The Medical Profession
( Originally Published Early 1900's )
One of the most useful and respected members of society is the doctor. This has at all times been the case; in ancient times "wise men," skilled in the knowledge of healing plants, were often the leaders and controllers of their people. In the case of the American Indians, the "medicine man" was usually the most feared and respected man in the tribe, for his relatively small knowledge of healing seemed to his fellow tribesmen a divine attribute and, in addition to being a doctor, he was a sort of priest—an intermediary between the tribe and the spirits which were thought to control it; he was considered a prophet and an interpreter of the divine will.
Nowadays the physician is looked upon principally as a man of science, trained in the prevention and cure of disease; but the old idea of the doctor as something more than a healer of physical ills alone still persists. Many people confide in their physician as they would in no one else. To him they bring their spiritual as well as their physical ailments, and the doctor, especially the old type of "family doctor," is often as much a general adviser and counselor as a physician.
The profession of medicine is a very noble one. The medical man goes through life caring for others, and much of the progress towards physical safety and health which the world has made is due to his efforts. Not only does he, by research work, discover the causes and cures of ills, and then apply this knowledge, but he is also a very potent factor in reform of all kinds. The betterment of sanitary conditions in tenements, factories, prisons and public buildings is largely his work. He has had, and still has, a great share in the establishment and proper administration of hospitals and public dispensaries and clinics, and in devising better methods of caring for the dependent and in any way defective classes.
The medical profession offers a very wide field of service. Most people when they think of the physician, think of him as a general practitioner. The ordinary "regular," or "allopathic," physician is usually a general practitioner. His practice is generally a private one, and he attends to cases of all kinds, advising and prescribing for patients, and performing minor operations. The general practitioner of the "regular" school treats his patients according to established precedents. He applies such treatment as his own experience and the experience of other physicians tell him has been effective in similar cases. After a careful physical diagnosis, he prescribes such medicines as are known to have had desirable results in similar cases.
The homeopathic physician believes in helping nature in its disease-fighting efforts by the administering of very small doses of medicine. He does not sanction the deadening of pain by opiates but, considering pain as a warning of something wrong in the body, advocates the removal of its cause. Homeopathic physicians have as much opportunity in private practice as "regular" physicians, for people are becoming more and more used to the doctor who "doesn't give so much medicine." But their chances of being appointed to positions in the public health service are slight. Most of the doctors who constitute the examining boards of the various branches of public health service are of the "regular" school, and look with some disfavor upon the homeopathist.
The osteopathist believes that every illness is brought about by some mechanical cause, such as pressure of bones upon nerves, resulting in a perversion of nerve functions. His remedies are, therefore, usually mechanical ones—massage, the application of braces and other means of removing the offending pressure.
Chiropractic is one of the newest forms of healing. The chiropractor also believes that most illness is caused by some structural abnormality, and he traces this back to pressure upon the nervous system at the spine. His treatment consists in manipulating or "adjusting" such vertebrae as he believes are out of alignment. Chiropractic is not officially recognized in all of the states.
The surgeon is a doctor who specializes in performing operations. Most general practitioners perform minor operations, but in serious cases the usual procedure is for the attending physician to call in a surgeon, who advises either for or against an operation and, if necessary, performs it. The surgeon is generally a specialist along one certain line limiting himself to operations of a definite type. Specialism is a field of great appeal to many, because it limits the types of cases which the physician must handle, and always brings larger financial returns than general practice. The specialist is an expert in some one branch-he may be a nose, ear and throat specialist, a gynecologist or an orthopedist. To be a specialist along any one medical line requires years of study and training in addition to extensive experience of a general nature. The specialist requires a large amount of tact in addition to a large amount of knowledge; often his opinion will differ from that of the doctor who called him into consultation, and he must, without destroying the other man's self confidence, firmly present his views.
There are numerous opportunities for the physician in public service as well as in private practice. First of all, there is service for the national, state and municipal governments. The army and navy need doctors, the public health departments, public hospitals, charitable institutions, departments of foods and drugs all require the services of medical men. Then there are openings in large corporations in insurance companies, railroads and industrial and fraternal organizations of all kinds. For the man of studious and experimental nature there is the wide field of medical research. Splendid work is steadily being done along the lines of discovering new methods of preventing and treating disease, by scientific research workers who devote themselves to this field of endeavor.
To be a physician is by no means easy work, and the boy who wishes to become one had best make sure that he will have certain necessary qualifications. The physician must, first of all, have a strong physical constitution. During all the years of preparation for actual practice he will have no regular hours of work and will be subjected to the dangers of infectious and contagious diseases. He will therefore need a robust body, and a certain amount of courage also, to face diseases of all kinds so closely as it will be his daily lot to do.
The prospective doctor must also have a studious nature—the power of intellectual application and concentration. As a student, he will have much to learn and, as a practicing physician, the same will hold true. He must keep abreast of all the medical literature which is published, so as not to fall behind in his knowledge of diseases and their cure. To do this, he must be capable of using the little leisure time he has to the best advantage. The physician must be observant, for this will help him in his diagnosis; he must be resourceful, quick and confident, so that he may not be found lacking in an emergency. He must be diplomatic and tactful, in order to deal successfully with all the various types of people he will have to meet; and, if he has some social experience, it will also be very helpful to him, in his relations with his patients. Above all, he must be honest and morally courageous, so that he will not succumb to the temptations towards unscrupulous acts with which he will occasionally meet, and so that he will inspire in his patients the respect and confidence towards himself which are so necessary in the practice of his profession.
The training of the physician must be a very thorough one. Most of the best medical schools require that entering students shall have had at least two years of college work before beginning their medical studies. The premedical college course should include such subjects as chemistry, physics, biology, English, one or more modern languages, zoology, psychology and mathematics. When the student has completed his studies in the medical school, he is ready to take a state examination, which, if passed, entitles him to a license to practice medicine. It is excellent training for the young doctor to enter a hospital as an interne for a year or two, for thus he will receive an amount of varied experience which will be invaluable to him.
The American Medical Association, Chicago, annually publishes the "American Medical Directory," in which may be found complete classified lists of the medical schools of the country.
The cost of a medical education is rather large—tuition fees, laboratory fees, the additional cost of at least two years of college work make the minimum cost about $3,000 in most cases. It is considered best for the student not to attempt to work while the school is in session, but during the summer vacation he may find employment in various sanatoriums and hospitals, and thus be enabled partially to earn the cost of his education.
When the young physician is ready to open his own office, he will become aware of one of the disadvantages of his profession—its overcrowded state. There are, in many communities, more doctors than are needed, but the young man who looks carefully about him and chooses a neighborhood where competition with other physicians will not be so keen will have a better chance of building a good practice. Another disadvantage of the medical profession is the fact that a physician can have no regular hours of work, but must at all times be ready to respond to a call upon his services. And, further-more, there is nothing to guarantee him a good or steady income, unless he is employed by a corporation or in a government position, at a fixed salary. Few doctors become rich. Great specialists, of course, receive large fees, but the average practitioner in the city usually does not have an income of more than from $3,000 to $5,000 a year. In the country he may make even less, but living expenses there are lower.
Hard work, the competition of quacks as well as capable doctors, and inadequate compensation will, however, not hinder the man who is a true physician from doing his duty well, nor will they discourage him; for the true doctor loves his work and is happy in the thought of the service he is rendering mankind.
CABOT, RICHARD CLARKE : "Training and Rewards of the Physician," J. B. Lippincott Co., Philadelphia and London, 1918.
COLWELL, NATHAN PORTER: "Medical Education, 1916-18, U. S. Bureau of Education Bulletin No. 46, 1918, Government Printing Office, Washington, D. C., 1919.
EMMONS, ARTHUR B., (Ed.) : "The Profession of Medicine: A Collection of Letters from Graduates of the Harvard Medical School," Harvard University Press, Cambridge, Mass.
OSLER, WILLIAM : "The Principles and Practice of Medicine," D. Appleton & Co., New York and London, 1920.
WEAVER, DANIEL WITTWER: "Medicine as a Profession," The A. S. Barnes Co., New York and Chicago, 1917.
American Medical Directory, American Medical Association, Chicago. American Journal of the Medical Sciences, Lea and Febinger, Philadelphia, Pa.
California State Journal of Medicine, Medical Society of the State of California, San Francisco, Cal.
Journal of the American Medical Association, American Medical Association, Chicago.
Medical World, E. S. Taylor, Philadelphia.
New York State Journal of Medicine, Medical Society of the State of New York, New York.