MEDICINE 
A5 A PROFESSION 
ONE OF A SERIES OF ARTICLES ON THE CHOICE OF A PROFESSION 
ADDRESSED TO UNDERGRADUATE STUDENTS BY MEN OF VARI- 
OUS CALLINGS TEN YEARS AFTER GRADUATION. 
LOUIS FAUGERES BISHOP, A.M., M.D. 
NEW YORK MEDICINE AS A PROFESSION 
I! V 
LOUTS FAUGERES BISHOP, A.M.7'm.T)‘. 
new YORK 
CLINICAL ASSISTANT, COLLEGE OF PHYSICIANS AND SURGEONS, MEDICAL 
DEPARTMENT, COLUMBIA COLLEGE; SECRETARY, SOCIETY OF ALUMNI, 
st. litre’s hospital; secretary, medical section, new 
YORK ACADEMY OF MEDICINE, ETC. 
Reprinted from THE RUTGERS COLLEGE TAR GUM 
NEW V()KI{ 
PRESS OF McAULIFFE & BOOTH 
3lt West 125th Stkeet, 
1896 MEDICINE AS A PROFESSION. 
It is a pleasing task to defend the claims of the most interest- 
ing of human sciences as a life work. For the right man no 
other profession than medicine offers so good an opportunity, or 
so satisfactory a career. Just what constitutes the right man 
and the successful career will form the subject matter of our 
discussion. The choice of a profession at all pre-supposes tastes 
and inclinations different from those which actuate the average 
man in the pursuit of his daily bread-winning. 
The cry of overcrowding in the profession is a false one. Of 
the medical profession at least one may speak with confidence 
in saying that there is great need of men, but the men to take 
these unfilled places must be men of excellent qualities of heart 
and mind. 
That medicine as a science and as a'profession has great 
attractions is shown by the fact that it is pursued by a very 
large number of those of independent fortune, and who take 
practically nothing in the way of financial return. For the'man 
who enters medicine strictly as a profession, whose tastes are 
strong enough for him to regard it as a privilege to be able to 
gratify them, to whom no sacrifice is too great which leads to 
greater perfection in his attainments, there are great rewards. 
There is only bitterness and disappointment for the one yvho 
seeks riches and glory and power by using this learned profes- 
sion as a means. As an end in itself the pursuit of medical 
science offers every attraction, as a means to other ends, but 
few promises. 
To get into the medical profession a certain process is neces- 
sary which one should know before choosing this career. It is 4 
popularly supposed that the medical degree is the gate-way. A 
student imagines that at one moment he is a lay-man, and a 
moment later through the magic of the diploma he holds in his 
hand, he is a physician. This is a great fallacy. It is the 
custom in this country to grant diplomas when a medical stu- 
dent’s preliminary education is about two-thirds passed. The 
completion of the latter part of the preliminary education, tin* 
hospital course, is left to his own honor and discretion. 
This often deceives the uninformed with the idea that a 
medical education is complete at the end of a medical college 
course of two, three or four years, while in fact from one to three 
years at least must be added to this, and considered education 
preliminary to practice. We are justified in regarding four and 
one-half to seven years as the time required by those possessing 
the degree of A. B. to properly enter the medical profession. 
On this account do not be misled by the fact that under our 
popular form of government few proper restrictions are placed 
upon the practice of medicine. Popular intelligence must take 
the place of law. Some States are in advance of others, but a 
legal right to act as a physician nowhere implies the moral right 
which proper training alone can give. In Massachusetts, for 
example, one may practice medicine without any degree or legal 
formality. In many States the mere perfunctory attendance 
upon two courses of lectures at any one of the so-called medical 
colleges that sprinkle our country from end to end, as if a great 
pepper box full of them had been shaken over it. However 
deceptive our apparent carelessness may be in this respect, what 
has been said about the requirements are practically true in 
most centres of intelligence. A medical degree does not give a 
man standing in the profession, nor does it give the public that 
confidence that will bring him patients. Occasionally a man 
surmounts by the inherent force of his character and by subse- 
quent training, the disadvantages of a false start, but such, 
lament to the end of their careers that their college courses 
were deficient, they missed their hospital training. 
A few words are necessary, to one who is considering medi- 
cine as a profession, in explanation of the so-called “schools of 
medicine.” 5 
"lhe medical profession is the oldest of all professions. Its 
history is mentioned by Homer as if it |had existed for a long 
time. We know that human nature and human relations have 
not changed a great deal since the time of the Siege of Troy. 
Very soon after, or perhaps co-incident with the establish- 
ment ol the medical profession, it was found expedient to adopt 
certain rules governing the relations of physicians. These 
weie simple, easy to understand, founded on common sense, 
humanity, and a high morality. These have controlled the 
profession lor these thousands of years. The history of medi- 
cine shows that in all ages there have been men unwilling to 
conform to these rules which have always been regarded 
necessary to the welfare of the profession. Even in the 
remotest times it was recognized that medical science was so 
extensive and complicated, and human hearts and minds so 
different, that it never would be possible for there to be a strict 
uniformity of practice and opinion among physicians. To put 
an end to disputes and dissentions for all time, the regular pro- 
fession oi that day, and the regular profession of this day, have 
followed a certain rule. It is this in substance—that every 
physician shall be allowed to practice and believe whatever 
pi inciples of the healing art seem to him to be to the best 
interests of his patient. Within the confines of the medical 
family he may advocate any principles that he chooses, but he 
shall not publicly advocate any exclusive system of practice. 
Upon the disregard of this rule and not upon any difference of 
opinion or practice are founded all the sects of medicine. The 
regular profession has always gone on, but from time to time 
men or bodies of men, actuated by various motives, have 
thought best to claim to have some better method than their 
fellow practitioners. They have thought best to attach to their 
method of practice, the name of some sect, very much as a 
ti ad e-mark is attached to some article of commerce. The 
regular profession has no such name, and never will have. The 
name “Allopathy’ is an invention of those, who feeling the 
disgrace of their own trade-mark, wished to saddle one upon 
the regular profession. The continued existence of “new 
schools” is due to the same cause as the continued use of any 6 
trade-mark in commerce—that is the demand for such an 
article. In the great centres of medical learning the question 
of different schools has long ceased to be a question of discus- 
sion. The medical meetings are scientific in character and 
spirit. Anyone with any subject or opinion whatsoever to 
present is given a respectful and attentive hearing. The 
science of medicine has so advanced in the past twenty years as 
to leave the knowledge previously possessed by the profession 
far behind, and the introduction of the scientific method has 
done much to dispel apparent differences of practice. It only 
rests with the public to restore harmony among all physicians, 
but so long as human nature is what it is, and one person 
wishes one kind of a doctor, and another wishes another kind of 
a doctor, greed of gain will always supply the demand. 
The point to be remembered by those considering medical 
education is this—that in’its very widest conception the ground 
of dispute between the so-called schools of medicine is no wider 
than differences of practice between individual men in any 
school. And more important still is the fact that it comprises 
but a part of medicine, namely, therapeutics, which though the 
part that is most prominently seen by the public, is yet but a 
small fraction of medical science. A properly trained student 
devotes perhaps nine-tenths of his energy during his college 
course to anatomy, physiology, the. natural history of disease, 
etc., in order that during the remainder of his life he may have 
a proper foundation on which to cultivate the art of treatment. 
For this reason the profession feels confident that if a student 
has a sufficient scientific ground-work of the fundamental sci- 
ences, he will not go far astry in therapeutics. It is character- 
istic of all irregular schools of medicine that, lacking as they do 
the cultivation of the fundamental sciences, they have never 
contributed anything substantial to the advancement of learn- 
ing, but have devoted their energies to claiming better systems 
of treatment. The power of diagnosis, the greatest test of 
medical attainments, depends wholly upon training of the kind 
that should precede the study of the application of drugs. Di- 
agnosis has a broader meaning than simply naming a disease. 
It means a conception of the exact condition presented in each 7 
individual patient, and the power to foretell what may be 
expected to happen. 
There is one other matter that lias of late years come so 
prominently before the profession and the public that it should 
even be considered by those who are deciding upon becoming 
physicians. The abuse of specialism in medicine is one of the 
dangers of the day to true medical science. Li Ice all errors it 
has its foundation in a germ of truth. True specialists have 
always existed and have always been of benefit to the commu- 
nity and an honor to the profession. They have done much to 
advance the science of medicine and have attained great fame. 
These are men who on a broad basis of knowledge, education 
and general medical experience have achieved a high degree 
of success in some particular line of worjk, ancLthis being recog- 
nized by their fellows, they had been so singled out to do that 
particular work that there is not time left for general practice. 
The specialist of these days is often the product of the 
commercial spirit which has led the student to devote himself 
to certain showy accomplishments in the management of 
particular kinds of disease with the prime object of attaining 
patients and fees. Such a man lacking the balance of the 
trained judgment and the ripe experience of the true specialist 
is misled by every will-o’-wisp theory. Hi; is deceived 
into declaring disease cured when symptoms have been 
temporarily removed. His patients are unduly elated by the 
often sincere assertions that they are cured, only to suffer 
disappointment when the hypnotic influence of the elaborate 
treatment has subsided. This does not apply to the really 
great men whose careers answer to the criterion that we have 
laid down, but to those men, who becoming specialists before 
they really become physicians are a detriment to the progress 
of medicine, and have done much in recent times to bring it into 
disrepute. 
The highest place in the profession and in the commu- 
nity is, and always has been reserved for the great medical 
and surgical consultant. It is the place which is filled by the 
concurring judgment of the profession and of the community, 
and it is seldom occupied by the undeserving, and yet public 8 
opinion has of late gone so far wrong that the man who asserts 
that his ambition is to be a general practitioner, and that his 
idea of a successful career is the attainment of the position of 
the general medical consultant arouses the derision of the mer- 
cenary public and the incredulity of a portion of the profession 
itself. 
These things are necessary to be understood by one about to 
choose this profession. The requirements of the physician are a 
sufficient love of his science and of humanity for him to sacrifice 
most of the usual pleasures of men, all of his time, and all of his 
attention. He has the least chance of making money of any pro- 
fession except the clergy, but fortunately, early in his career, the 
love of money is usually lost.. His expectation of posthumous 
fame is very small. There have been many really great physicians 
in all ages, but one can count on his fingers all those that are 
remembered. Medical literature is re-written in every genera- 
tion and the names of the original authors are omitted. To be 
really great the physician must have that love for his work 
which does not seek fame. The rewards of the physician must 
come chiefly from his own consciousness of work well done. 
For his maintenance he is dependent upon his fees which are in 
the nature of honorariums. He cannot himself place a value 
upon his work, and human gratitude seldom rises to the poinf 
of a proper compensation. He is the servant of all. When sent 
for he goes without thought of reward. In times of epidemic 
and plague he is sacrificed for the protection of the people, but 
such is his reputation for greatness of soul that this is hardly 
an occasion for remark. As was said in the beginning, the man 
who will look to the work itself as an end, and who will regard 
it as a privilege to be one of so great a profession, the choice of 
medicine as a career cannot be a mistake. 
30 West Thirty-sixth Street.