Sharp practice? Yes. Dishonest? No. The patient has agreed to pay a fee of $1,000. He has paid $500 down and promised to pay the rest in sixty days. The doctor has merely induced him to put this promise on paper. If the maker of the note is responsible (and the doctor has assured himself of this in advance) the full $1,000 is secured then and there, less an ordinary discount fee on $500, as a note of this kind is easily negotiable. The doctor has taken the precaution to protect himself instead of depending entirely upon the honesty and good intention of his patient.
The latter has barely left the office before both check and note, properly endorsed, are on the way to the bank where the note is discounted and the proceeds, with the check, deposited to the credit of the physician.
It may be said that this sounds too easy and simple to be true. Perhaps it does to those who are not acquainted with the methods of the up-to-date “case taker.” But fees, and big fees, are being obtained in exactly this manner every day in every large city in the country.
The physician who has a well-established office practice does not, as a rule, resort to this method with his regular patrons at first. He charges what seems to be a large fee, $5 to $10 each time a patient calls, extends credit indiscriminately, and loses fully one-half of the money represented by his book charges. If he is wise he learns by experience, and caters to the patronage of strangers from whom he can get his fees in advance. He gradually gets too busy to receive those who want their fees charged. He has learned his lesson and is willing to profit by the example set by other doctors who, while not recognized as models in the line of ethics, know how to make the practice of medicine pay.
“How’s business, Doc?” asked a friend of a physician who has achieved considerable fame as an office specialist.
“Bully,” was the reply. “Did over $300 to-day.”
“Get it?”
“No, but it’s good.”
And the poor fool actually thought so until he failed to get any adequate returns from the many bills he sent out, or the numerous calls made by his hired collector. Now he is making money. Why? Because every caller, whether regular patient or stranger, who wants to consult that doctor professionally, must “ante” his $10 with the polite secretary in the reception room before he can get into the doctor’s office. Result, exodus of dead beats, and others whom there was no profit in seeing.
Prominent attorneys adopt this system. Why is it not just as ethical and fair for physicians to employ it? If a patient agrees to pay the fee asked by the physician there is no reason, moral or legal, why he should not do so. And yet, unless this fee is paid in advance, or well secured, the chances are about ten to one that the doctor will never get it.