THE PROPOSED DOCTORS' UNION.
[To THE EDITOR Of TITS "SPECTATOR."] SIR,—Your admirable article in the Spectator of October 3rdl on the proposed Doctors' Union, in which you point out the difficulties, and in fact the dangers, surrounding such a scheme, requires a little supplementing from the "inside," if I may so put it. You say that "it is of vital importance that members of the medical profession should regard themselves. as something higher than mere honest salesmen,—that they should feel, in fact, that they are the holders of a sacred, trust ; " and again, that " it is essential to maintain the general idea that doctors have a duty towards the community." It is, I doubt not, very desirable that medical men should• recognise something of this nature, desirable not only from the point of view of the poorer patient, but also in order that the profession may continue to be regarded as a more or less- unselfish one ; but it is sometimes difficult for this desideratum to force itself home to the inner consciousness of the doctor. The difficulty magnifies itself at the quarter's end when his tradesmen's bills need to be paid, while his own bad debts would cause any tradesman to relinquish business as a poor speculation. It may be very conducive towards one's general health to fondly imagine oneself the holder of a " sacred trust," but there is little meaning in the euphemism ; the trust is one basing its existence on Act of Parliament ; the law of the land necessitates a very large outlay of time and money before a medical qualification is obtained. When- this preliminary has been accomplished, one discovers that the law of the country does not protect or even recognise the qualified doctor except by imposing on him one or two duties, such as compelling him to sign death-certificates without charge, to notify certain infectious diseases to avoid the penalty of a fine, and enforcing his attendance at police- courts or assizes at, what is frequently, a ridiculous remuner- ation. The chemist or the unqualified " doctor " is allowed„ so far as any legal interference is concerned, to practise medicine and surgery without these duties attaching to him. The State does not undertake the task of prosecuting the ; any actions have to be initiated by medical men themselves. They are therefore few, and frequently, on account of the ill-defined condition of the law, unsuccessful; if successful, the only penalty inflicted is a paltry fine, and the offending one may and generally does continue his ways just as openly as before. The unqualified man is- not supposed to sign death-certificates, but he does do soi and his certificates are frequently accepted. A registrar of deaths, even if he wished to refuse them, has no method of determining whether a man is possessed of a qualification or not, for the State does not provide him with a register of medical men; it would be too expensive ! No, Sir, if the medical profession has duties, the State has corresponding. obligations ; it should protect the medical qualification, or at least render the condition of the law such that the profession can protect itself. If society in a humanitarian mood desires. the nearest doctor to run at once to the scene of an accident, or to the bedside of a poor person urgently ill, the loss should not all be borne by that nearest doctor ; society itself should compensate him by giving him a claim to some- pecuniary remuneration from some public fund. In the midst of the keen competition for a livelihood the absolute one- sidedness of this so-called "sacred trust" is forcing itself upon the attention of even the most altruistic medical men, and since every other occupation, either professional or com- mercial, from the barrister down to the most nnskilledt labourer, protects itself by combination, it is perfectly certain
that medical men will learn a lesson from the example of those others who talk so placidly of the duties which doctors owe to the community.—I am, Sir, &c., E. H. S.
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