, 1888-10-24
LONDON PHYSICIANS.
FEATURES OF HOSPITAL PRACTICE
IN THE ENGLISH METROPOLIS.

"a IA1SAchLIts
Private Medical Practice in London.
Works on Medical Science.
DR.. William Campbell, one Of the most
prominent physicians in Kansas, has been
in London studying features of London
hospital practice Some of the obserya-
tiOns made by him concerning the results
Of his visit are very interesting. He said,
in conversation the other night, that the
practice of medicine in London was es-
s~entially different from the practice in the
United States. In our country physicians
had much better opportunities, and he
was certain that they were all better
practitioners as a class. He has been in
the hospitals of Philadelphia and New
York, and now is of the opinion that a
student can gain more practical knowledge
in the hospitals of those cities thar in
London, although study in a London hos
pital gives a man a better name. The
American surgeons are much more skill
full operators than the English. They are
more delicate and gentle. 1t is to the
discoveries of American surgeons that
much of the mitigation of pain in opera
tons has been reached. DR.. Campbell
says that in nearly all of the London hos
pitfalls American manufactured instru-
ments are used. Cocaine, an American
discovery, has only recently been en-
ployed.
DR.. Campbell gave some of the reasons
for the superiority of the American prac-
titioners. He said that when an Ameri-
can physician had secured q proper
amount of knowledge he could, with care
and attention, gain a general practice. He
became engaged at once in studying prac-
teal questions from actual experience.
While he is not as much of a book man as
the English physician, he has a much bet
Ter practical knnWlnHOn In ENGLAND No
physician can hope to obtain a practice of
any value unless he has or has had some
official connection with some of the great
hospitals. He cannot have a first class
practice unless he has reached a come
ton with a well known hospital, a mem
bership in the Royal College of Surgeons,
or through some piece of special good
fortune, a title.
SIR MoRELL MACKENZIE.
Take the case of Morell Mackenzie. His
fortune is absolutely made through the
title conferred upon him for his treat
ment of the crownp prince. Where he had
one patient before he had the crown
princes case, he now has at least twenty.
His income has gone up at least e12, 600,
or $751; 900, a year from his practice alone.
London has a very large number of
hospitals. Any one can go to the greater
number of them for free treatment. 1t
- ''pHcSNA tAAeS OLAIg ItAlClIlS Will apply
for free treatment who are not able to
pay. Yet DR.. Campbell says that in the
hospitals where he has been the greater
portion of the people who apply for free
treatment are well dressed and have
every appearance of being well to do.
Some of the ladies are in silks and furs
n give every evidence of possessing
ample means. One of the most striking
of the patients of this class was a hand
| soma and Diftn6 uprnG 101u wha hoe
been studying on the continent for come
time preparatory to going on the operatlc
stage. She was always accompanied by
her brother, who looked as well to do
and prosperous as she did handsome n
distinguished.
TIL treatment in the hospitals is rough
and careless of the patients feelings.
There is no patient who applies for free
treatment at the hospital who can escape
the personal examination of any of the
students who assist at the clinic. One
would think that a person of refined SEN
sibilities would not care to place himself
under the rude handling of English hos
pital surgeons and the personal eXamina-
ton of thirty or forty students rather
than pay the fee which would be required
in consulting q physician in private prac-
tice. The well-to-do do not appear, how
ever, to mind the disagreeable features en-
tailed upon a hospital consultation. They
bear all of its inconvenience with stolid
composare so long as they are able to save
the guinea fees which they would be re-
quired to pay for private treatment.
IvATE MEDICAL PRACTICE.
The surgeons in charge of the hospitals
encourage the people to come there to take
treatment. The reason of this goes back
to the whole system of medical practice in
London. 1t is the policy of the leading
| aud ctrnnaEgf1,1 r,an &, o1,,f,n1 80 A. H..
tails to keep the private practice of medi-
cine in the fewest possible hands. BY
treating the mass of people free in the
hospitals they make it impossible for the
younger physicians to obtain q practice
except by coming up through the difficult
path of hospital examination and APP
proval. Those who are in control Of the
hospitals are few in number. Those who
can obtain connection with them are also
few, and to these few alone goes the pri-
vate medical practice of London. Admis-
sion to the places in the hospitals is the re-
suit of competitive examination upon
theoretical subjects. Physicians who hope
to get a practice often spend the greater
part of their lives in unpaid attendance
upon the hospitals and in working upon
their books in order to reach a place where
they will be able to apply their learning
in the art of healing.
The physicians who are struggling to
make places for themselves often write
works IN medical science. Some of these
works AVE been eminently successful,
yet it is a fact that n number of eminent
London medical authors, who are quoted
the world round as high authorities upon
special subjects, ave not reached a posi-
ton where their private practice pays
their expenses. The high fees exacted is
another part of the system of keeping pri-
vate practice in a few hands. The guinea
fee is exorbitant. Few people can afford
to pay the ordinary fees of a London
physician. The fellows of the Royal col
lege Cannot sue for debts for medical SER
vices. This is another element against
the younger practitioners. The fellows
are supposed to be in a position where