The Doctor's Dilemma: Preface on DoctorsShaw, Bernard
Philosophy
The Doctor's Dilemma: Preface on Doctors
Shaw, Bernard
Physicians
advance becomes often a necessary measure of self-defence, whilst the
County Court has long ago put an end to the tradition that the doctor's
fee is an honorarium. Even the most eminent physicians, as such
biographies as those of Paget show, are sometimes miserably, inhumanly
poor until they are past their prime. In short, the doctor needs our
help for the moment much more than we often need his. The ridicule of
Moliere, the death of a well-informed and clever writer like the late
Harold Frederic in the hands of Christian Scientists (a sort of sealing
with his blood of the contemptuous disbelief in and dislike of doctors
he had bitterly expressed in his books), the scathing and quite
justifiable exposure of medical practice in the novel by Mr. Maarten
Maartens entitled The New Religion: all these trouble the doctor very
little, and are in any case well set off by the popularity of Sir Luke
Fildes' famous picture, and by the verdicts in which juries from time to
time express their conviction that the doctor can do no wrong. The
real woes of the doctor are the shabby coat, the wolf at the door,
the tyranny of ignorant patients, the work-day of 24 hours, and the
uselessness of honestly prescribing what most of the patients really
need: that is, not medicine, but money.
THE PUBLIC DOCTOR
What then is to be done?
Fortunately we have not to begin absolutely from the beginning: we
already have, in the Medical Officer of Health, a sort of doctor who is
free from the worst hardships, and consequently from the worst vices,
of the private practitioner. His position depends, not on the number
of people who are ill, and whom he can keep ill, but on the number of
people who are well. He is judged, as all doctors and treatments should
be judged, by the vital statistics of his district. When the death rate
goes up his credit goes down. As every increase in his salary depends on
the issue of a public debate as to the health of the constituency under
his charge, he has every inducement to strive towards the ideal of a
clean bill of health. He has a safe, dignified, responsible, independent
position based wholly on the public health; whereas the private
practitioner has a precarious, shabby-genteel, irresponsible, servile
position, based wholly on the prevalence of illness.
Public-domain text, read in full here on John Shaqi.
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