DOCTORS' POSITION.

Auckland Star, Volume LXV, Issue 68, 21 March 1934, Page 11

DOCTORS' POSITION.

SERVICE FOR NOTHING

NEW ZEALAND CONDITIONS.

CHKISTCHtTRCH DOCTOR'S VIEWS. Dr. T. A. Mac Gibbon, of Christchurch. writes as follows to tho Christchurch "Press": — Two days ago you had an interview with one of my medical colleagues about tlio medical profession. In this interview it was stated, in reference to the increased number of medical students at the University of Otago, that there was a shortage of medical men in New Zealand, and that during prosperous times there were more medical entrants than in hard times. I regret having to differ from both of these opinions. Instead of there being a shortage of medical men in New Zealand there are probably 33 1-3 per cent too many. The only shortage is to be found among the house surgeons in the State hospitals, and the reasons for this shortage lie solely in the hospital policy of the Dominion. Probably 80 per cent of the surgical | work of the country is done in the State hospitals and by the medical profession, without any remuneration whatever. It is called an honorary system. The house surgeons take the place of students in other large hospitals of tho Old World, in that they take notes, do dressings, and in other ways understudy the honorary medical men of the hospital. They also perform the duties of the house surgeons and house physicians of these other hospitals; but in the Old Land tho so-called voluntary hospitals do not admit to their wards the same number of patients in proportion to the population that New Zealand does to its State hospitals. That means that there is little remunerative work left for the average man who practises surgery outside these hospitals. There are, of course, a few well-favoured men who can make a good living in private even to-day. But there has, during the last 25 years, been an increasing tendency on the part of New Zealanders to seek their medical treatment in the State hospitals, where they get their attention gratis.

Anxieties of Practice. 1 Practice, therefore, outside the hos-| pitals is becoming more and more limited, and the house surgeons, knowing this, are afraid to stay too long in our institutions, fearing that they may I miss tho opportunity of earning their livelihood in private. It is quite a com- J mon custom for men, because 'of this fear, to ask to be relieved of their appointments so that they may be able to start in practice, and so earn their own living, or to take some remunerative post in the services or in a country hospital. Were it possible to keep the house surgeons two or three years in our hospitals, making it worth their while monetarily, we would solve the problem at once of the shortage of house surgeons, and so do away with the need of increasing tho number of medical students; but, as things arc, the house surgeons would bo foolish to remain longer than six months or a year in our hospitals. Another thing that makes for shortago is that our young men, after a year's internship in a Iview Zealand hospital, desire, and rightly so, to get to the Old Land and there gain experience under the masters of our craft. The problem is difficult and yet must be faced; because there is, undoubtedly, hardship among the young and middle aged medical men in practice in New Zealand. The public little knows the distress and heartaches of the medical! men with young families in New Zealand to-day. The only people who are making a good living in the medical profession to-day are the lodge doctors and one or two with good-class practices and i a few specialists, particularly those i doing abdominal surgery. These, of course, do not know much, and perhaps do not care much, about the anxieties of the middle-class medical practitioner!, who, like all middle classes, are the backbone of their calling.

Living on Air. With regard to there being more medical entrants' in prosperous times, that is contrary to fact. To-day, owing to the usual avenues of employment being closed' to the young, the university is being crowded with students from the high schools and other secondary schools, because the parents do not know what to do with their children. In prosperous times, commerce and other professions offer larger emoluments, and careers of greater adventure, and certainly of less worry and trouble than the medical profession. There is a glamour, however, about the medical profession; and because the medical man has to dress tho part, live in a good home, and drive in a good motor car, the public think that his job must be a very profitable' one. But the cost of education and the constant need of refresher courses which have to be taken 14,000 miles away make one wonder, from the business point of view, whether it is a good proposition to put one's boy into medicine. Medical men are supposed to be like clergymen; only the clergyman gets his stipend and his free house, while the doctor, cxccpt in the case of lodge doctors, is supposed to render the most modern service and yet to live on air. The last four years have shown how much the public value their medical profession in terms of livelihood. I think it is only fair to warn parents that, while there is always room at the top of the tree for brilliant and painstaking and industrious (underline the last two) youths, for the youth of average intelligence tho opportunities of making a living in the medical profession are very small in comparison with the trades, commerce or other professions. In all the other professions and trades there are fixed charges for work done. Tho lawyer has his scale of fees laid down for him, tho stockbroker has his, the architect gets CJ per cent on the value of the buildings for which he draws tho plans and supervises the erection thereof; the auditors have their fixed scales of fees; the skilled tradesmen through their unions, cannot receive less than a fixed remuneration; while the doctor does 00 per cent of his work either for nothing or for a nominal fee. And to-day even most people grudge even the nominal fee.