mm vWWSSA MS* ml NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service ■***»*■•* ■&• ;■'>'■ -..■.. .i&'iib RULES AND REGULATIONS OF THE BOSTON MEDICAL ASSOCIATION. BOSTOjY; printed BY J. BELCHER. 1811. At the annual meeting of the Boston Medical Association, March $, 1811. Voted, That the Secretary procure one hundred printed copies of the rules and regulations of the Boston Medical Association, together with all the amendments ; and furnish each member wtih one copy. *. , REGULATIONS, &c. Respecting Fees to be charged by the Physicians of the torvn of Boston, and respecting other matters connected with the same. At a meeting of the Physicians of Boston, held at Vila's, Janua- ry 24th, 1806. Dr. Lloyd was chosen Chairman. Dr. Fleet, Secretary. Voted, That a Committee of seven be appointed to revise the Fee Bill and make such alterations, &c. as they may think fit. Voted, That Drs. Danforth, sen. Dr. Rand, sen. Dr. Warren, sen. Dr. Welsh, Dr. Jackson, Dr. Dexter and Dr. Spooner be this Committee. At a meeting of the Physicians of Boston, held at Vila's, Febru- ary 11th, 1806. The Committee on the Fee Bill made tfie following report, which was read and afterwards debated by paragraphs altered and . adopted.—then Voted, That no physician shall omit charging all necessary vis- its on account of the number made in one day. Voted, That every gentleman of this Association, be supplied with a copy of the regulations signed by every other who agrees to the same. Voted, That these regulations (i. e. the report) shall go into operation from the 1st day of March, 1806. That there shall be an Annual Meeting of this Association on the 1st Wednesday in March, and that the Secertary be impower- ed to provide a dinner, and assess each Subscriber of the Regula tions for the same. 4 This regulation to commence its operation after the present year. That the Secretary be desired to give a week's notice of the same to the Association. That the thanks of the Association be given to the Chairman, and also to the Committee, for their services. e is "1 I? to | • N. B. The night in these cases is considered as begin- ning at 11 o'clock P. M. and ending at sun rise. 1 5 3 5 S 2 5 10 1 3 6 4 12 15 fr.5 to 10 Cts. 50 The following table contains the lowest fees, which shall be charged for the services, to which they are annexed respectively ; but in proportion to the importance of the case and of the advice afforded, or in consequence of an extraordinary attendance, the charges shall be increased ; and the Subscribers consider them- selves bound to increase their charges agreeably to this rule. DL Visit . ....... First consultation visit..... Each do. do. after the first *Rising in the 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. off or below the castle Do. out of town, for every mile from the centre of") Boston •-.... j Do. at Roxbury street, Cambridge port, or Charlestown 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 .... Ordinary advice at the Physician's house Extra advice at do. do. according to the importance of the same . 50 Dls. Cts. 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 excision of small tumors ..... Reducing luxations or fractures of small bones^ stitching recent wounds, opening large abscesses and similar operations . Passing Catheter ...... Do. do. frequently repeated, without charging the visit ...... Venesection, in addition to the fee for visit, when at the patient's house .... Extraction of tooth, or dressing at Surgeon's house The same operations at patient's house Vaccine Inoculation ...... Case of Gonoirhaea ..... All other cases of Syphilis ..... Emetic, Cathartic, Anodyne, each EXPLANATIONS. In cases of Midwifery, when the child is born but not the pla- centa, before the arrival of the accoucheur, the whole fee is to be charged. When both child and placenta arc born before the ar- rival ©f the accoucheur, half or the whole fee is to be charged according to the circumstances. 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 account, an account may be presented for two thirds of the amount, for which the same patient stands charged on he physician's books. But particulars not expressed. } 40 20 } 10 } 8 } 5 5 } 1 } 1 1 1 5 10 15 50 50 50 6 When the circumstances permit, every Physician shall present his account immediately after his attendance 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 pre- sented every January, and it shall be an invariable custom to en- deavour to settle all accounts in that month, or at least annually. Printed blanks shall be used for accounts in one of the forms following, viz : When the account is not an annual one, the following form shall be used. Mr. Dr. For Medicines administered and attendance on from to Dls. Cts. Boston, Received Payment, 7 When the account is an annual one, one of the following forms shall be used. Mr. Dr. 181 His Annual Account for Medicines Dls. Cts. v administered, and attendance, viz. January, February, March, April, May, June, July, i August, September, October, November, December, Boston, Received Payment, 8 Mr. Dr. 181 His Annual Account for Medicines admin- istered, and attendance in his family. Received Payment, Boston, Dls. Cts. In addition to the foregoing Regulations, the Committee propose as a custom to be observed in future, That in cases of consultation the consulting Physician should send his bill to the attending Physician as soon as his service is completed, and that it then be the business of the attending Physician to present the bill. 9 PROCEEDINGS 6/ the Association of Boston Physicians, at their annual meeting on the first Wednesday in March, 1807. Voted, That there shall be chosen, by ballot, at every annual meeting of the Association, a standing committee of three mem- bers. That the duty of this committee 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 con- cern the honour and interest of the said Association. Voted, That no member of this Association shall hereafter consult with any practitioner in this town, who is not a member of the said Association. Voted, That when the Physician, engaged to attend in any case of Obstetricy, is absent, and a second delivers the woman, the latter shall receive the fee and relinquish the patient to the first. Voted, That, 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. Voted, That 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 former. Voted, That the standing committee be requested to prepare a code of Medical Police, to be submitted to the consideration of the Association at their next annual meeting, or sooner if expedient. JOHN GORHAM. Secretary. March, 1807. 2 10 Extracts from the votes of the Association of Boston Physicians, at their annual meetings in 1808 and 1809. Voted, That it shall be the duty of the Secretary to select those votes of the Association, which are important, to print them and distribute a copy to each member. » Voted, That if, in any case of obstetricy, a second physician be called in consultation, both the attending and consulting physician shall charge at least the usual fee for delivery. Voted, That in case any member of this Association, becomes acquainted with the conduct of another member, which he consid- ers as a breach of the rules and regulations of the Association, it shall be his duty to make the same known to the standing com- mittee : thereupon the committee 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. Voted, That in future all resignations shall be made in writing addressed to the Secretary ; that the Secretary shall lay this re- signation before the committee, and that they shall either give notice of this resignation to each member, or call a meeting of the Association as they may think most proper. Voted, That in future it be contrary to the rules and regulations of this Association for any member to make a previous contract with any family for a definite sum as a remuneration for his an- nual attendance on that family. 11 Extracts from the proceedings of the Boston Medical Association n\ the years 1810 and 1811. Voted, That in future there be a semiannual meeting without a dinner, on the first Wednesday in September. Voted, That the Association be at liberty to make use of a fourth form of bills, as follows. Mr. to Dr. Dr. For Medical Attendance on from to Voted, That the report of the standing committee on the sub- ject of admission of new members to the Association be accepted. This report contains the following rule, viz. That the regulations of the Association be offered for subscrip- tion to all candidates for Medical practice in this town, who have received a Medical degree at Harvard College, or are members of, or have received letters testimonial of approbation, or of licence from the Censors of the Massachusetts Medical Society ; and that the Secretary be charged with the execution of this regulation, with which he shall comply in every instance so soon as he shall learn, that any candidate of the above description may have es- tablished himself in this town, or in case the Secretary have doubts in any instance, respecting the propriety of offering the articles to any candidate above described he shall call on the standing com- mittee 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. Voted, That to any person who in the judgment of his physician cannot afford to pay the fees prescribed in the regulations of this Association, the charges may he for two thirds the amount of those fees—or every member of the Association shall be at liberty to make his charges uniform and allow the deduction of one third 12 on making out his bill, as has been heretofore done; provided however, that there shall not be made a deduction either in first making the charges or in making out a bill, from the fees for « cases of midwifery," and " for rising in night and visit." Boston, The undersigned approve of the foregoing Regulations, and agree upon their honour to comply with the same. -^jagyMJCy<■•»»-.. • ■ Med. Mist. WZ B7Hr 1*11 c.l y!t&>