-<. f t RULES AND REGULATIONS OF THI BOSTON ME 1) I C A I. ASSOCIATION. ■..-., ,.. ., . »-,V -•;, BOSTON-:- PRINTED Br JOHN ELIOT. 1817. AT the :iununl meeting Of the members ot" the Boston Medical Association, hold- •:n on the first Wednesday of March, 1816, John G. Coffin, .M. 1). and Gkorkk Matward, M. D. were chosen a Committee to revise and amend the existing by- laws of the Association ; and at the annual meeting in March, 1817, tiny reported the annexed Rules and Regulations, which, being read and discussed by sections, were adopted and ordered to be printed for the use of the members. Attest, GEORGE HAYWARO, Secretary. Boston, March, 1817. ♦ RULES AND REGULATIONS. MEMBERS. THE regulations of the Association shall be of- fered for subscription to all candidates for medical practice in this town, who have received a medical de- gree at Harvard University, or are members of, or have received letters testimonial of approbation, or of licence from the Censors of the Massachusetts Medi- cal Society ; and the Secretary shall be charged with the execution of this regulation, with which he shall comply hi every instance, so soon as he shall learn that any candidate of the above description may have established himself in this town, or in case the Secre- tary has doubts in any instance, respecting the pro- priety of offering the articles to any candidate above described, he shall call on the Standing Committee for advice and direction; and in case any person to whom he offers the regulations shall refuse or neglect to sign the same, the Secretary shall make known such refusal or neglect to the Standing Committee. Every candidate at the time of becoming a member of the Association shall sign the following obligation, which shall be in a book deposited with the Secretary. The undersigned approve of the regulations of the Boston Medical Association, and agree upon their honour to comply with the same. All the members of this Association, after arriving at the age of sixty, shall be considered as honorary members, and shall be invited to the annual dinner of 4 the Association, and shall be exempted from all as- sessments ; but in other particulars shall be governed by the rules and regulations of the Association. All resignations of members shall be made in writ- ing to the Secretary, who shall immediately lay them before the Committee, who shall either notify each member or call a meeting of the Association, as they may think most proper. OFFICERS. There shall be chosen by ballot at every annual meeting of the Association, a Secretary, and Standing Committee of five members. The duty of this Com- mittee shall be, to advise and direct the Secretary in the admission of new members to the Association. They shall have power to call special meetings, and it shall also be their duty to attend to all matters, which concern the honour and interest of the Asso- ciation. MEETINGS. There shall be an annual meeting of this Associa- tion on the first Wednesday in March, and the Secre- tary is empowered to provide a dinner, and assess each subscriber of the regulations for the same. Any member, however, by giving the Secretary notice ten days previous to the annual meeting that he does not intend dining with the Association, shall not be as- sessed for the dinner. The Secretary is directed to give a week's notice of the time and place of meeting by an advertisement in the newspapers, and a printed card sent to each member. 5 If any member refuses to pay his assessment for the annual dinner and other expenses, his connection with the Association shall thereupon cease, and the Secre- tary shall inform the members of it by a circular note. RULES AND REGULATIONS. No member of this Association shall consult with, or voluntarily meet in a professional way, or aid or abet, any practitioner in this town, who is hot a mem- ber of the Association. When a physician, engaged to attend a case of obstetricy, is absent, and a second delivers the woman, the latter shall receive the fee and relinquish the pa- tient to the first. If the first arrive, while the second is present, and before the woman is delivered, the second shall retire and resign the patient to the first. If a physician be called to a patient, who has usual- ly been attended by a family physician, on the arrival of the latter the patient shall be resigned by the for- mer. No member of this Association shall make a previ- ous contract with any family for a definite sum as a remuneration for his annual attendance on that family. If any member becomes acquainted with the con- duct of another member, which he considers as a breach of the rules and regulations of the Association, it shall be his duty to make the same known to the Standing Committee, who shall enquire into the case and decide upon the same as they may think proper, provided, that both the Committee and member accused shall be at liberty to refer the question to the Association. 6 FEE BILL. The following table contains the lowest fees, which shall be charged for the services, to which they arc respectively annexed ; but in proportion to the impor- tance of the case and of the advice offered, or in con- sequence of an extraordinary attendance, the charges shall be increased ; and the members of this Associa- tion consider themselves bound to increase their char- ges agreeably to this rule. Cts. First visit may be charged .... Every subsequent one ..... First cousultation visit..... Each do. do. after the first . *Rising in die night and visit .... Rising in the night, and advice at the Physician's house Visit on board a vessel at the wharf . Do. on do. do. in the stream above the castle Do. on do. do. otF or below the castle Do. out of town, for every mile from the centre of Boston....... Do. at Roxbury street, Cambridgeport, or Charlestonn Consultation visit at either of the above places, first visit Each subsequent one ..... Case of Midwifery in the day .... Do. do. if any part of the attendance is in the night ...... Advice at the Physician's house, according to the ) importance of the same .... \ Capital operations, as amputation of large limbs, lith- otomy, trepanning, and extirpation of large tumors Operation of fistula in Ano .... Tapping for dropsy, and reducing luxations or frac- ) tures of large bones . . . . ) Amputation of fingers or toes, and excission of small ) tumors.......$ Reducing luxations or fractures of small bones, i stitching recent wounds, opening large abseesses > and similar operations ..... ) * N. 6. The night in these cases is considered as beginning at 11 o'clock, P. M. and ending at sun rise. 7 Dolls. Cts. Passing Catheter...... Do. do. frequently repeated, without charg- ing the visit...... Venesection, in adition to the fee for visit, when at the patient's house .... Extraction of tooth, or dressing at Surgeon's house The same operations at patients house Vacciue Inoculation . .... Case of Gononhaea ..... All othei rases of Syphilis .... EXPLANATIONS. In cases of Midwifery, when the child is born, but not the placenta, before the arrival of the accoucheur, the whole fee is to be charged. When both child and placenta are born before the arrival of the accoucheur, half or the whole fee is to be charged according to the circumstances. This rule is not to be applied to cases where the delay arises from the accoucheur. Whenever it is necessary to- make more than three visits to a woman after delivery, all additional visits shall be charged as in ordinary cases. Notwithstanding the foregoing regulations, it is agreed that to any patient, who, in the judgment of his physician, will be unable to defray his whole ac- count, a discount of one third may be made from the above charges, without expressing particulars, except- ing in cases of obstetricy and rising and visit in the night. All visits made at a late hour in the evening are to be considered as extraordinary attendance, and may be charged accordingly. If, in any case of obstetricy, a second physician is called in consultation, both the attending and consult- i i 5 10 50 50 8 ing physician shall charge at least the usual fee for delivery. When the circumstances permit, every physician shall present his account immediately after his attend- ance in a fit of sickness. This shall be particularly attended to in cases of midwifery. In ordinary cases of attendance in families, an account shall be present- ed every January, and it shall be an invariable custom to endeavour to settle all accounts in that month, or at least annually. No member of this Association shall omit charging any necessary visits made on the same day, on ac- count of their number. In cases of consultation the consulting physician should send his bill to the attending pbysician, as soon as his service is completed ; and it should then be the business of the attending physician to present the bill. Printed blanks may be used of the following form : Mr. to Dr. For Medical attendance on r y ■?<■> /