6o6 THE POPULAR SCIENCE MONTHLY 



their incomes. Further, the greater their success in the prevention of 

 disease the less the labor that would be required in the cure of it. 



Under the present system much dissatisfaction exists over the 

 charges made by physicians. The poor patient will get together $200 

 or $300 for an operation or will be treated by novices free of charge, 

 while the rich man will pay $1,000 for the same service. The physician 

 is bound by the ethics of his profession to heed the call of every indi- 

 vidual without any preliminary inquiries as to ability to pay, and must 

 give both prescriptions and medicine to many without hope of reward. 

 He must depend for his livelihood upon the honesty and liberality of 

 those who are able to pay for his services. It also places the burden of 

 caring for the sick poor upon the sick well-to-do, because the physician 

 must make his charges according to the net income desired. The 

 system further tends to develop a class in the community that is looked 

 upon as a pauper group requiring care according to special methods. 

 Out of this condition has risen the system of free dispensaries to which 

 physicians volunteer their services, and to which the poor may go for 

 treatment. The physician prefers to volunteer his services to an insti- 

 tution of this kind rather than have the poor come to his office to inter- 

 fere with his private practise. Their presence in the office is desired 

 about as much as is the presence of the colored person in the office 

 among white patients. The poor are made to feel the disgrace of their 

 poverty and the well-to-do who frequent the dispensaries are induced to 

 falsify as to their real ability to pay. 



The present system is unfair to both the physician and the public. 

 The young practitioner, eager to gain experience, is perhaps rewarded 

 for the voluntary service rendered, but the experienced physician who 

 must devote a certain portion of his time to unremunerative practise is 

 unjustly treated. In certain cases he may derive benefit from the 

 voluntary service in that it may bring him into touch with diseases not 

 usually met with in regular practise. But the general dissatisfaction 

 with the growth of free dispensaries, hospitals, etc., is proof that the 

 medical profession is opposed to both an excessive volunteer service and 

 to a diminished practise. On the other hand, it is unfair to the public 

 because it places upon the poor the stigma of asking for assistance for 

 relief from illness for which he is perhaps not responsible. Prevailing 

 materialistic standards permit the erection of buildings that pure air 

 and bright sunlight never penetrate and that in time become veritable 

 breeding grounds of disease. The poor man, because he is too poor to 

 afford anything better, is forced to live in these dens with every chance 

 that both he and his family will contract serious illness. He goes to the 

 free dispensary and is liable to have his home pried into by some charity 

 visitor or to become known as the recipient of alms. The individual 

 receives the burden that a neglectful society has placed upon him and is 



