The Embalming of the Dead
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us, who either from want of time or of business capacity are only too prone to accept a plausible thing without searching inquiry into its real nature and future effects. 1 am not aware, however, that the fact of the National Deposit Friendly Society being an excellent organisation for the promotion of thrift amongst the laity demands our enthusiastic acclamation, especially if such increase of wealth is in part the result of our increased necessity; nor do I see why we. should give our ready aid to any association which however plausible its prospectus may be was certainly not established for the pecuniary benefit of the medical profession. One would almost imagine from the style of argument and language adopted by the supporters of the National Deposit Friendly Society, that the chief object of those responsible for its inception was the outcome of an overwhelming desire to increase the incomes of medical men and to reduce the annual amount of their bad debts. When, however, I see that by giving my aid to such a society I most certainly redue'e my income, I begin, to question the reality of this apparent solicitude on my behalf and to feel much more inclined to go on as I have been wont to do, even with the accompaniment of " bad debts." Let a medical man who charges the orthodox and ethically correct fee divest his mind of the first pleasing impression made upon it by the very plausible but misleading scale of fees issued by this Society. Let him, then, go carefully into the question of what would be the effect upon his income of the wholesale admittance into the Society of those of his patients who are tradesmen, skilled artisans, shop assistants, clerks, etc. Then if be be not able to prove that his income would be considerably reduced thereby the assistance of figures is less than I imagine it to be. It is the specious Visit and medicine for two days, 2S. 6d. which throws dust in the eyes of most men, and it is not till they contrast the remuneration they usually obtain for attendance upon, say, a case of pneumonia with that which they would receive at the Society's rate, that the real value of the scale is manifest. A man who is the habit of charging small fees may not lose by giving his aid to the Society; but a man who charges the minimum ethical fee most certainly will. I do not suppose however that members of the Society wish to have only the services of third-rate men. Apart from the question of adequacy of remuneration, t&iere is another aspect of this matter which requires consideration, namely, the desirability or otherwise of permitting the intervention between us and our patients of a third party. In some cases this intervention is unavoidable; but it may be laid down as a broad principle that the more we sanction and acquiesce in such a condition of things the more we shall suffer, especially if the third party happens to be the laity in combination either in the form of medical aid institutes, industrial assurance companies, or national deposit friendly societies, for the very rai8on d'etre of such bodies so far as we are concerned is the acquisition of medical services at as low a rate as possible. We have suffered enough already from the action of lay combination, and it is time we ourselves combined and offered to it a firm resistance. The spirit of altruism of which one correspondent speaks has its limits. I am perfectly aware of the altruistic work done by the profession in the past; but when I consider that the result of all our modesty and selfabnegation has been ever increasing exploitation by combinations of the laity, it appears to me that our altruism requires neutralising by the infusion of a little of the selfishness of commerce. The sooner we realise the fact that as well as being scientists we must also be men of business the better will it be for our ,temporal welfare. Had we been more commercial and less altruistic in the past, so many of us would not be to-day draining the cup of poverty and impotency.-I am. etc., J. RATCLIFF-GAYLARD, M.D., Hon. Secretary, Extension Committee, Medical Guild. Manchester, June 4th.