Quacks and Grafters

by Anonymous

“In looking for an explanation for the existence of this evil, I think several factors must be taken into account, among them being certain changes in our social and economic conditions. This is an age of commercialism. We are known to the world as a nation of “dollar chasers,” where nearly everything that should contribute to right living is sacrificed to the Moloch of money. The mad rush for wealth which has characterized the business world, has in a way induced some medical men, whether rightfully or wrongfully, to adopt the same measures in self-protection. The patient or his friends too often insist on measuring the value of our services with a commercial yard-stick, the fee to be paid being the chief consideration. In this way the public must come in for its share of responsibility for existing conditions. So long as there are people who care so little who operates on them, just so long will there be cheap surgeons, cheap in every respect, to supply the demand. The demand for better physicians and surgeons must come in part from those who employ their services.

“Another source of the graft evil is the existence of low-grade, irregular and stock-company medical schools. In many of these schools the entrance requirements are not in evidence outside of their catalogues. With no standard of character or ethics, these schools turn out men who have gotten the little learning they possess in the very atmosphere of graft. The existence of these schools seems less excusable when we consider that our leading medical colleges rank with the best in the world and are ample for the needs of all who should enter the profession. Their constant aim is to still further elevate the standard and to admit as students only those who give unmistakable evidence of being morally and intellectually fit to become members of the profession.

“Enough men of character, however, are entering the field through these better schools to ensure the upholding of those lofty ideals that have characterized the profession in the past and which are essential to our continued progress. I think, therefore, that we may take a hopeful view of the future. The demand for better prepared physicians will eventually close many avenues that are now open to students, greatly to the benefit of all. With the curtailing of the number of students and a less fierce competition which this will bring, there will be less temptation, less necessity, if you will, on the part of general practitioners to ask for a division of fees. He will come to see that honest dealing on his part with the patient requiring special skill will in the long run be the best policy. He will make a just, open charge for the services he has rendered and not attempt to collect a surreptitious fee through a dishonest surgeon for services he has not rendered and could not render. Then, too, there will be less inducement and less opportunity for incompetent and conscienceless men to disgrace the art of surgery.

“The public mind is becoming especially active just at this time in combating graft in all forms, and is ready to aid in its destruction. The intelligent portion of the laity is becoming alive to the patent medicine evil. It is only a question of time when the people will demand that the secular papers which go into our homes shall not contain the vile, disgusting and suggestive quack advertisements that are found to-day. A campaign of reform is being instituted against dishonest politicians, financiers, railroad and insurance magnates, showing that their methods will be no longer tolerated. The moral standards set for professional men and men in public life are going to be higher in the future, and with the limelight of public opinion turned on the medical and surgical grafter, the evil will cease to exist. Hand in hand with this reform let us hope that there will come to be established a legal and moral standard of qualification for those who assume to do surgery.

“I feel sure that it is the wish of every member of this association to do everything possible to hasten the coming of this day and to aid in the uplifting of the art of surgery. Our individual effort in this direction must lie largely through the influence we exert over those who seek our advice before beginning the study of medicine, and over those who, having entered the work, are to follow in our immediate footsteps. To the young man who seeks our counsel as to the advisability of commencing the study of medicine, it is our duty to make a plain statement of what would be expected of him, of the cost in time and money, and an estimate of what he might reasonably expect as a reward for a life devoted to ceaseless study, toil and responsibility. If, from our knowledge of the character, attainments and qualifications of the young man we feel that at best he could make but a modicum of success in the work, we should endeavor to divert his ambition into some other channel.

“We should advise the ‘expectant surgeon’ in his preparation to follow as nearly as possible the line of study suggested by Richardson. Then I would add the advice of Senn, viz: ‘To do general practice for several years, return to laboratory work and surgical anatomy, attend the clinics of different operators, and never cease to be a physician. If this advice is followed there will be less unnecessary operating done in the future than has been the case in the past.’ The young man who enters special work without having had experience as a general practitioner, is seriously handicapped. In this age, when we have so frequently to deal with the so-called border-line cases, it is especially well never to cease being a physician.

“We would next have the young man assure himself that he is the possessor of a well-developed, healthy, working ‘surgical conscience.’ No matter how well qualified he may be, his enthusiasm in the earlier years of his work will lead him to do operations that he would refrain from in later life. This will be especially true of malignant disease. He knows that early and thorough radical measures alone hold out hope, and only by repeated unsuccessful efforts will he learn to temper his ambition by the judgment that comes of experience. Pirogoff, the noted surgeon, suffered from a malignant growth. Billroth refused to operate or advise operation. In writing to another surgeon friend he said: ‘I am not the bold operator whom you knew years ago in Zurich. Before deciding on the necessity of an operation, I always propose to myself this question: Would you permit such an operation as you intend performing on your patient to be done on yourself? Years and experience bring in their train a certain degree of hesitancy.’ This, coming from one who in his day was the most brilliant operator in the world, should be remembered by every surgeon, young and old.”

Oh, surgery! Modern aseptic surgery! In the hands of the skilled, conscientious surgeon how great are thy powers for good to suffering humanity! In the hands of shysters “what crimes are committed in thy name!”

With his own school full of shysters and incompetents, and grafters of “new schools” and “systems” to compete with on every hand, the conscientious physician seems to be “between the devil and the deep sea!”

With quacks to the right of him, quacks to the left of him, quacks in front of him, all volleying and thundering with their literature to prove that the old schools, and all schools other than theirs, are frauds, impostors and poisoners, about all that is left for the layman to do when sick is to take to the woods.