POPULAR

CHAPTER X.

ESTIMATES OF PHYSICIANS.

THERE is no class of men whose talents and attainments are so erroneously estimated by the public as are those of physicians. Some of the causes of this erroneous estimate have been brought to view in the chapters on the Uncertainty of Medicine, and on Good and Bad Practice. I propose in this chapter to treat of this subject more distinctly, to point out some other causes operating with those which I have already mentioned, to show the results of this false estimate of medical character and attainments, and to develope some plain principles, on which a correct estimate may for the most part be secured.

I presume it is sufficiently clear to the reader, from the views which I have before presented, that the community cannot judge with any degree of correctness directly, of the practice of physicians,—either of the truth of the principles on which it is based, or of its actual results.

How then shall the community judge of physicians? This question I will endeavor to answer.

The view which I gave, in the first chapter, of the uncertainty of medicine, I trust, made it obvious to the reader, that a thorough education is pre-eminently necessary to the

In endeavoring therequalifications of any

proper practice of the medical art. fore to form an estimate of the physician, let the evidence of his having obtained such an education be well considered.

But what is this evidence? Is it to be found in the bare fact that he has a diploma, obtained from some respectable medical institution? While a diploma is worth something as evidence, as there must be some improvement of the means of education, in order to pass the examination requisite to obtain it; yet it must necessarily be defective evidence. That the truth may be more fully ascertained, let the inquiry be made, how far the physician has improved the advantages he has had; for it must be remembered, that it is especially true of medicine, that a diligent and wise use of limited opportunities will impart more knowledge and skill, than can be acquired by a careless and unwise use of the most extensive advantages afforded by the profession.

I will allow that there are difficulties in the way of arriving at the truth in this inquiry, and the public are often most grossly deceived by the parade which is made by some physicians, in regard to the opportunities which they have enjoyed. Still, I apprehend, that the erroneous judgment of the public in regard to such cases, arises from a too ready confidence in mere pretensions, and that it can be avoided for the most part by a little more pains-taking in making the inquiry, and by applying tests of another character, to which I shall soon allude.

But education in the science of medicine is practically despised by quite a large portion of the community. Though this sentiment is not often distinctly avowed, yet it exists to a greater extent than is generally supposed. shows itself in an indifference to the true evidences of a

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physician's qualifications, and in a readiness to put the quack on a level with the thoroughly-educated physician, or even above him. These indications of the prevalence of this sentiment, are not confined to the ignorant; but they often appear among the well informed, and even the learned.

Sometimes this sentiment is boldly avowed in language like the following: I care little about the evidence of a physician's having had an education. The fact that he is successful in treating disease is worth vastly more than a piece of parchment. Many a man has risen to eminence in other professions by his own exertions, without any great amount of education; and why should not this be the case in the practice of medicine? There was Franklin, who rose by his own efforts to a post of honor and usefulness far above multitudes of his cotemporaries, who had a most finished education; and why should there not be Franklins in medicine, as well as in other departments of knowledge?"

The assertion, that success in curing disease is worth more than a piece of parchment, is strictly true. But the evidences, on which a correct estimate of success can be formed, are not ordinarily, as the reader has seen in the chapter on Good and Bad Practice, within the reach of the community; and the attempts which it makes to form an estimate from the defective evidence at its command, often result in the bestowment of the praise due to success upon those who are really unsuccessful.

As to the use which is made of so great a name as that of Franklin to justify a disregard of education in medicine, I remark, that those who hold such language forget three very plain truths. 1st. That self-education is, after all that can be said, education. It is education acquired in spite of difficulties, and without the aids which men usually have.

2d. That education thus obtained indicates the possession of uncommon power of mind. There are but few Franklins in any profession. It is not common for men to rise to eminence with the small means which he enjoyed, and in face of the difficulties which he encountered. 3d. That Franklin, and all those men who have thus risen to eminence, so far from despising education, made most diligent use of all the means of education which they could command, aspiring all the time to higher and higher advantages; and while they lamented the deficiencies of their own early training, they labored most assiduously to give to others the most extensive means of acquiring knowledge. Very different from this, I cannot avoid remarking in this connexion, is the spirit of those pretenders in medicine, who affect to despise education, and who claim that they have an innate skill, which education can neither impart nor improve.

I shall in another chapter maintain, that it is both the duty and the interest of the community, to demand that there shall be a respectable standard of education in the medical profession, and will therefore dismiss this topic for the present.

The second source of evidence, in regard to the qualifi cations of a physician, is to be found in the unbiassed opinion of his medical brethren. I allow that there are difficulties in the way of obtaining such an opinion. There is, on the one hand, the prejudice of rivalry, and, on the other, the partiality arising from mutual interest. Sometimes these influences extend beyond the individual and arrange medical men in small parties, or cliques; and these often render it exceedingly difficult to discover the standing which any physician has among his brethren, Yet it is true, that every physician has a general estimate

put upon him by the profession, and it is commonly a correct one. And this estimate can ordinarily be ascertained by any one, who makes due allowance for the influences to which I have alluded.

While this strictly professional reputation, which is awarded to every physician by his brethren, is commonly very nearly correspondent with his true merits, that which the public awards to him may be far otherwise. It is often the case, that, while a physician, of whom his brethren have an exalted opinion, meets with but little favor from the community; another, who is a very ordinary practitioner, and who is so considered by the profession at large, has an extensive practice, and a high popular reputation. Such a physician may be treated with much outward deference by his medical brethren, on account of the position in which the public favor has placed him; and this is often very erroneously considered as evidence, that he is held in great estimation by the members of the profession generally.

I pass now to the consideration of a means of estimating the qualifications of physicians, which is of a more practical character, and more certain in its results, than those which I have already mentioned. And yet it is one which has been very generally neglected, for reasons which I shall give in a future stage of my remarks.

There are certain mental qualities, which are essential to the possession of skill in the practice of medicine. Whoever is found to possess these qualities, you may be sure, will with proper education make a good physician. And if they are wanting in any one, no education, nor experience can supply the deficiency. He never can be truly skilful as a physician; and if such an one acquire a reputation for skill, which is no uncommon thing, all that