A more “pestiferous professional parasite,” if possible, than the foregoing, is the doctor who refers a patient from a distance, with a request to send the bill to him. Here again Dr. Lydston says: “I have sent many such bills first and last—accent on the ‘last’—but have never received a remittance, nor do I expect my reward in Heaven. In the first place, I am not so sure about getting there, and if I were, and knew that those doctor debtors were going to be there too, I—well, I’d ask for a change of venue. As for the patients who are accessories to such professional ‘hold-ups,’ a fellow wouldn’t want to chase around all over hades to collect his fees from them.” No less an authority than Dr. John P. Lord, president of the Western Surgical Association, in an address delivered before the association, said: “The practitioner,” he said, “will call a man of sufficient standing to enable him to name a fancy price as the consultant’s fee, which he collects, and then remits the consultant the minimum fee. The graft element is also going into medical politics and some county societies are controlled by it.” It will be noticed that Dr. Lord does not find fault 165so much with the division of fees, as with the unfair manner of division. His plaint appears to be, not that division in itself is wrong, but that the man who handles the money does not treat his professional brother fairly. There’s a lot of truth in this, but the objectionable practice is mostly confined to a class of short-sighted practitioners who don’t take the future into consideration. Another doctor, speaking on the same subject, said: “This is an age of commercialism in medicine and surgery. Graft rules the majority. There are a few old fogies, like myself, who don’t graft—but do you know why? Just because we’re too old to learn how. Oh, yes, we’d all do it if we had a chance, I presume. We’d be forced to. Those who do it claim that they have to. It may be the public’s fault, but it’s certainly hard on the public which has to do the paying and which doesn’t know whether it has stomach ache or appendicitis. “In ancient Rome the doctors used to graft successfully. They’d place a finger on the severed end of an artery and say to the patient: ‘Now, old fellow, just come across with the fee, right away, or the finger will be removed and you’ll bleed to death.’ “We are coming to that. We may not work it in the same way, but the idea will be the same. Even now they—or we—want money before operations, and will endeavor to learn something of a patient’s standing in the community before his check will be accepted. Wouldn’t a business man do the same thing? And if surgery is becoming a business, why isn’t it proper? 166It is proper—from that standpoint. But, oh, the pity of the passing of old ideals!