Femina, A Work for Every Woman

by John A. Miller

“Germany, which has relatively less than half as many doctors as America, is already groaning over its surplus. When one compares France with this country, the excess of medical men here seems most astonishing.

“A comparison of the United States with European countries, in whatever way it is made, leads one to think that there is something almost alarming in our medical productiveness.”

In connection with the above comparison, in which it is shown that Germany has proportionately less than half as many doctors as the United States, it will be interesting to learn the views of the German profession. The Berlin correspondent of the Medical Press writes that the “Deutcher Ærztebund,” Society of German physicians, felt it to be their duty to warn the guardians of young men studying in the gymnasiums or high schools, against entering the medical profession, the state of overcrowding being so great as to insure disastrous consequences. In glancing over the above figures, there is one very important point which is greatly in favor of the German profession and militates against the Americans. It is the enormous patent-medicine trade and quacking that is done through it in the United States; on the whole, this has been calculated to amount to at least fifty per cent of all the doctoring that is done; that means, that where one hundred doctors now practice for a living, fifty more could make a similar living, were it not for the patent and quack medicine trade, which, in some of the German States, is almost prohibited, and in others I know it is entirely inhibited.

When the Society of German physicians warns the German people that an overcrowding “insures disastrous consequences,” what does it mean?

This is a question which, we presume, was answered in Germany, and it is certainly worth our while that we should answer it here, and in this we have decidedly the advantage, because in that country the answer was entirely based upon what was anticipated, while in this we can answer from what we have already realized, namely, disastrous consequences to honor and to integrity on the one side, and to health and security against imposition on the other. To this I have already referred. Everyone competent of judging, and who has lived in that country, knows from study and observation that the arrangements and conveniences there for treating the sick are in a much higher state of perfection than with us. Hospitals and physicians are as accessible to all classes as the most humane and philanthropic heart can desire, and now we learn that if this wholesome state of affairs shall continue with less than half the proportion of doctors that we have here, there must be no further increase of physicians, or it would insure disaster. This statement and warning a close and careful observer clearly appreciates. The writer was personally acquainted with a large number of German practitioners while in that country, and knows as an actual fact that while their fees were and are much smaller than anything ever paid in this country, they had not overmuch to do, and were only leisurely employed. This applies to some of the greatest and world-renowned medical professors, as well as to the ordinary general practitioners. But there is a reason for all this, too. These men as a rule are honest, they are no money grabbers, they are thoroughly competent and scientific and manufacture no diseases to suit emergencies nor conjure up complaints that have no real existence. If their number were doubled, if the normal proportion were disturbed, the disaster would surely follow, professional demoralization would ensue. So the German profession sounds a timely note of warning ere the canker of selfishness has destroyed the noble altruistic principles of physicians, without which the doctor is as likely to be a messenger from hell as a ministering servant from heaven.

Medical legislation in this country has been nothing less than a farce, partly because the general public is not aware how abased the profession is, and partly that Americans are extremely jealous of what they term personal liberty. It is being attempted to remedy some of the abuses of the medical profession by regulating the practice of medicine by State Examining Boards. Experience has demonstrated that these boards are but the excrescences of the various medical colleges, who are themselves the root of the very evils that are sought to be remedied. The duties of these boards are simply to make themselves officious, and to inquire into the source of the credentials or diplomas of the applicants for a license to practice medicine, and not into the qualifications or competency of the applicants. All that is necessary under such laws is simply to present a diploma of some sort; whether it was stolen, or the diploma of a dead man, or gotten from any of the numerous worthless colleges, is not made the subject of inquiry; and as by far the greatest number of quack-salvers in this country have diplomas, the law falls short of remedying quackery.

There are, usually, enough boards of examiners, representing the different schools, so that the different interests of the diploma manufacturers are well represented. A medical examining authority whose functions and powers do not go higher or beyond the mere granting of licenses, or which does not examine into the qualifications of the persons who possess diplomas, is utterly absurd, because it is no protection against ignorance and imposition. A law that presumes that all persons holding diplomas are qualified and competent to practice medicine, is essentially wrong, or inadequate to fulfill the purpose for which it was designed. I have known graduates from what were considered good colleges who could neither write a safe prescription nor diagnose a case.

There is only one way towards an approach to an efficient and intelligent board of medical examiners, and that is, one single State board in which the different schools may be represented as to their pet theories of prescribing medicines, but in all other departments of medical science and art there must be a uniformity of talent and qualification.

There must be a standard of excellence established by the State, which is higher than and above the recognized standard of any medical college, for no medical college is trustworthy in this respect.

The State in its sovereignty must prescribe what shall constitute a medical education, and the requirements should be embodied in the statutes. A license or degree from that source, after a final examination, should be the only legitimate license to practice medicine.