There are times when as explained in Chapter X, the full fee cannot be obtained in cash on the spot. When this occurs the only way out of the difficulty is to get the patient to sign a note. But never, when it can be avoided, allow the note to be made payable to yourself. Draw it to the order of the patient and have him endorse it. Also make it payable at a bank, the name of which is specified. This makes it negotiable and, if the financial standing of the maker is satisfactory, it will be readily discounted wherever he is known. It is comparatively easy for the maker of a note payable to the order of a second party to evade payment, or at least greatly delay it, on the plea of “no value received.” It becomes doubly so in cases where the note is drawn in favor of a physician, or the maker lives in another state. When this occurs, and it cannot be shown that the paper has passed into the possession of an innocent holder for a bona fide consideration in the 172ordinary course of business, there will be trouble in collecting on it should the maker repudiate the obligation. In such event collection, if made at all, must be enforced through the medium of a law suit. This necessitates service on the maker. If he can be found within the limits of the state in which the note was signed he can be sued there, but, as a general thing, this is a forlorn hope. As a general thing it necessitates a court action in the state where the maker resides, and this means a hearing before a jury of his own neighbors. In such cases a non-resident claimant has small chance of winning, no matter how just his claim may be. And this chance is still further reduced if he is a physician. Residents of other states do not look with favor upon non-resident doctors. Not only this, but as a general thing they think it their duty to assist a neighbor in evading payment of an obligation to a doctor who is not one of them. Notes drawn in the manner described—made payable to the order of the signer and endorsed by him—are not so easily repudiated. In short the burden of proof, should a contest be made, is not on the holder but on the maker. When such a note passes into the possession of a third party the only question about collection is as to the financial worth of the signer. Under this latter condition notes of this kind are iron-clad. When suit is brought on a note made to the order of a physician, and the plea raised of “no value received,” the holder must prove that full value was given and this is not always easy to do in cases of medical treatment. The patient may have been absolutely cured but, if he 173chooses to perjure himself and deny it who is going to prove the contrary? It will be invariably held that no one is so competent to judge of improvement, or lack of improvement, as the patient himself.