disgrace to the profession, that yet has been forced on tiin profession, practitioners beiii" ground down to impossible payments and to a degrading and sweating level of work only to be equalled in the lowest examples of poorest labour.

AY hat I wroto in Juno last will now «L r "Poatinfr at this juncture: J he questions of contract practice and low fees for medical attendance have been burning within the rank* of the proiession for many years; payment for tho service of medical men has boon ground down to sweating point, whilp meilical men themselves have proved unbusinos--like, unorganised, and weak. AVhat has besn Iho result? Chiefly the incalculable toss of the public ;it large? The time has come when we ought not to nvnea matters. Let the plain and painful truth Ijf known now. 1 lie mass of cheaply-paid work in the past, has been a dishonest mockery. Club work has been made to ray by (he quantity and the slipshod ve? in which it has been done, while sixpenny dispensaries have been, and are, even worse than that very quackery over which (ho mouthpieces of the profession are sa ready to be righteously indignant, it may be argued, that a great deal of club and cheap dispensary work is not so badly done. Who knows? Medical men know (hat propsr time cannot be spent over cases and proper medicines cannot be given for the money. That is the answer. Just how many deaths occur through this kind of work can never b« demonstrated.

"You may lead a hor«e to water but you cannot make it drink. Nor can you ret tly> best out of medical men by Shite direction—unless you. pny them properly. The worst medical work I hare ever fen has been-that 'under Stat*! machinery.' where certain hours, certain par, aiid certain routine have been renuired of and nothing more Tt may bo argued that medical men are sure to cxert themselves f.i their utmost under Mr. Lloyd-Gorge's Bill. It is more than I'l-ely. however, that certain medical men will be favoured for some r<>a=on or other. Iroal health committees bpin.g just as able to fxhibit partiality as 'church nr ■chanel district visitors—vvih the result that the work will not be competitive, but will be promoted, rcTubfed. or defended, as th>> ciin m.iv be, by wirnand district visitors of ' various SIXTY VISITS A DAY. Let me quote again from "The Serpent and the Cross" of Mr. Stephen Andrew, who knew his subject well as he wrofe, looking the. facts squarely in the face, and writing as lie realised in his heart: "To make a living by club doctoring," says the young assistant, "is low-down work. It means that the doctors are sweated and the patients neglected. Club doctoring means that a large number of people die every year from want of care and attention. The doctor who does little else than club doctoring has so much (o do that he can dp none of it properly. . . I myself have paid as many as sixty , visits in a day. It means that not a single patient is examined properly, not a single one is really diagnosed. He gets his symptoms treated, and if they are not duo to anything serious, as is usually the case, all goes well, bill if there is anything really tho matter the patient may pay _for waul of diagnosis with his life. . . • Then consider what the cftVct is on the doctor: lie never makes a diagnosis, until iu time lie is quite un- i able to diagnov? anything. . . . The better class doctors have tried to abolish tins club work, with the icsult that people have said they were thinking of nothing but their own pockets. I'cols: Club work pays as long as the club doctor has no conscience. Doctors of the baser sort know this, and carry on in spite of all attempts to abolish the iniquitous system." The "British Medical Journal" has commented on the aborein those words: "The evils of club practice are too glaring to be overlooked, and the statements made in this book are supported by facts."

Now, \uuler Jlr. Lloyd-George's Act we are. to have a new patent stamp put upon contract work that will be underpaid. That certain doctors will be found to do tho work is only too likely to prove true; but, in tho name of humanity, ought they to be allowed? For if things have been bad enough iu the "green tree," what may we expect when they are even more completely "cut and dried," when the masses are at the mercy not of the "good men and true" of the profession, but of the failures? WORSE CONDITIONS THAN EVER. And the public must remember this, that under State control remedy or redress for wrong will bo subject to bureau and red-tape regulation and defence. ,\u<l complaints cinnot make the failure-;, nf the profession in'o fiisi-clnss scientists ail at micp. Wrong diagno-is and slipshod prescribing will not receive the ea>y recognition and the rendv nllernative that free men can obtain. Xo, the work imd'.'r th» Act us i! stands will ultimalcly selik. diiH'ii to worse confr.ict conditions Hum ever. Vndor free circumstance?, patients heing able to choos<> their doctor and lo pi'.y him a reasonable fee. tho health ralo nf llic Tiritish nuldie. independent, nf contract practice, has been a credit for'm.'iiiy di'C.idna lo a hard-working and e.NCcediii''lv able biidv nf prolc-sional men. Onlv Hi" conn-ad work Iμ* lippn :, ):l<,l liillicr--1-1. and a blol thai ha- hveii 10,, 1,,,,.. IvM.g .■i.iic":.l(.d Im.mi the Miblic. Xmv' lorVHllh, il i-.' vi)l|.;li|- K, ,„(, I;,, till'. 1,1., l biggi'i' and blacker 111". 11 cv-r l;v new .-n----acliiu-iil of !'Mili:iiiiw,l. Mciliciil ii:m, mil-/ clcai-lv ami In.m-'lli- Corns IliN „„. hapiiy pro .peel mid n-i-t by rclming 1., niter Mill. Hip uiiliolv bu-in,--.

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