clubs, and in which the patients are therefore taken on wholesale terms and very numerous, the unfortunate assistant, or the principal if he has no assistant, often does not undress, knowing that he will be called up before he has snatched an hour’s sleep.  To the strain of such inhuman conditions must be added the constant risk of infection.  One wonders why the impatient doctors do not become savage and unmanageable, and the patient ones imbecile.  Perhaps they do, to some extent.  And the pay is wretched, and so uncertain that refusal to attend without payment in 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.