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JAMA 100 Years Ago
December 13, 2006


Author Affiliations

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Assistant Editor.

JAMA. 2006;296(22):2745. doi:10.1001/jama.296.22.2745-c

The insurance examination question, discussed elsewhere, is related very closely to that of contract practice. At various times during the last few years we have called attention to the fact that the “battle of the clubs” of our English brethren will have to be fought in this country at some time, and that the sooner we commence the fight the easier it will be won. Gradually and surely this evil is spreading, and in some localities has already produced most disastrous conditions—conditions that are as harmful to the public as they are ruinous to the profession. If we mistake not, in another ten years there will be scarcely a community in the country in which our profession will not be feeling this blight, i. e., if something is not done to check it. It is not the legitimate contract practice that is to be feared (for there is a form of contract practice that is legitimate, as, for instance, the contract to attend injured workmen—but not in sickness nor their families—employed in a mill or factory), but the organizations that are gotten up for the purpose of buying a physician's services at whole-sale and selling them at retail. There is no doubt about the viciousness of this form of contract practice, whether it be in the case of a fraternal order or connected with an organization created solely for the purpose of supplying a physician's services at a minimum fee; and this should be fought vigorously. Contract practice is one of the most serious evils immediately threatening the medical profession of this country.

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