Femina, A Work for Every Woman

by John A. Miller

Such a method would establish a system that would clearly define the status of every medical practitioner. The board must have the power, and it must be their duty, to examine each and every applicant for a license, as all candidates for the army medical service are examined. All this noise and talk about a preliminary examination and an extended course of medical study are simply the vaporings of superficial minds. It is neither the preliminary course, nor the length of time that a person consumes in trying to become a doctor, in which the public is interested, but what kind of doctor a person is when he hangs out his shingle and begins to practice, whether he is competent to do that which is expected from him in the hour of sickness or great peril, irrespective of any diploma or any medical college. Foreign graduates should be amenable to the same examination, for behind these, too, belongs the interrogation point. The gushing mediocrity of some of these diploma holders gives rise to the suspicion that their credentials are not genuine.

As an American to the manor born, I would not for a moment deny the humblest citizen an opportunity to elevate himself to the highest professional honors; but why can he not be required to thoroughly equip himself and prove, by oral and written examinations on subjects of preliminary education, that his mind has become disciplined for broader or special studies, irrespective of any course in a college? After the State has satisfied itself of the proficiency of the applicant in scholastic acquirements, it should go further, and examine into the qualifications for a degree of medicine, just as they do in the U. S. Army, only with this exception, that no diploma of any medical college should be required from the candidate, and if he has one it should not be recognized.

This would simply incorporate in the State laws the distinctive feature of the University of London, which examines and confers graduation on persons who have received instruction in such institutions at home and in the colonies as have satisfied a Secretary of State with regard to their studies.

This university also has and exercises a power of examining for degrees persons who have not been at any institution. Nothing could be more democratic than for the State to make such a provision for State medical examinations. The German Government does precisely the same thing, with the exception that it makes graduation from the medical department an essential prerequisite. It has a State board of examiners to examine all graduates in medicine of their own universities, to further prove if they are really qualified. A diploma in Germany is of no value; it is the so-called ærzliche Approbationspruefung, State’s examination, that gives the license to practice legally.

When this is found necessary, notwithstanding the high standard of German medical schools, how much more is this safeguard against incompetency needed with us? I have endeavored to prove from the methods of Germany and the course of the United States medical department that diplomas cannot be accepted as bona-fide evidence of a medical education. With us a half dozen doctors can get together any time, incorporate a medical college, call themselves professors, and start out advertising themselves and their college for the purpose of manufacturing diplomas and doctors. Why, a diploma under these conditions should not be worth the parchment it is written on, as evidence of a medical education, unless attested by a higher and perfectly independent authority!

If the public once understood that too many doctors are dangerous to the morals and health of society, they would be quite as anxious as the most enthusiastic medical educator to remedy the evil.

The question of too many doctors is one of economical and social science, not of medical science, and, therefore, it can only be intelligently considered from these philosophical standpoints. It is a well-understood and accepted law of political economy that in the industrial pursuits, whether in the manufacturing departments or in agricultural production, the surplus or glut in the market of any of the products of industry, reduces the price and stimulates consumption, which, in the course of time, is regulated by a suspended or reduced production, thus restoring a healthy equilibrium. It would be an absurdity to apply the same rule to a surplus of doctors, because human ills or diseases do not increase in proportion to the surplus of doctors, nor will fees be any less. But the surplus, in order to live, must live on the earnings of the community, and here the disastrous consequences appear.

The credulous, and those who often may imagine that they require medical advice, become the unconscious victims of the unhealthy disproportion, for the doctor seizes the opportunity to make a case, while the normal proportion of cases do not reach around. Thus, it is calculated that at least fifty per cent. of all the diseases for which patients are treated are fictitious as far as actual disease is concerned, and the remaining fifty per cent. are, in the majority of instances, overdosed and overdoctored. For this reason medical legislation would not make a privileged class of physicians, nor throw unusual safeguards around medical practitioners, but medical legislation is to protect the people themselves from imposition and quackery.

The reason for the overcrowded state of the profession is not alone the laxity of medical laws, or the low standard of medical education in most of our colleges, but the general tendency of the country population to drift into the cities. Honest labor has not the dignity which its importance demands, and a radically faulty method of common-school education is another reason. Utilitarian manual methods, in which the hands are educated for useful employment and the minds to habits of industry, are to be wished for. Young men who have acquired a technical education in mechanics and arts will learn to respect labor in every department, and their ambition in life will be greater than to swing a cane or wear a silk tile.

In proportion as the productive employments are made respectable, this questionable ambition to become M. D.’s will fall off.