The Doctor's Dilemma: Preface on DoctorsShaw, Bernard
Philosophy
The Doctor's Dilemma: Preface on Doctors
Shaw, Bernard
Physicians
A review of the counts in the indictment I have brought against private
medical practice will show that they arise out of the doctor's position
as a competitive private tradesman: that is, out of his poverty and
dependence. And it should be borne in mind that doctors are expected
to treat other people specially well whilst themselves submitting
to specially inconsiderate treatment. The butcher and baker are not
expected to feed the hungry unless the hungry can pay; but a doctor who
allows a fellow-creature to suffer or perish without aid is regarded as
a monster. Even if we must dismiss hospital service as really venal,
the fact remains that most doctors do a good deal of gratuitous work
in private practice all through their careers. And in his paid work the
doctor is on a different footing to the tradesman. Although the articles
he sells, advice and treatment, are the same for all classes, his fees
have to be graduated like the income tax. The successful fashionable
doctor may weed his poorer patients out from time to time, and finally
use the College of Physicians to place it out of his own power to accept
low fees; but the ordinary general practitioner never makes out his
bills without considering the taxable capacity of his patients.
Then there is the disregard of his own health and comfort which results
from the fact that he is, by the nature of his work, an emergency man.
We are polite and considerate to the doctor when there is nothing the
matter, and we meet him as a friend or entertain him as a guest; but
when the baby is suffering from croup, or its mother has a temperature
of 104 degrees, or its grandfather has broken his leg, nobody thinks
of the doctor except as a healer and saviour. He may be hungry,
weary, sleepy, run down by several successive nights disturbed by that
instrument of torture, the night bell; but who ever thinks of this
in the face of sudden sickness or accident? We think no more of the
condition of a doctor attending a case than of the condition of
a fireman at a fire. In other occupations night-work is specially
recognized and provided for. The worker sleeps all day; has his
breakfast in the evening; his lunch or dinner at midnight; his dinner or
supper before going to bed in the morning; and he changes to day-work
if he cannot stand night-work. But a doctor is expected to work day and
night. In practices which consist largely of workmen's clubs, and in
which the patients are therefore taken on wholesale terms and very
numerous, the unfortunate assistant, or the principal if he has no
assistant, often does not undress, knowing that he will be called up
before he has snatched an hour's sleep. To the strain of such inhuman
conditions must be added the constant risk of infection. One wonders
why the impatient doctors do not become savage and unmanageable, and the
patient ones imbecile. Perhaps they do, to some extent. And the pay is
wretched, and so uncertain that refusal to attend without payment in
Public-domain text, read in full here on John Shaqi.
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