Dr. W. A. Evans, commissioner of health for the city of Chicago and for twenty years in touch with the medical profession, says that hundreds of physicians in Chicago are virtually without means to support their families. What a man situated like this often does do in the circumstances may work disaster even upon the general public. He may help put the records of the health department to the bad. Here is an example in point. “A young doctor is called into a family which lives in the rear of a man’s place of business, above the store or next door to it. The competent young physician discovers a patient suffering from diphtheria, scarlet fever, maybe smallpox. The law requires the posting of placards 210and the isolation of these victims of contagious diseases. But at once the family in such close connection with the place of business recognizes what such a placard may mean to the business by which the family of the patient lives. “Will you imagine the pressure that may be brought to bear on this physician whose own family is so dependent upon him? Isn’t it reasonable that with sufficient compensation offered him he is likely to cover up the infectious case? Or if the family has not thought of offering the inducement, the young doctor himself may propose it and ask the limit of compensation.” Educated, brainy physicians of high standing, are beginning to balk at some of the ethical commandments which bar the way to a doctor’s increasing his income. When Dr. Oscar A. King was asked what he thought about the division of fees, he said: “Why not? The physician who has diagnosed the trouble and finds that an operation is necessary may have paid only two or three visits to the patient at $2 or $3 a visit. The result is that, honestly, he must give his patient over to a surgeon. ‘What surgeon?’ is asked most frequently by the patient. Honestly the doctor names a man who has taken many cases from him and most successfully. But where the physician gets $8 or $10, the surgeon may get $150, $300, or $500. And—except for the physician—the surgeon never would have heard of the patient.” “It’s all fair enough if openly above board,” said Dr. Evans, in reply to the same question. “It would be a most logical thing in business, only that the public is not 211prepared to compare business with the professions of medicine and surgery. When it comes home that both doctor and surgeon must be assured of a living, however, the fact is a jar to the purely ethical.”