The sun. [volume] (New York [N.Y.]) 1833-1916, 1904-10-11
SURGEONS FEES IN AMERICA.
A Professional view Of Secret Remedies,
Advance Payments and Heavy Charges.


Advance Payments and Heavy Charges.
To TBg EDITOR OF THE suS--Sir' Public
interest In at present engaged In the Doyen-
Croker suit. The three chief points relate
to the question OF the use OF n secret remedy.
payment In advance for services and the
charging Of an exorbitant fee. Editorial
comments In the lay press seem TO be pretty
fair toward sur geons In general. but the views
are sufficiently varied TO call perhaps for
concise statement relating to customs among
surgeons In America. This Is not 10 De
taken az q criticism OF DR.. Doyen. for we may
not be properly Informed upon the features
OF his case as whole.
Secret remedies are generally held to be
worthless. and to be advertised as remarkable
for purposes OF revenue only. physician
may believe that he has q certain remedy OF
great value. and learn later that he was mis-
taken. Mistakes are corrected quickly az
the meetings OF the medical societies. ana
representative members Of the profession
are eager for the approval or ready Tor the
disapproval Of such Jurles OF their peers
This feeling Ia 10 general and 30 deeply seated
that the claim Of possession Of secret rem
edy Immediately places physician under
suspicion.
Payment in advance for services IL a trans
action that Is not customary between sur
geons OF high standing and patients OF the
responsible class. There are several reasons
for this. A surgeon may find that he cannot
accomplish quite what was expected and de-
sired. and he naturally feels that his services
were not 80 valuable as he had hoped they
would be. on the other hand, he may nna
himself in the presence OF an unexpected
opportunity to exercise the last degree oil
skill In the application OF his art. and TO renuer
invaluable services to his patient. TINS 10
all determined after the performance OF an
,,,I ale Qnr n
rience can anticipate as accurately as an ensi-
neer, there are nevertheless occasions when
he would not wish to be tempted to Keep
fee that had been paid to him In ADVANCE
There Is commonly-in New YORK. NJ least
a pretty good understanding between the
patient the surgeon and the physiciahs
who are engaged upon any given case. ana
financial questions are settled upon the De-
lief that all parties are friendly toward each
other.
1t Ia proper and even desirable for patient
to know in advance about what the expense
item Is likely to be. however. and 1t Is not
wholly improper to agree upon contingent
Fee although such an arrangement Is not
held TO be quite professional. There are
certain unwritten laws in the profession
which cannot be understood by the laity or
even by members Of the profession who are
not imbued with the finest professional feeling
precisely as with the social code among gem
tlemen.
The third and last question relates to the
so called eXorbltant fee. Among five thou,
sand young men graduating from the medical
schools Of this country. perhaps 1our thou-
sand wish to become surgeons. ii one nun
dred among the NUN Der give themselves the
years OF extended study and the special tram
ing that are held to be desirable not more
than ten OF the one hundred may hnd that tney
can carry the responsibilities and adaPt
AkA
there will be one who does some one sort OF
9Is xd VIII VIII the ss o YIN ssus
A surgeon who does one sort Of work parttc;;
ularly well develops the art and the manual
rIence. At the time when he feels that ne
should charge SIS for certain operation ~
ssoes not Pc That he shoud charge
IA 500 for the same operation his services may
be worth Just about that amount. and wnen
he feels that he nc NAV be Worth
far more than that and all the while y 10
the same surgeon and the same sort OF an
There are few patients. who would be willing
Ard able on Sa the 5. Rns but
nS MGu SiSSue . :s to f
the mastery services. however. 1t e not
ss Of as s Psyss
principle is this: All should pay the same
amount for the, same kind Of work. but II
have the pleasure, and real one it Is, too. Of
II Would not be possible to pay an sxorbi-
eeons themselves who would be willing 70
pay the largest fees. They are the ones who
An exorbitant fee is one that is not p5opor +.
tomato to the character Of the york f that y
done, or in accordance with the nnanoiaI
cities. where things are on grand scale erandd
S ps Sst @ 81 Ike srsi ss
fession as whole. and usually Of the family
physosn in PARTICULAR for in th tn &c Sonnty
II is not common thing for patient to 90
directly to the surgeon. The surgeon is pre-
scribed, by the physieian, who feels f =; ne 2
much swerved by motives of friendship or pr
policy in his selection OF authorities to help
S"s L Rn aes pysesn Tsrey
ted to charge a large fee for an ordinary
operation that was not very well done. an q
seemed to him that the affair was such large
undertaking. The incident was not likely
be Spces and
tents are pretty safe against incompetent
work and exorbitant fees at the hands Of men
who enjoy the right sort OF recognition oy
surgeons fight a good deal among them
selves. and they are jealeus and envious
but but the disturbance is MI due to the EFFORT
to be most useful. and the professional spirit
Of intellect. Of character and Of skill: They
are onposed to the idea Of ne use OF d secret
remedies; the payment g, ices 80 IN ADVANCE
According to census reports. $500 600 900
were given to educational institutions during
the last decade, but only a few millions went
toward medical education When three
hundred millions OF dollars are given to medi.
cal educ alton alone in a decade. the money
viii he expended upon men who are little in
terasted In the matter OF gain for themselves.
and whose guiding motives are altruistic
Ask A phyeician whether he would rather
have A large income. due to his own efforts.
or whether he would prefer e have al s5i
entirely to the scientific side OF his work and
the common answer would surprise the aver
age layman. ~ i. M
NEW YORK. Oct. 10.