WEST VIRGINIA RESOLUTIONS, 
Member American Medical Association, Ohio State Medical Society, North 
Central Ohio'Medical Society, National Association Railway Surgeons, 
Surgeon C. C. C. & St. L. R’y, Erie Railway, Professor Oper- 
ative Surgery Ohio Medical University, Etc., 
Oalion, Ohio. 
WEBB J. KELLEY, M. I)., 
Rend at the Joint Meeting of the Northern Ohio Medical Societies at Mansfield, 
Ohio, November 6th, 1891. 
Reprinted from “ The Cleveland Medical Gazette, ” 
November, 1891. 
PRESS OF 
Hijei. & Hubbell, 110 Sheriff St., 
Cleveland, Ohio. THE AMERICAN MEDICAL ASSOCIATION AND THE 
WEST VIRGINIA RESOLUTIONS.* 
WEBB J. KELLEY, M. D., GALION, OHIO. 
Member American Medical Association, Ohio State Medical Society, North Central Ohio Medical 
Society, National Association Railway Surgeons, Surgeon C. C. C. & St. L. R’y> Erie 
Railway, Professor Operative Surgery Ohio Medical University, Etc. 
At the annual meeting of the State Medical Society of West 
Virginia, June 11, 1890, a committee was appointed to memorialize 
the State Societies of adjoining states and the American Medical 
Association upon the subject of the relations of contract surgeons 
of the different railroad systems to the general profession, and to 
ask these societies to consider how far the rules adopted by rail- 
road corporations for the government of the surgeons in their 
service infringe upon the rights of the profession at large, as set 
forth in the code of ethics of the American Medical Association. 
It is well known that large bodies of men are in the employ of 
these corporations ; that these men live in widely scattered com- 
munities and that these corporations have established systems of 
contract surgeons to attend to employes and passengers injured by 
accidents occurring while in their employ or care as passengers. 
It is also well known that these corporations have adopted rules 
for the government of these surgeons and of those injured, direct- 
ing that these surgeons assume entire charge of such employes or 
passengers when injured, regardless of the rights of any outside 
medical men who may have been summoned and is in attendance 
upon such persons prior to the arrival of the company’s surgeon, 
even if in addition the physician first in attendance be the family 
♦Paper read at the joint meeting of the Northern Ohio Medical Societies at Mansfield, Ohio, 
November 6th, 1891. 2 
Kelley : West Virginia Resolutions. 
and personal attendant of the party injured, and in most cases 
have served a notice to this effect on the general profession. For 
instance, section 4 of the general order No. 2 of the Baltimore 
& Ohio Railroad Relief Department says : 
Upon the arrival of the company’s surgeon and taking charge of the patieht 
the called surgeon, if one has been called, shall be distinctly notified by the 
company’s surgeon that the company will be no longer responsible for his attend- 
ance or service and that they are no longer required. 
In section 5 of the same company’s instruction, it says : 
Company’s surgeons upon arriving at the place of accident will take exclusive 
charge of the case and entirely relieve any surgeon other than the one under 
contract with the company from further care and attendance. The called surgeon 
shall be ditinctly notified by the company’s surgeon and the officer in 
charge, that the company will be no longer responsible for his attendance or 
service. Should the patient prefer the services of a surgeon other than the one 
provided by the company, it must be distinctly understood by the patient and the 
said surgeon that neither the company nor the Relief Association will be respon- 
sible for the services rendered. 
To the majority of the State society this appears to place the 
physician in direct conflict with section 6 of article 5 of the code 
of ethics and causes infringements upon the rights of physicians 
first called, who charitably respond to such calls, while knowing 
the rules of the company, because of the urgency of the case. 
Again, in the establishment of these systems of contract sur- 
geons we believe the practice of accepting passes as compensation, 
in lieu of the regular fees customary to the profession, is detri- 
mental to the best interests of the profession by lowering the 
standard of the values of surgical services, and further demoral- 
izing because it gives to these wealthy corporations services at far 
less rates than the profession charges to individuals for like 
services, and further, that these corporations come under that 
part of section 3 of article 1, relating to the duties of the pro- 
fession to the public, and vice versa, which exempts institutions 
endowed by rich individuals, societies for mutual benefit, for the 
insurance of lives, etc., from the privileges set forth in section 1 
and section 2 of the same article. Kelley : West Virginia Resolutions. 
3 
Further, it seems to your memorialists that if members of the 
profession are left to make contracts to furnish an unlimited 
service of the kind required for passes, and in some cases small 
fixed money payments, with these larger corporations without 
affecting their ethical standing, all stigma of unprofessional or 
unethical conduct should be removed from those of the profession 
who contract with private individuals to furnish medical or surgi- 
cal services, including medicine, by the year or month, at fixed 
sums. 
In conclusion we hope your society will consider this subject, 
and if agreeing with us that this is an evil, join us in bringing 
this to the American Medical Association, for it is to decide what 
action, if any, is proper under the circumstances. 
The foregoing is respectfully submitted in behalf of the com- 
mittee appointed, as before stated. 
Wesley H. Sharp, M. D., 
These famous West Virginia resolutions of Dr. Wesley Sharp, 
remind me of the fact “that from the days of the Roman Empire 
down to the present time, men have capped the climax of their 
defeat by self-destruction. Rather than endure disgrace they have 
acted as their own executioners. In those days when Romans 
believed it a disgrace to be killed by a foe in battle, suicides were 
common. We might also bear in mind the heroic suicide men- 
tioned in the Scriptures: Sampson, in order to be revenged on his 
enemies, pulled down the temple in which they were reveling 
and perished with them.” 
It is even so with these West Virginia professional brethren— 
defeated by some professional brother at home—they now seek to 
commit professional suicide by introducing and having passed by 
the American Medical Association, a series of resolutions that 
would debar three thousand loyal working members of the pro- 
fession from participating in its membership. If passed, it would 
simply set a precedent that in five years would entirely 
Parkersburg, W, Va., Nov. 28, 1891. 
Chairman of Com. 4 
Kellf.v : West Virginia Resolutions. 
destroy the association itself. It would be committing profes- 
sional suicide. 
Take the recent meetings of the American Medical Association, 
and who have been its most earnest, laboring members—members 
who attend the sessions of the sections, prepare papers, and make 
the sessions of the sections, especially the surgical, interesting? 
Look in their pocket and you will find a little piece of paste 
board that will explain their calling. They are railroad surgeons. 
A class of surgeons who have done as much, if not more, good 
in the last twelve years for the profession and suffering humanity 
than any other class of specialists in it. They have in their 
National Association to-day a membership of over one thousand; 
the largest membership of surgeons in any society in America, 
and notwithstanding this fact, there is an attempt being made to 
debar them from membership in the society of which they are the 
very heart and soul. A society, which but for their presence at 
the annual meeting, would hardly make a respectable showing. 
Railroads are corporations carrying on a business of vast magni- 
tude in which the millions of dollars of the stock-holders are in- 
vested, and for which they expect some return. Ever since I can 
remember anything about railroads, it has been a common idea that 
they were the legitimate prey of anyone who might perchance have 
a bill against them, and, my friends, the “anyone’s” are mighty 
numerous. The American people were not satisfied with the fif- 
teen or eighteen miles an hour schedule; they demanded rapid tran- 
sit both for themselves and their wares. Rapid transit insures 
accident—accidents cause personal injuries—personal injuries in- 
sure damage suits—damage suits cost money—who pays the 
money? Surely, not the individual who demanded the rapid tran- 
sit—not by any means. He generally manages to be around, 
however, and is a personal friend of someone who is injured, and 
he also has a lawyer friend who knows just how to make the rail- 
roads pay for this special kind of an injury. I can assure you that 
next to the pass friend, these lawyer leeches are the bane of all Kelley : West Virginia Resolutions. 
5 
railroad officials. Now when this case comes up in court does the 
worthy professional brother from West Virginia tear his hair and 
soil his clothing in an endeavor to reach the court room with the 
object in view of seeing that the railroad company does not get 
the worst of it? Not by any means. He is one of those fellows 
who sits back and says:—“Give it to him, Bill, and if you can’t 
make him produce, I’ll help you.’’ Is it any wonder then that 
railroads were compelled to employ surgeons for self-protection? 
The railroads found that by employing “good surgeons’’ to look 
after these cases they saved money, and being harrassed beyond 
endurance by bills presented by outside surgeons for attendance 
upon injured employes, they, at first, simply as a matter of ex- 
periment employed surgeons at all principal points where employes 
were likely to become injured. It was found to pay, and what has 
been the result of the experiment ? A full corps of surgeons are 
employed on every trunk line in this country ; stretchers are placed 
at convenient points; dispensaries have been opened, and magnifi- 
cent hospitals established. So much for the railroad part of it. 
What has it done for the profession and community at large. 
Twenty years ago, when my honored father accepted the position 
of surgeon for the Atlantic & Great Western Railway, railroad 
surgeons were a rarity, and railroad surgery was in an embryotic 
state. How many poor men are there now, who are stumping it 
or carrying around an empty sleeve that could have received bet- 
ter treatment to-day, and probably have saved an arm or a leg. 
Then anyone did the work, generally the first doctor to be found. 
To-day one man does all, or nearly all, the work in a town or a 
city. The result has been wonderful—experience tells, and to-day 
limbs are saved and made useful members that a few years ago 
would have been amputated. Would you prefer to have an ovarian 
tumor removed from your wife, by a man who seldom, if ever, 
performed the operation, if you could secure the services of a 
Tait? Isn’t the comparison reasonable? Wouldn’t you prefer, if 
injured in a railroad collision, the services of Senn, Outten, Gail- 6 
Kelley : West Virginia Resolutions. 
braith, Connor, or a man of their experience, to a man who 
rarely attended a similar case? Have you any idea of the number 
of cases of injuries that a railroad surgeon attends if he is located 
at the end of the division? My father and myself have attended 
over twenty-five hundred cases in the little city of Gabon. 
Wouldn’t you think that experience would be of benefit to an in- 
jured employee ? Comparisons are odious, still they sometimes 
convey a wonderful amount of truth. 
Coming down to that part of the resolutions relative to the 
taking charge of the case by the company’s surgeon on his arrival 
and the discharge of the called surgeon, also the contract work, 
I fail to see anything wrong about this. QuotiAg from a recent 
letter sent me by one high in medical circles : “I suppose we 
might get along far better if we had less ethics. Let the gblden 
rule be our ethics, and not trouble ourselves with petty jealousies 
about what our neighbor is or is not doing. No amount of ethics 
will make a gentleman out of a sneak or a boor, and it is folly to 
waste time on such people. The Lord only knows how to deal 
with such, ” and 1 might add that when they are jealous doctors, 
no doubt he often wishes that the other fellow had the passing of 
the sentence. There is to be found in every community men in 
the profession who are gentlemen, and professional gentlemen. 
What course would he pursue in a case of this kind? If the 
patient preferred the first called surgeon, I have no doubt but that 
the company’s surgeon would examine the case sufficiently to make 
his report, and gratefully withdraw. Personally, I have done this 
a great many times. Of course the patient must pay his own bill, 
and why shouldn’t he? An individual applies for a pension ; if 
successful, the government must j>ay out money. Do they trust it 
to the family physician and pay him for his certificate? Not by 
any means. He must go before a pension board of examining 
surgeons, who are appointed by government officials, and pass an 
examination on his injuries, and the government are sure to get 
him far enough away from home that his family physician will Kelley: West Virginia Resolutions. 
7 
have no influence with the examining board. Isn’t the family 
physician ignored for a contract surgeon, and more than all, a 
political contract surgeon ? How many pension examiners has the 
State Medical Society of West Virginia ever tried for doing con- 
tract work ? 
An individual wishes to insure his life in the New York, the 
Equitable, New York Mutual, or some company of their standing. 
Does the family physician receive the benefit of that examination? 
Oh ! no ! the company has a “ hired hand ” especially appointed 
for that work. He makes the examination. Is he brought to 
trial before his county association for doing contract work? No ! 
that’s legitimate ! but nevertheless there is not a dozen physicians 
in this room but what have signed contracts to make examinations 
for life insurance companies for a stipulated amount. Is it not 
just as much contract work as the railroad surgery? If it is 
wrong, I am an awful sinner, having signed contracts with some 
thirty companies. 
My friend Reed, here in Mansfield, is Health Officer. He 
receives a stipulated salary on an uncertain amount of professional 
work. Has the North Central Ohio Medical Association barred 
him from membership ? From the way he works for the society, I 
am rather inclined to think they admire him. 
I remember three or four years ago, I visited Richmond, Vir- 
ginia. They have an elegant body of professional gentlemen there. 
In the course of a conversation with Dr.Brock, he informed me that 
he had been police surgeon of Richmond ever since the war. 
Don’fyou suppose that with such men as Hunter McGuire, in 
Richmond, that in his official capacity, Dr. Brock had attended 
patients that belonged to Hunter McGuire? Dr. Brock is an 
elegant polished gentleman, and I never imagined any one would 
endeavor to keep him out of medical society, yet his neighbors in 
an adjoining state think he is all wrong. I could go on and relate 
instance after instance where the family physician is wholly 
ignored for the contract individual, and still there is nothing said. 8 
Kelley : West Virginia Resolutions. 
But if a contract railroad surgeon happens to step on the toes of 
some West Virginia family physician, a howl goes up all over the 
state that reaches far over the mountains into the quiet home of 
the Ohio physician, and disturbs his pleasant dreams of a fat fee 
and a good dinner. 
As far as the code of ethics is concerned, there is not one word 
said, either directly or indirectly, about contract work, and I defy 
our worthy West Virginia brethren to produce it. Listen to the 
section referred to by them : 
“ Article 5, Section (i.—It often happens, in cases of sudden illness, or of 
recent accidents or injuries, owing to the alarm and anxiety of friends, that a 
number of physicians are simultaneously sent for. Under these circumstances, 
courtesy should assign the patient to the first who arrives, who should select from 
those present any additional assistance that he may deem necessary. In all such 
cases, however, the practitioner who officiates should request the family physician, 
if there be one, to be called, and unless the further assistance be requested, 
should resign the case to the latter on his arrival.” 
“ Article 1, Section 3.—But neither institutions endowed by the public or 
by rich individuals, societies for mutual benefit, for the insurance of lives, or for 
analagous purposes, nor any profession or occupation, can be admitted to possess 
such privileges. Nor can it be expected of physicians to furnish certificate of 
inability to serve on juries, to perform military duty, or to testify to the state 
of health of persons wishing to insure their lives, to obtain pensions, or the like, 
without a pecuniary acknowledgment. But to, individuals in indigent circum- 
stances such professional services should always be cheerfully and freely accorded. 
To sum the whole thing up in a few words—the railroad corpo- 
rations employ a large number of men—these men constitute a 
large family, and when one of the family is injured, the corpora- 
tion w'ho is the head of the family and pays the bills, sends for 
their family physician. He comes and sometimes the called phy- 
sician objects to turning the patient over to the family physician. 
This has probably happened down about Parkersburg once or twice, 
and as a result the profession of West Virginia are attempting to 
commit professional suicide.