The Washington herald. [volume] (Washington, D.C.) 1906-1939, 1909-01-17
BILL FITS INCOME
Cures Come High When Pa
tient Is Wealthy Man.
OFFSETS CHARITY PRACTICE
Better Dodge Appendicitis IL You're
Rated at a MiIIiOn-New York Ply
Average Annual Pay of Practifion-
ers Is Less Than CIergymen.
How much do I owe YOU. doctor.'

How much do owe you. doctor2"
Really, my dear sir, I haven't had
time to investigate your income and look
Up your rating in Bradstreet's
Thunder. What's my income got 10
do with your bin for services? When 1
buy a thing I want 10 pay the market
price, which is ultimately based on the
cost Of production. You evidently want
to reverse the economic law and charge
all the traffic viii bear. like the big mon
Oplies. Why. man. that's unnatural; it's
Ike those Oriental shopkeepeTs,'
"Gentiy. my friend. You don't under
stand the ethics of the medical profess
sion We physicians, are not to be Glassed
with manufacturers or traders. Do they
ever give away anything A large part
Of our practice Is charity. Ours prices
justihably range from nothing up 20 sew
eral thousand dollars Our services are
humanitarian. ike those Of the clergy:
they are often priceless. and cannot be
balanced on a scale Of dollars and GEMS
says the New York Tribune.
That sounds sort Of reasonable. doc.
feel Ike apologizing- Only II must be
hard for you professionals to figure out
the details o. q bill. making II match with
the patients necktie and his diamonds.
and all that. Maybe the patients wear
ing q 'phOny' stone. or he's dressed way
beyond his means. or he's q rich man
dressed cheap. You must be Sherlock
Holmes to know the right price 10 charge
when you haven't time 10 investigate
and want cash on the spot"
1T is an art. admitted the physician
In the words Of an eminent surgeon
quoted in The North AmeHcan Review,
by DT. A c. Heffenger, The fixing Of a
fee correctly is a talent which IS either
born in a man. OF only learned after long
experience The physician should en-
deavor 10 ascertain the patients cir
cumStances. BE can thus be in a posi-
ton. knowing as he does the gravity OF
the operation or its triviality, 10 say
what the operation IS worth 10 the pa
tient The physician Is necessarily the
better judge. Of the two. Z"
That's a beautiful theory; III sure
read that article" said the patient. hast
fly scribbling a check Of sufficient pro-
portions 20 avert an inquiry az his bank.
Still, you can always argue on the other
side. and I know some men who'd rather
judge for themselves what an operation
was worth. to save their lives or other
wise. 4 man who isn't particular about
living wouldn't like to pay fancy price
An operation may seem elegant 10 the
painter, but thar doesn't take account Of
the customer.
Standard Charge Impossible.
No standard price for medical services
is possible. according 10 the argument Of
Dr. Hefenger. The fee evolves with the
evolution Of the pocketbook. It is claimed
that one-third OF New York City practice
IS charity. and much OF that Legitimate.
Those short-sightsd persons who object
to a sliding scale 90 not realize the nature
Of professional services. There vas
mother who objected to metropolitan
surgeons charge of s1en0 for removing
her sons appendix. and wanted 70 pay
only sS0. but the surgeon had witnesses
10 prove that the fiiial appendix was
worth the price. and he received the full
amount. The mother. perhaps with char
acteristic feminine lack OF logic, failed
10 see the connection between a fat hank
account and a plethoric appendix. and
that the removal Of one should naturally
result IN the reduction OF the other From
another point Of view, this appendix had
been distended with Rialt0 Holsters and
other costly foods. instead Of cornell beef
and cabbage. and II is worth something
70 restore the young man 70 an exalted
digestive career.
The possession OF great wealth carries
with IL heavy obligations, Il IS stated,
and these obligations are rightfully
cashed by the practitioner. Some wealthy
men don't have the instinct OF distribD-
ton, Ike college builders and library
givers. and these need announcement
Legal fees are no more invariable than
medical fees: they depend on the amount
Of money involved in a lawsuit, OF the
wealth Of the client and the jeopardy
OF his position.
American fees are not worse than Eng
bsh. A city specialist charges from s.
TO S2o for an Office visit, and asks about
$50 for half a days trip out Of town 4
day or two spent away from the Office
Is worth between 500 and S1.e09 There
was a railroad owner who hired an OBJ
stetricaI specialist 70 remain with his
daughter during a critical period. which
lasted for Two months. The service was
successfully performed and Il was well
WI III q AEE Va -a-lIls nCAiA- a. A4AE -alE
Of 500 a day and a bonus Of Sl,0oo.
Examples of Big Fees
An ordinary man with a fractured
finger going TO an ordinary surgeon might
pay a trifing fee, but when a rich polo
player had his broken finger attended by
an eminent New York surgeon II cost
him 1900. The finger vas worth that in
polo playing for that particular cJlo
player Again. there was a person Of
means. who had an appendix removed
from the left side and paid $500 for the
job. He was perhaps thankful that the
appendix was not on some other side.
LapaTotomy, which is a more unpleasant
operation than il sounds. was executed
on the wife Of a wealthy BOstOnian, and
the grateful husband guessed about right
when he sent a check for s1oo0O to the
surgeon.
Some bills are necessarily rendered TO
the estate OF the deceased person. In
one such case s25,000 was netted by ply
stefan for a weeks final services. A week
stin better paid was that Of a family
physician who attended a patient in
yacht from New York 70 a port in
one Of our Southern States The patent
died from tuberculosis as they arrived
in port and the doctor earned SS9.00O DR..
Adolf Lorenz. the Austrian surgeon, re-
eeived S75,0G3 for going TO Chicago and
treating Lolita Armour.
The average yearly income Of the two
hundred thousand medical practitioners
IN the United states is said 20 be $50 II
the exceptionally big fees were excluded
from the calculation. the average Temu-
neration would probably amount 70 that