This is often brought about by the shyster M.D. overreaching himself by diagnosing some simple affection as something very dangerous, in order to have the greater credit in curing it. But he at times overestimates the confidence of the family in his ability. They are ready to believe that the patient’s condition is critical, and in terror, wanting the help of everything that promises help, call in a doctor of some “new school” because neighbors told how he performed wonderful cures in their families. When the patient recovers speedily, as he would have done with no treatment of any kind, and just as the shyster M.D. thought he would, the glory and credit of curing a “bad case” of a “dangerous disease” go to the new system instead of redounding to the glory of Dr. Shyster, as he planned it would.
Is it any wonder true physicians sometimes get disgusted with their profession when they see a shyster come into the town where they have worked for years, patiently and conscientiously building up a legitimate practice that begins to promise a decent living, and by such quack methods as diagnosing cases of simple fever, such as might come from acute indigestion or too much play in children, as something dangerous, typhoid or “threatened typhoid,” or cases of congestion of the lungs as “lung fever,” and by “aborting” or “curing” these terrible diseases in short order and having his patients out in a few days, jumps into fame and (financial) success at a bound? Because the typhoid (real typhoid) patients of the honest doctor lingered for weeks and sometimes died, and because frequently he lost a case of real pneumonia, he made but a poor showing in comparison with the new doctor. “He’s just fresh from school, you know, from a post-graduate course in the East.” Or, “He’s been to the old country and knows something.” Just as if any physician, though he may have been out of school for many years, does not, or may not, know of all the curative agencies of demonstrated merit!
Would a medical journal fail to keep its readers posted concerning any new discovery in medicine, or helpful appliance that promises real good to the profession? Yet people speak of one doctor’s superior knowledge of the best treatment of a particular disease as if that doctor had access to some mysterious source of therapeutic knowledge unknown to other physicians. It is becoming less easy to work the “dangerous diagnosis” graft than formerly, for many people are learning that certain diseases must “run their course,” and that there are no medicines that have specific curative effects on them.
There is another graft now that is taking the place of the one just mentioned, to some extent at least. In the hands of a fellow with lots of nerve and little conscience it is the greatest of them all. This is the graft of the smart young fellow direct from a post-graduate course in the clinics of some great surgeon.
He comes to town with a great flourish of trumpets. Of course, he observes the ethics of the profession! The long accounts of his superior education and unusual experience with operative surgery are only legitimate items of news for the local papers. Certainly! It is only right that such an unusual doctor should have so much attention.
There is no “starving time” for him. No weary wait of years for patients to come. At one bound he leaps into fame and fortune by performing “big operations” right and left, when before his coming such cases were only occasionally found, and then taken to surgeons of known ability and experience. The reputable physician respects surgery, and would respect the bright young fellow fresh from contact with the latest approved methods who has nerve to undertake the responsibility of a dangerous operation when such an operation is really indicated. But when it comes to mutilating the human body by cutting away an appendix or an ovary because it is known that to remove them when neither they nor the victim are much diseased is a comparatively safe and very quick way to get a big reputation—that is the limit of quackery. And no wonder such a man is so cordially hated by his brethren. He not always hated because he mutilates humanity so much, as because his spectacular graft in surgery is sure to be taken as proof conclusive that he is superior in all other departments of therapeutics.
And it puzzles observing laymen sometimes to know why all the successful (?) operations are considered such desirable items of news, while the cases that are not flattering in their outcome pass unmentioned.
I find most complete corroboration of my contention in the president’s address, delivered before the Western Surgical and Gynecological Association at St. Louis, in 1907, by Charles W. Oviatt, M.D. This address was published in the Journal of the American Medical Association, and I herewith reprint it in part:
“The ambitious medical student does not usually get far into college work before he aspires to become a surgeon. He sees in the surgical clinics more definite and striking results than are discernible in other branches. Without being able to judge of his own relative fitness or whether he possesses the special aptitude so essential to success, he decides to become a surgeon. There will always be room for the young surgeon who, fitted by nature for the work, takes the time and opportunity to properly prepare himself. There is more good surgery being done to-day than ever before, and there are more good surgeons being educated to do the work. If, however, the surgeon of the future is to hold the high and honorable position our leaders have held in the past, there must be some standard of qualification established that shall protect the people against incompetency and dishonesty in surgeons.
“That there is much that passes under the name of surgery being done by ill-trained, incompetent men, will not be denied. What standard, then, should be established, and what requirement should be made before one should be permitted to do surgery? In his address as chairman of the Section on Surgery and Anatomy of the American Medical Association, at the Portland (1905) meeting, Dr. Maurice H. Richardson deals with this subject in such a forceful, clear-cut way, that I take the liberty to quote him at some length: