Large Fees and How to Get Them: A book for the private use of physicians. Albert V. Harmon
the realm.” It is queer that the newspapers should write up the most minute details of the wonderful exploits of some poor fellows, together with their family histories, and publish their photographs, without their knowledge or consent—especially queer when we read in conclusion that “Professor John Doe is the greatest surgeon that ever lived.” Why not come out and acknowledge that these are paid for? This would give an equal chance to all, and especially to young fellows who have money enough to pay for similar things. He who has not the price should not find fault with the fellow who has, for, “business is business.” Meanwhile, my young friends, remember that “big mountains may do what little mountains may not do.”
When Koch’s tuberculin was yet new, soon after it escaped, half-fledged from the laboratory, only to be captured and made to perform like a trick monkey for the benefit of the laity, there came a ring at the phone of a prominent daily paper: “Hello, is this the Daily Bazoo?” “Huh, huh, it are.” “Well, I’m Dr. Squirtem Galls. I wish you would send a reporter over here at once. I want to be interviewed on Koch’s tuberculin.” It is said that $25 changed hands, but I don’t believe it. The gentleman would never advertise—at that rate—“no sir-ree.” My informant was once the sporting editor of the War Cry, and hence unworthy of credence.
And what wonderful contributions the newspaper-great-men are making to science! The daily paper is the place to study appendicitis and things. It is not long since I learned from a distinguished surgeon friend of mine, via a daily paper, that evidence of a blow having been received on the head is an imperative indication for craniectomy, whether symptoms are present or not.
In preference to the clandestine methods now in vogue, would it not be better for men in authority to write signed articles for the newspapers and intelligently present medical matter to the public? But that wouldn’t be ethical, would it? Such topics as “Advice to Young Men,” “Letters to Young Wives” and “How to Keep Healthy,” must be left to the quacks. We will confine ourselves to the surreptitious blowing of surgical horns and never mind the false notes.
Meanwhile, let us stand back and watch the procession of modest men who never advertise—oh, no! At the head, with haughty mien, comes Professor Keene Carver, preceded by a herald in blood-red garb, blowing a large brass horn. Then comes the “bearded lady,” whose blonde and breezy whiskers so delight the heart of his swell society clientele. And here comes Rip Van Winkle—a middle-of-the-road “eclectic,” gathering up his long and weedy beard to keep it from getting tangled up in the scientific barbed wire fence along the route. And here comes another sure-enough “regular,” evidently a medicine man—so rare nowadays. He is riding in a swell turnout and is on his way to his clinic. How do I know that Professor Windy Bowels is a regular? Because the gentleman who is riding beside him to his clinic is a reporter on the Chicago Daily Jib-boom.
I presume that the suggestion that I have made of the advisability of taking the public frankly into our confidence and giving it accurate information so far as its comprehension goes, by signed articles, in preference to clandestine advertising and the promulgation of fallacious ideas of medicine and surgery, will meet with bitter opposition. I nevertheless believe that a better education of the public is the only way to down quackery. The opposition will come chiefly from the surreptitious advertiser, who sees a prospect of other men getting the advertisement that he believes to be his proprietary right.
Then there is the tribe of the Microcephali. The howl of protest will be long and loud from the pews occupied by these far-famed champions of medical orthodoxy. “We won’t put our discoveries or contributions in the newspapers—not ever.” And gazing at their lemur-like front elevations, we can well believe that they would have no trouble in establishing a “halibi.”
Apropos of “discoveries,” it may as well be understood that the public is bound to get the details of them sooner or later, and, when the time is ripe, the matter should be presented to it in a clear and intelligible form—comprehensible to the layman.
CHAPTER II
THE PHYSICIAN WHO SUCCEEDS
To a great extent Nature has a commanding influence in the equipment of the successful practicing physician—the man who actually secures the desired results in his treatment of patients, builds up and retains a good practice, and obtains a financial income of respectable proportions.
Any man of ability, with the necessary education and training, may obtain a certain amount of success as a physician and make a modest income—or drag out a miserable existence; this latter is the most probable. It is a well-established fact that the great majority of physicians are not what the world would call prosperous. This is not because they do not earn enough to secure a competence, but because they do not get it.
The doctor’s bill is almost invariably the last one paid. His practice is generally among the middle classes, people whose intentions are good, but whose incomes are limited. If there is anything left after the rent, and grocery and butcher and other bills are paid the doctor will, perhaps, get something on account, but as a rule he doesn’t.
This is mainly owing to the fact that the average physician is a poor business man; he does not place an adequate value on his services, and is slack in looking after collections. If pressed by his wife, or some friend, to be more particular in this respect, his almost invariable reply will be:
“It would not look well for me to put myself on the same plane with merchants. Mine is a profession, not a trade. Besides, I’m in duty bound to do a certain amount of charity work.”
Now charity work is all right in its place. An honest, upright practitioner will never refuse to respond to a call for his services in deserving cases because the payment of his fee is uncertain, but this does not obtain to the extent of virtually making paupers of people who are actually able to pay. And yet this is really what happens when a physician conducts his business affairs in a slipshod manner, and this is what most of them do. There is no excuse or reason for it.
But we started in to tell of Nature’s part in the equipment of the successful physician. What is the equipment? The possession of a robust, healthy physique, a sunny, cheerful disposition, and a fair knowledge of medicine, and ordinary business ability. All are essential if real success is to be attained, either in a medical sense, or in the accumulation of a respectable income.
Let us take two instances for the purpose of comparison. In one case we have a practitioner with just a fair knowledge of medicine, but in the possession of all the characteristics mentioned. His very presence in the sick chamber acts as a tonic to the patient.
Then we have a thin, undersized, nervous, dyspeptic physician; dissatisfied with himself and the world generally. He is a thorough master in medicine, and his treatment is more scientific than that of his less learned brother. His presence in the sick chamber, however, has anything but a soothing effect on the patient. On the contrary it irritates him, and the effect of the scientific treatment is nullified. This is not an exaggerated case. There are thousands of just such men in practice.
Which practitioner is going to have the greatest meed of success? The answer is easy—the one who cheers and encourages his patient by the magnetism of his presence.
Talk as we may, suggestion is a powerful factor in the practice of medicine. I do not mean by this that suggestion alone will cure illness (this statement is made without intention of affronting those who believe in Christian Science). But there is ample evidence to the effect that suggestion goes a long ways in making medical treatment effective. It is only the physician whom Nature has equipped in the manner indicated who can offer the right kind of suggestion and he does it unconsciously.
A physician of this kind is bound to become popular, and popularity begets a large practice and commensurate fees, provided the practitioner is in the right location, and has the business acumen to place the proper value on his services.
From time immemorial physicians have been imbued with the idea that they