“DELIVERING THE GOODS”.
Much has been said (but less written) about the cause of the drift of the public away from the medical profession. It is a frequent topic of discussion between physicians who intelligently observe the signs of the times and reflect upon them.
That such a drift exists and is making itself keenly felt in the medical profession is obvious.
Witness the rapid increase in numbers and power of all the numerous non-medical cults, including osteopathy and chiropractic, and the medico-political opposition to them.
Witness the feverish political activities of Federal, State and municipal “official medicine,” continually seeking more power that it may be exercised to compel compliance with its edicts and enable the medical organization to retain control.
Witness the widespread literary propaganda in the public press, inspired by “the organization,” constantly calling attention to the wonderful discoveries and accomplishments of modern medical men and institutions, presented in the most attractive and popular style, designed to arouse public interest in their doings. Good writing, too-much of it.
“Theres a reason.” In fact, there are many reasons, some of which are carefully kept in the background and seldom referred to.
Come straight to the point and let us face the situation squarely.
The main reason, from the publics point of view, is that the medical men are not “delivering the goods”.
Hence, the “drift” to non-medical practitioners.
As vendors of supposedly curative remedies they are too often guilty of the crime of “substitution”. Instead of individualized therapeutic service and curative medication, too many physicians are passing over the counter, at a high price, specious imitations of both, in the form of hurried interviews, three-minute “examinations,” superficial opinions, diagnoses which are merely guesses, “standardized” medical and surgical procedures, “snapshot” prescriptions and “bluff.”
Or they are going to the other extreme and beguiling the patient into submitting to a round of elaborate and expensive special examinations and tests, most of which are quite unnecessary and lead to the employment of costly medical or surgical measures which have no curative relation to the disease process itself-if it exists-but are directed toward some mere product of the disease; hence are merely palliative.
“Laboratory workers” are constantly making discoveries, by so-called “research,” of new “specifics” for various diseases which are duly brought to the attention of the ubiquitous reporter, who is allowed to write them up for the benefit of the public with just the right amount of judicious censoring (so that the requirements of professional modesty may be met), and just the right number of discreet reservations (in order that a quick shift may be made if the therapeutic dart turns out to be a boomerang) Meanwhile the advertising agencies, the manufactories and “laboratories” thrive, and the exploiters “wax and grow fat”.
Is the public really as dense and as gullible as it appears to be? Or is it beginning to see through this fog of delusion and mis-representation?
Two recent incidents, involving both schools of medicine and selected from among many of a similar character in the personal experience of the writer, may throw some light on the situation.
In a case which has been under the care of a prominent homoeopathic physician of long experience and excellent reputation, inquiry was made as to why a change of physicians had been made.
The reply was that, first, the patient (a woman) had “not been well since an attack of influenza four months before.” During which time several “complications” had developed; second, that the physician had not seemed to be interested in the medical features of the case and would not take time to listen to symptoms nor make proper examinations.
“His examinations were too cursory,” said the husband. “He would come in, glance at the patient, ask about the temperature, cut short or ignore any attempt to relate the history since his last visit, hurriedly put up some medicine and leave before he had been in the house five minutes”.
When surprise was expressed, the patient said, half apologetically: “Well, what could you expect? He is too busy and sees too many people. You know he charges only one dollar at the office and two dollars at the house and a great many people go to him for that reason. He is always rushed”.
She then went on to relate that she had been at his office repeatedly, always finding his waiting room full of patients, and that several times she had seen him, at the close of his office hour, leave the house to make outside visit, while several angry patients yet remained who had not been attended.
“How can anyone expect to get or give good service under such conditions?” she asked.
“I stood it a long time,” she continued, “because I liked him so much as a man. But when I found myself getting no better and gradually getting into a chronic state, I made up my mind it was time to call in someone who would take some interest in me medically and give time enough to the case to enable him to treat it properly.
“I believe Dr.________is an able physician and a well meaning man,” she continued, “but he is working under a wrong policy and does not realize it. If he would charge three times as much and see one-third as many patients they would be satisfied and he would be happier, get better results and be just as well or better off financially”.
With rare discernment this highly intelligent woman had put her finger upon one of the commonest and most virulent points of “focal infection” in the medical body. Look at the situation for a few moments.
Here is a man of genial personality, good native ability, of excellent training as a prescriber, long experience in medicine and surgery, high reputation in his community and popular among his patients, who has allowed himself to become overcrowded with work, hasty and superficial in his examinations, inaccurate in his prescribing and unsuccessful as to result-and all largely because of a bad financial policy.
It is known that this physician charges the same fees today that he did thirty years ago. The evidence goes to show that he has made little or no progress in professional skill and technical efficiency during that time-has in fact retrograded; also, that some of his patients know it.
It is reasonable to assume that under an enlightened financial policy and a consistent program based upon right ethical and financial principle, conscientiously carried out, it would have been possible for him to make substantial progress in skill and technical efficiency and become an honor to the profession. Under such conditions his services would now be worth at least five times as much as they were thirty years ago, and he not only would be justified, but would have no difficulty, in charging and collecting proportionately larger fees-provided he actually rendered the service and got the results.
Here, by the way, is about the only saving feature of this case-that he had not yielded to that particular form of greed which has led others to charge high fees while failing to give the kind and quality of service that alone justifies them. Probably his “Inward monitor” has been able to make its voice heard distinctly enough occasionally to restrain him in this respect.
It would have been better for all parties concerned if he communed with that higher and wiser self more frequently. As things are, he is charging very small fees for very poor service- in which there is a kind of consistency-but it is still open to question whether the service he gives is really worth anything. This particular patient did not consider it worth anything to her and frankly said so; and she will not fail to tell others. Who will say that she is not right?.
The other instance refered to was in connection with the case of a baby, six months old, the child of wealthy parents who live in a New Jersey town. The case presented certain puzzling features which had baffled the skill of the conscientious young allopathic local physician. He had finally advised the parents to employ a New York specialist (allopathic), whom he recommended highly as his former teacher, the author of books on the treatment, care and feeding of infants, and of high standing as a pediatrist.
The mother narrated how she had taken her baby to New York, had been received by a uniformed attendant and ushered to the desk of an assistant physician whose duty it was to register the case and make a preliminary examination and diagnosis. He occupied about two minutes in the performance of this duty. He then called a nurse, who took the card which he had written, escorted her to the waiting room and left her, stating that she would be called in her turn.
The lady counted eighteen patients already awaiting their turn, took out her watch, noted the time and began to wonder how long she would have to wait. At the end of forty minutes the nurse conducted her into the presence of the great man and introduced her, handing him the registration card at the same time.