Omaha daily bee., 1908-12-12
BILLS TO FIT YOUR INCOME
Physicians Services Rated on "What
the Traffic Will Bear"
CURES COME HIGH FOR WEALTHY
Better Dodge the Surgeon n You're
Scheduled at n Million
Charity Practice Must
ne onset.


Thunder! What 8 my income got to do
with your bill for services? When 1 buy n
thing l want to pay the market price, which
Is ultimately based on the cost Of produce
ton. You evidently want to reverse the
economic law and charge all the traffic
will bear, like the big monopolies. Why,
man, that's unnatural; It's like those orr
email shopkeepers."
Gently, my friend. You don't under
stand the ethics Of the medical profession.
We physicians are not to be classed with
manufacturer or traders. Do they ever
give anything away7 A large part of our
practice Is charity. Our prices JustIfiably
range from nothing up to several thousand
dollars. Our services are humanitarian,
like those Of the clergy; they are often
priceless. and cannot be balanced on a
scale Of dollars and cents"
That sounds sort OF reasonable, doc. 1
feel like apologizing. Only It must be hard
for you professionals to figure out the de-
tails of a bill, making 1t match with the
patients necktie and his diamonds, and all
that. Maybe, the patients wearing a
'phony' stone. or he's dressed way beyond
his means, or he's a rich man dressed
cheap. You must be Sherlock Holmes to
know the right price to charge when you
haven't time to investigate and want cash
on the spot"
1T is an art admitted the physician.
I'm the words of an eminent surgeon in the
North American Review by DR.. A. c. Hef-
fenger, The fixing of a fee correctly is a
talent which Is either born in a man or
only learned after long experience. The
physician should endeavor to ascertain the
patients circumstances. He can thus be
in a position, knowing as he does the
gravity of the operation or its trivality, to
say What the operation is worth to the
patient. The physician is necessarily the
better Judge of the two " -"
The possession of great wealth carries
with II heavy obligations, It is stated, and
these obligations are rightfully cashed by
the practitioner. Some wealthy men don't
have the instinct of distribution, like col
lege builders and library givers, and these
need encouragement Legal fees are no
more invariable than medical fees; they
depend on the amount of money involved
In a lawsuit or the wealth of the client and
the jeopardy Of his position.
American fees are not worse than Eng
lish. A city specialist charges from S to
$50 for an office visit and asks about $50
for half a days trip out OF town. A day or
two spent away from the office is worth
between 800 and $1,000. There was a rail-
road owner who hired an obstetrical spe-
cialist to remain with his daughter during
a critical period which lasted for two
months. The service was successfully per-
formed and It was well worth a fee of
1000, being at the rate of 500 a day and a
bonus Of 1900.
That's a beautiful theory; I'll sure
read that article. said the patient,
hastily scribbling a check of sufficient
proportions to avert an inquiry at his
bank. still. you can always argue on
the other side, and 1 know some men
who'd rather judge for themselves what
an operation was worth. to save their
lives or otherwise. A man who isn't par
ticular about living wouldn't like to pay
a fancy price. An operation may seem
elegant to the operator. like a painting
does to the painter, but that doesn't take
account of the customer"
Standard Charge Impossible.
No standard price for medical services
Is possible, according to the argument of
DR.. H~effenger. The fee evolves with the
evolution of the pocketbook. 1t is claimed
that one-third of New York City practice
Is charity, and much of that illegitimate.
Those short-sighted persons who object
to a sliding scale do not realize the ma
ture of professional services There was
a mother who objected to a metropolitan
surgeons charge Of 1000 for removing
her sons appendix, and wanted to pay
only $500, but the surgeon had witnesses
to prove that the filial appendix was
worth the price, and he received the full
mount. The mother, perhaps with char
acteristic feminine lack of logic. failed
to see the connection between a fat bank
account and plethoric appendix, and tina
the removal OF one should naturally re-
suit in the reduction of the other. From
another point of view, this appendix had
been distended with Rialto Holsters and
other costly foods, instead of corned beet
and cabbage, and 1T was worth something
to restore the young man to an exalted
digestive career.
Examples of Big Fees.
An ordinary man with a fractured finger
going to an ordinary surgeon might pay a
trifllng fee. but when a rich polo player
had his broken finger attended by an emf.
Hent New York surgeon 1t cost him $1,000
The finger was worth that in polo play.
ing for that particular polo player. Again
there was a person of means who had al
appendix removed from the left side and
pdlu elo,VV TOT the JOD. ne Wd5 perhaps
thankful that the appendix was not or
some other side. Iaparotomy, which IL
a more unpleasant operation than 1t sounds
was executed on the wife Of a wealthy
Bostonian, and the grateful husband
guessed about right when he sent a check
for $4,000 to the surgeon.
Some bills are necessarily rendered TO
the estates of the deceased person. In
one such case SIS 900 was netted by a
physician for a weeks final services. A
week still better paid was that Of a
family physician who attended a patient
in a yacht from New York to a port I'm
one OF our southern states" The patient
died from tuberculosis as they arrived in
port and the doctor earned 10000. DR..
Adolf Lorenz. the Austrian surgeon, re-
ceived $1,000 for going to Chicago and
treating Lolita Armour.
The average yearly income of the 100000
medical practitioners In the United States is
said to be $3.50. II the exceptionally big fees
were excluded from the calculation. the
average remuneration would probably
amount to that OF the low-paid. clergy.
There is sometimes complaint OF col
fusion between family physicians and spe-
cialists. the former referring cases TO the
800 -