Page:Popular Science Monthly Volume 84.djvu/610

606 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 individual 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 institution of this kind rather than have the poor come to his office to interfere 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