The morning news. [volume] (Savannah, Ga.) 1887-1900, 1894-07-15
COMPENSATION OF PHYSICIANS.
The Richer the Patient the Greater
the Fee, Says DR.. Hammond.
From the New York Law Journal.


From the New York Law Journal.
In an article in the North American Re-
view for June, 1894, entitled What
Should a Doctor Be Paidl" DIR. William
A Hammond takes the ground that
charges for medical and surgical services
should be graded according to the wealth
of the patient. He squarely contends
that physicians should be allowed to re-
coup themselves for ill-paid or gratuitous
ministrations to the poor by exacting gen
erous tribute from the rich. He appar-
emily claims that it ought to be consid-
cred legitimate for a physician to make a
bargain in advance with rich man, who
is seriously i'll, that if cure be effected,
or the progress of the disease arrested,
the physician shall receive a certain pro-
portion of the patients fortune. One of
the writer's illustrations at least shows
that he has the courage of his convic-
tions He says:
THE tourist captured by Sicilian
brigands does not hesitate to give $40. 900
under the threat that failure to do so will
result in the amputation of his nose. He
would give ten times as much, if he had
it, to save himself from so horrible a
mutilation. But should a surgeon, by a
sklllful operation, preserve the same or
gan of the same tourist from the destruc-
tive influence of injury or disease, the
probability is that, should he fix his
monetary compensation at so large a sum
as $500, he would be regarded as almost
as much of a robber as the Sicilian
brigaDds, and that even many of his fel-
low practitioners would look at him with
that degree of envy which the obtaining
of such fee would excite"
We are glad that the illustration was
used, for it brings out the essential vice
of DR.. Hammond's contention so forcibly
that extended counter argument is I'M
necessary. The discussion has a bearing
upon fees for legal services as well, and
as to both professions, the system of
banditti's ransom, rather than conscien-
tiOus service of mankind for a fair and
just compensation, determined by the
comparative seriousness of the service
and the standing of the doctor or lawyer
rendering it.
DR.. Hammond draws envious COMPARE
sons between fees of physicians and those
of lawyers, which latter are to an extent
determined not by intrinsic standards,
but by the rem involved. This distinc-
ton, when it exists, arises from the ma
ture of the rem itself. Where rights Of
property are the only thing concerned in
the legal proceeding ii is not improper
that the value of the property gained or
protected, for a client should enter as an
element in the problem of determining
the proper remuneration. In cases where
it is allowable for lawyers to undertake
business on contingent fees, the Justice of
a proportlonate rate of the compensa ton
will be quite generally recognized. Ordi-
nary collection business obviously falls
under the same rule, as does also convey
ancing, where principle not unlike that
Of insurance comes into play. Forms of
legal business that arc more analogous to
medical services are criminal proceedings
and matrimonial cases. The contention
has been made, and even iudicially sane
toned, that it is legitimate for a Jury to
gauge the value of legal services in de-
Tending person on criminal trial, ac-
cordlng to the latter's wealth, which
proposition we deem unsound in principle
and inevitably tending to make legal
practice mercenary system of ransom or
tribute. The temptation of an advocate
to perform unprofessiCnal acts, and en-
tlrely lose sight of the proper restraints
OF an officer of the court, in defending
rich rogue on criminal charge, would
obviously be greatly increased if the coun-
sci realized that success would legally en-
title him to certain proportionate share
OF the clients fortune, no matter how
large it was
One passage from DR.. Hammond's pa
per, however, offers a suggestion toward
the true rule for fixing charges for pro
fessional services which are purely per
sonal in their nature. He saws:
The value of medical services is al
ways great, and it is only the rich who
can properly compensate the physician
who renders them. When the same ser
wees are given TO poor person, it is i'm
possible that they can be adequately re-
warded, and hence smaller fees are cheer
fully received. 1t is really not that the
rich are charged more, but that the Door
are charged less. IL would seem right
that medical fees should be arranged upon
the basis of the patient being worth a GER
tain amount (say 100000, and that the
honorarlum, if he chooses to use that
term, should be adjusted accordingly. be-
ing more or less as the wealth of the pa
tient was greater or less than the sum
fixed upon
in dealing with rich patients and eli
ents, physicians and surgeons. and law
yers acting in cases not involving specific
property, should make out their bills not
commensurately with the wealth of their
employer, but simply on the basis that he
IS rich enough to pay whatever is right.
The charges should be fixed according to
the practitioners standing and experience
ana the amount of labor involved the Gus
tomary rates Of practitioners of equal
Stanulng IN the same community for sim
liar services being kept in view as a guide
and possible corrective This general
rule would not preclude the acceptance of
smaller fees from poor people, but il
would debar practitioner from charging
a man worth Sl,000,000 more than one
worth 500, 900 for the same service. We
believe IT Is essentially communistic. and
subversiye of professional conscience and
dignity, TO charge q rich man all that can
be screwed out of him, in order 70 make
up for what one thinks he ought to have
received on account Of professional acts
OF charity or mercy.
The King OF Italy has sent 900 francs TO
the chairman OF the committee in charge OF
ne erection OF a monument to Marshal Mac
Mahon OF France.
doom MN
0ooley-fes; Just saw him lick On envel
ope which contained "a letter asking N. 80 iiot-
sail 90 marry him Boston GotlfIsr ''