A Doctor’s real inner feelings after attending Doctor’s meetings & their thoughts on finances & money. “I had my innings last night all right enough, and I’ve been divided between amusement and mortification ever since. I attended a meeting of a local Doctor’s group, and one Doctor read a paper on the subject of ”Successful Practice.”
He was a pleasant appearing chap with a thin, intellectual face. Well, sir, he hadn’t been going more than ten minutes when he hit on one of my raw spots, and from that time on he hit them on an average of once a minute.
I enjoyed his paper until he took up the financial side of practice. I knew in a minute that he didn’t know anything about a successful practice, and probably never would. He said that in estimating successful practice the money which is made should not be considered; that a practice might bring in large sums and not be successful, which, of course, is true; and that it might be successful in the highest degree and still not be highly remunerative, which, of course, Is not true.
He wouldn’t have put it so inelegantly, but it translated itself to my mind like this, “that if you’ve done a good grade of treatments and arrive at old age with no means of support and without physical ability to longer earn your living, you’ve been successful.” I noticed that very few were giving him any interested attention, the others seeming to pay him attention merely in a polite way. In fact, I don’t believe anybody else gave him half the attention I did, because I wanted to get up right then and there and tell him a few things I’m sure he didn’t know.
At the close of his address, the presiding officer rose and uttered a few neat words, which he probably didn’t mean at all, but which had been carefully prepared to make the essayist feel good. One or two Doctors criticised the paper In the usual way, by complimenting the author and then largely agreeing with him. I felt sure that one of them didn’t really approve of the paper, and didn’t wholly mean what he said In approval of it, but he did not have quite courage enough to come out and cross all the society traditions by saying the things he really believed. When the second critic sat down, the presiding officer threw the paper open for general discussion and here’s where I got into the game.
After waiting a minute or two to see that nobody else was ready to say anything on the subject, I got recognition from the chair and opened my remarks In a mild way by saying that the paper of the evening was lopsided, that It had left out some of the most Important elements of successful practice, which I should be pleased to call to the attention of the meeting, and that It advocated a wholly mistaken and wrong Idea about the financial side of practice.
Well, I hadn’t gotten any further than this, when every man In the room was sitting up and taking notice. I saw a smile go round, but that didn’t stop me any because I knew just what I wanted to tell them.
Then I told the society about another Doctor , of whom the essayist reminded me strongly. I told them about his excellent moral and religious character, his courteous manners, his excellent qualities as a parent and father. Perhaps I drew it pretty strong right In here, because I was working up to a contrast which I wanted to make as effective as possible. Then I went on with a description of his professional ability, his extensive knowledge, his unusual technical skill and his conscientiousness.
You know him well enough to know it would be pretty hard to exaggerate these things, because he certainly Is a wonder In these ways, but I stated them for all they were worth; this was the top of my grade and from here I started for my climax. I painted an accurate and detailed picture of his financial conditions. I told how entirely lacking he was in business-getting ability, how few were his patients, how much too low were his fees compared with what they should be, and how cramped was his own life and the lives of the members of his family.
I told how few were the family pleasures, as we estimate pleasure to-day, without travel, without vacation and without even the home luxuries. Then I related how he had been doing skilful surgery work for over twenty-five years, that he was now past his prime and that his practice could never be any bigger than it Is; but that it must grow less and less as he becomes physically Infirm.
I closed this part of the talk by asking them, “Is the Doctor successful who has conducted a highly skilful practice all these years, who has reaped from it almost no material benefits for himself or his family, that a clerk In a store could not provide, and who faces old age and physical Infirmities, with no savings and no assured Income?”
I didn’t give them a chance to answer this, because I wanted to answer the question for them myself; and I went on to show that there are two parts of medical practice, the professional side and the business side, and that practice Is not broadly successful which is not successful In both. I agreed heartily with the essayist that practice is not successful simply because it makes money, but I denied positively that a practice was successful which did not provide comfort in the present and plenty for old age.
I insisted that a Doctor who completed a normal period of practice without having provided for himself and his family in the future, unless some catastrophe made this impossible, was a failure, and that no professional etiquette or courtesy of speech could cover it up. Right here I happened to glance at the essayist of the evening, and saw that he was red in the face, and seemed to be covered with mortification. I decided right then that I had said too much, and with a closing word or two, sat down. When he rose to close the discussion he seemed to find it somewhat difficult to speak, but said he felt called upon to differ with the last speaker, because he believed that the finances of a practice had nothing whatever to do with Its success.
He believed that success was dependent absolutely upon the degree in which the Doctor was true to the best traditions of the profession and the care and skill with which he served his patients. Also that financial returns were so far secondary that they should not be considered. On the way home, I found out from my host, who had taken me to the meeting, what made the essayist red in the face. It seems that in describing another Doctor I had described that man to a “T.”
Of course I hadn’t meant anything of this sort; but there are so many of such Doctors in the profession that one is liable to run onto them anywhere. I wish I had some way of blazoning from one end of this country to the other the fact that the practice which is not financially successful is only half successful. I do not mean that merely making money is a sign that a practice is successful; not at all.
But I do mean to say that the practice which does not provide the Doctor and his dependents with comfort now and protection in their old age is a failure, no matter how skilful he or she may have been. The notion that a Doctor must live and die poor; that he should get along on a day laborer’s hire, or the wages of a clerk; that he Is not entitled to pleasures and even luxuries, and that he should not provide himself with plenty for the future, unless something beyond his power prevents.
Is all foolishness and is all dead wrong. I know these things are not so, because every once in a while I meet some Doctor who has waked up to the Importance of the business side of his practice and Is making himself independent, not by the exercise of unusual ability, but merely because he has used his financial common sense.
I’m sorry I hurt his feelings, but I know that it’s a good deal more pleasure to practice when you can see the bank balance Increasing annually. And I believe a Doctor who is making money has more heart for good work than one who is not.
“That’s my experience anyway.”
Mr Amir Khan is really wrong – it seems!!!!