David further told me that in Freeland the physician is not paid by the patient, but is a public official, as is also the apothecary. The study of medicine is nevertheless as free in the universities here as any other study, and no one is prevented from practising as a physician because he may not have undergone an examination or passed through a university. This is the inevitable consequence of the principles of the commonwealth. On the other hand, however, the commonwealth exercises the right of entrusting the care of health and sanitation to certain paid officials, as in every other kind of public service. These appointments are made, according to the public needs, by the head of the Education Department, who, like all other heads of departments, is responsible to his own representative board--or parliament of experts, as we may call it. It is the practice for the professors to propose the candidates, who, of course, undergo many severe examinations before they are proposed. Anyone who fails to get proposed _may_ practise medicine, but as the public knows that the most skilful are always chosen with the utmost conscientiousness conceivable, this liberty to practise is of no value. Anyone who thus fails to get proposed, and has neither the energy nor the patience to attempt to wipe off his disgrace at the next opportunity, simply hangs his medical vocation on a nail and turns to some other occupation. The elected physicians are not allowed to receive any payment whatever from their patients. At first their salary is moderate, scarcely more than the average earnings of a worker--that is, 1,800 hour-equivalents per annum; but it is increased gradually, as in the cases of the other officials, and the higher sanitary officials are taken from among the physicians. As the payments are controlled by the departmental parliament, and as this is elected by the persons who in one way or another are interested in this branch of the government, the best possible provision is made to prevent the physicians from assuming an unbecoming attitude towards their patients. No one is obliged to call in any one particular physician. The physicians live in different parts of each town, as conveniently distributed as possible; but everyone calls in the physician he likes best; and as physicians are naturally elected as far as possible upon the Representative Board for Sanitation--whose sittings, it may be remarked in passing, are generally very short--the number of votes which the representatives receive is the best evidence of their relative popularity. It goes without saying that foreign physicians also, if they are men of good repute and do not object, have the same right as the Freeland physicians to submit their qualifications to the proposing body of professors. It should be added that in the larger towns, besides the ordinary physicians and surgeons, specialists are also appointed for certain specific diseases.