Richmond dispatch. [volume] (Richmond, Va.) 1884-1903, 1893-08-25
&DOCr0RS.
A Reconsideration OF THE QUESTION
OF FEES.
v,.,r,.,n.,,on 70 value the Services Of
Tho Lawyer Higher Than Those
of the Doctor.
To the Editor Of the Dispatch:

To the Editor OF the Dispatch:
wou,d no Obliged if you will paolish
tbe following article which has just APP
peared in the Neo York Medical Record, one
OF the leading journals IN the medical
world. IL was originally designed for the
pIspIrcn. as will appear. The object 10
10 instruct people who have never gwen
tho subject any thoughtful attention;
There Is A great tendency TO reduce all
wages TO the same level; that's, so much
an hour. The value OF the work to the
employer must never be lost sight OF. ~
abs he should pay its full value. Inc
quicker the work is done the better for
sll. But l torbear. as your space Is
valuable. W. WI
High Fees and Low Fees.
To the Editor Of the Medical Record:
sIn: I see that in your issue OF June
2ith you refer to the high fees OF the doc-
tors IN the "Mackay case. have oeen
thinking for some time OF discussing tne
subiect In the newspapers. but your NOR
ial suggests II might be better, perhaps
that IL be first considered IN medlca'
journal. IL ia of interest both to the n1ed-
ical profession and the public. / shali DC
as brief as possible. .,,,oh
A clothier can only give man SO hiuc ,i
for making a coat because he can only sen
give laboror so much per foot lot Vne
ditch dug because the land IS only worth
80 much 10 hun for cultivation. 30 IN
these and similar cases. there Is necessarily
6red limit TO the value of the work done.
In medicine and in law there are at least
two limits. to-wit: The value OF the wofR
done and the ability topay. But the
1oiue Of the service and the ability 70
nav have no real CONNECTION the
ono with the other. The poor
mans life and health are as dear to nun as
the rich mans 50 the value or the WoIh
done IA the same We adopted tarin oil
fees from necessity. As most people arc
poor. the tariff IS low. There were no
ip,lliopaires when II was made. III the
ability TO nav was the only guide. the
schedule would be a long one. III we
CHARGE the poor man 81 for visit, the
millionaire should be charged SlOJ, DuI
IN almost ali transactions the hrst question
20 be considered before settlement IS Jhe
value of services performed. tnIortu-
nately. men seem TO lose sight OF the Value
OF medical services except in extraordinary
cases. such as the saving of life 10y sur
plcal operation. Yet there is, Or con oe'
no endowment of life without health;
hence its inestimable value. Lawyers get
their fees secured before they begin Work.
This is impossible TO the doctor tor oovi-
Gus reasons. The lawyers fees are also
does lesa work ordinarily. Jurles should
be very careful how they set ASIDE the
doctors fees. A physician does more
charity IN one week than o lawyer IN
wear. The public owes the former mucn'
the latter nothing.
FEES OF MACKAY's DOCTORS.
The fees Of Mackay's doctors were So
O0O and $500: they are considered eur
nous by some people. and Vet lawyers get
$4,000, $50. 900. and 5000 fees when less
than life Is involved. As a class the latter
are not AS well educated as the former.
We're Mr. Mackav shlpwrecked ana lie
called upon good swimmer 10 save him,
AID he did IT, would $4,000 be too much
20 paw, though II took the rcscuer only
ten minutes to do the work! We think
u0t. A man will give all that he hath tor
ms life" 1t Is impossible often to express
IN money the value of medical services:
hence it was once the custom. on the
part of men of wealth especially. to give
the doctor what is known as an hOnora-
num-" something beyond the zee charged.
as an oppression OF the PATIENTS hlgner
obligation. This was beautiful custom
which has fallen, IN the Southern states,
INTO sad decay. There may be mere
mercenary service in medicine, or high.
honorable devotion to dutv and humanity
taat loses sight of all pecuniary reward;
rs motlve-pOwe Is pure love. Sometimes
the doctors work is heroic. Like moth
el's love. we can't find its value. Every
man dies debtor TO his ther,and thous-
Gnds die debtors to their doctors. though
the fee is paid. Furthermore. the
value Of the physician's work cannot he
estimated. like that of the mechanic.
The doctors knowledge is cumulative. A
man with five years experience NAV make
as good a plough or locomotive "a one
with twenty years experience. lie only
requires q certain amount OF mecbamca
skill of q certain sort. But doctor Wits
twenty years experience bIiugs an I'M
mense mass of information got from hun
dreGs and thousands of cases. He pours
out upon this one case all his careful OBJ
seryatons derived from all bis cases of
like character. together with the knowl-
edge he has got from books. indeed all
his mental wealth. Neither can he dlsas
sociate this one disease from the healthtul
action or the entire system.
SYMPATHY.
No account is taken by the public
of the painful sympathy and dread
ful anxiety suffered by the doctor IN
the practice of his art. There Is no such
strain in mechanical work. He suffers
with his patient. He is often miserable
on this account. The patient Is III his
dreams as we'll as IN his waking thoughts.
lie is often an old and dear friend, man
or woman invaluable In the family and IN
the community. The doctors reputation
is also at stake. To him all hearts turn IN
anxious solcitude. It is often intensely
painful. | knew an excellent doctor
once 10 flee from this anxiety: he gave
up the case rather than endure 1t. Some
times the physician has to endure the dis
tress OF want of confidence In the patients
friends. The heaviest sorrow borne by
the Great Physician was the want OF ap-
nf fol
tlfying thing IN doctors life IS the re-
luctance Of men to paw their bills. though
abundantly able to do SO; they must be
itemzed, Some keep account OF your VS.
its, and rebates are asked for, low as the fees
are. The love of money IN some men seems 10
kill out all gratitude, as l showed In my
Forty Years O Doctor" do not think L
am writing from O doctors standpoint.
When / was eighteen years OF age l saw
that money could not discharge less OBJ
legation than those of a sick man to kind
and faithful doctor. When l left the Acad-
envy | said TO the principal, and was per-
fectly sincere. as | handed him my fathers
check for my tuition, Sir, this IL small
expression of nv obligation for your valu-
able services to me-" remember he SEEM
ed much surprised.
DOCTORS POOR.
The public need instructing on this
point. How few physicians. after thirty
or forty years Of hard work, get rich. The
great multitude die poor. This IS proof
that the fees are not high. Inc man who
does get rich paws high price for it, he
has little rest day or night, and no Sab
bath-day to calm his tired and troubled
spirit. Few doctors make their sons
physicians; they would shield them from
life of toll and hardsnips. In the South
few are oble from their practice alone to
give their children first-class educations.
w. w. PARKER, nj. ID.
RICHMOND. VA.
rue CuopcNCN OfIcCTinN