THE GLOBE. THURSDAY, MARCH 9, 1882. THE FRIENDLY SOCIETIES AND MEDICAL ATTENDANCE.

Globe, Volume XXIV, Issue 2472, 9 March 1882, Page 2

THE GLOBE. THURSDAY, MARCH 9, 1882. THE FRIENDLY SOCIETIES AND MEDICAL ATTENDANCE.

Some little time ago a meeting was held to consider the propriety of making arrangements by which, as far as medical attendance was concerned, all the Friendly Societies here should be amalgamated. The idea seems to have been that it was advisable that the Societies should have a doctor entirely to themselves—a doctor, that is, who should receive a fixed sum per member, and be debarred from private practice. A farther part of the scheme was that there should be established a separate druggist’s business, which should dispense all medicines for the combined Societies. Although the Societies have every right to manage their own internal affairs, yet wa make no apology for bringing this matter before the public, because it is in reality more of a public than a private matter. The Societies include such a large percentage of the population in their membership that anything that affects them can well claim to be discussed openly. As is well-known, by existing arrangements each club annually elects its medical attendant. In some of the clubs two medical men are elected, and each member can employ the services of whichever of the two ho wishes by intimating his choice at the beginning of a quarter or year. The amount allowed by the' club to the doctor for professional attendance and medicine for each member, his wife and family, irrespective of number, is £1 per annum. By the arrangement proposed the other day it is suggested that the doctor employed by the Society should receive only 10a per member, and that the other 10a should go to the druggist’s business. Now without desiring in any way to interfere in the private affairs of the Societies, as the matter is of such general interest we would desire to point out certain objections which seem to stand somewhat in the way of the plan just started. There can be no doubt that, if a doctor were chosen for the amalgamated business of the Societies, ho would have to be appointed for a term of years, or at all events would not be removable annually at the will of a bare majority of

•the members, except he were to grossly •misconduct bis cases. As the professional man appointed would have to give 1 up all private ‘business and attend solely to the members of the Societies, no man doing any business at all would think of taking the post unless there were some security in its tenure. Now the most desirable feature in the existing arrangement is that there is a considerable “ swing ” in

the system. Medical men are appointed annually, and members have thus the opportunity of recording whether they

are, or are not, satisfied with the manner in which they have been looked after during the previous year. In cases where two medical men are chosen, members have of course n further latitude allowed them. Now, with regard to medical treatment, it is a well-understood fact that much depends on having a doctor that suits one. Take two medical men of apparently equal ability, and one will .probably please a sick man or woman much better than the other, and from no other cause but from a species of electrical affinity that appears to establish itself between the doctor and his patient. The one doctor seems to inspire confidence, which the other does not. And It is evident that there is a reason for this. Medical science has not been reduced to an exact science. The definition of a doctor, given years ago by a certain philosopher, that he is a man who introduces into a body about which ho knows but little substances the effects of which he can •only guess at, is luckily growing less and less true year by year. But nevertheless it is certain that doctors of equal eminence do not alike successfully strike at the root of maladies in certain patients. Consequently it would seem that one of the main features in any scheme for the supply of medical aid to the members of Friendly Societies should be that as large a latitude as possible should be allowed to members in the choice of doctors. But the scheme proposed would make a cast iron rule which would impose on all members the same professional man for a term of years. As we have said before, it is not apparent how a doctor could be got rid of unless he were to go flagrantly wrong. Members of Friendly Societies are not, as a rule, wealthy. One of the main inducements with them for joining such societies is that connected with medical attendance. Even in serious cases they would be compelled by their circumstances to employ the medical attendant of the amalgamated Societies. Nor would they have annually any chance of expressing their dissatisfaction. At present, even if there is no well founded dissatisfaction, members may got rid of their professional attendant simply because he does not suit them. No reason need be given, and no slur is cast on the medical man if the doctor of the Society is charged. There is also the question to be considered whether, under the proposed arrangement, the quality of the advice ■ received would be equal to that at present obtained. 'Our own opinion is that it would not. Doctors now make their Society work dovetail in with their private practice. When visiting a member of a Society, it is an easy matter to drop in upon a private patient that lives close at hand. The Society work is made an adjunct only to private practice. It gives a doctor more extended experience, and does not interfere with his more lucrative work. We think that no man of considerable professional ability would be willing to be debarred from all private practice. Moreover,the very fact of having private practice gives an elasticity to the work of a medical man, which would he lost if he were a servant of the Societies. We all know about the value 1 of what is called the “ Government stroke.” A certain routine has to be < gone through, and there is no direct in- ■ centive for a man to exert himself. The 1 doctor of the amalgamated Societies could 1 mot hope to extend his practice by his J skill in his profession. He would be the • Societies’ man if only he did nothing .glaringly wrong. I With regard to the question of 10s only being given to the doctor and the ( other 10s being kept for the drugs, this, 1 too, would not seem an improvement. It is the custom in England for many medical men to make no charge for the 1 medicine they supply. Charging as they do a uniform fee for professional advice and opinion, they select the remedy best adapted to the ease, and prescribe it or dispense it irrespective of cost. It is not the quantity of medicine, but the amount of benefit that has to bo considered. Or, in instances where, unfortunately, cases are past receivin g any benefit, or resist all treatment, the amonnt of professional skill expended is what has to be weighed. The fewer drugs that are introduced into a patient’s body the better, consistently with Ms receiving sound treatment. The proposal we are treating of weighs the professional skill of the medical attendant and the drugs in a pair of scales and finds that they balance exactly. This j seems to ns to bo somewhat ridiculous, and not likely to attract a first-rate man into the service of the Societies. As we mentioned at starting, we have no wish to interfere in the private arrangements of the Societies, but it can do no harm to ventilate this matter, affecting, as all arrangements on this subject must do, the comfort and welfare of such a large number of people.