Doctors

In that extravagant world of which I dream, in which people will live in
delightful cottages and ground rents will serve instead of rates, and
everyone will have a chance of being happy--in that impossible world all
doctors will be members of one great organisation for the public health,
with all or most of their income guaranteed to them: I doubt if there
will be any private doctors at all.

Heaven forbid I should seem to write a word against doctors as they are.
Daily I marvel at the wonders the general practitioner achieves, having
regard to the difficulties of his position.

But I cannot hide from myself, and I do not intend to hide from anyone
else, my firm persuasion that the services the general practitioner is
able to render us are not one-tenth so effectual as they might be if,
instead of his being a private adventurer, he were a member of a sanely
organised public machine. Consider what his training and equipment are,
consider the peculiar difficulties of his work, and then consider for a
moment what better conditions might be invented, and perhaps you will
not think my estimate of one-tenth an excessive understatement in this
matter.

Nearly the whole of our medical profession and most of our apparatus for
teaching and training doctors subsist on strictly commercial lines by
earning fees. This chief source of revenue is eked out by the wanton
charity of old women, and conspicuous subscriptions by popularity
hunters, and a small but growing contribution (in the salaries of
medical officers of health and so forth) from the public funds. But the
fact remains that for the great mass of the medical profession there is
no living to be got except at a salary for hospital practice or by
earning fees in receiving or attending upon private cases.

So long as a doctor is learning or adding to knowledge, he earns
nothing, and the common, unintelligent man does not see why he should
earn anything. So that a doctor who has no religious passion for poverty
and self-devotion gets through the minimum of training and learning as
quickly and as cheaply as possible, and does all he can to fill up the
rest of his time in passing rapidly from case to case. The busier he
keeps, the less his leisure for thought and learning, the richer he
grows, and the more he is esteemed. His four or five years of hasty,
crowded study are supposed to give him a complete and final knowledge of
the treatment of every sort of disease, and he goes on year after year,
often without co-operation, working mechanically in the common incidents
of practice, births, cases of measles and whooping cough, and so forth,
and blundering more or less in whatever else turns up.

There are no public specialists to whom he can