March 29, 1890


JAMA. 1890;XIV(13):458-459. doi:10.1001/jama.1890.02410130026004

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Can there be any fixed rate of compensation for any and all kinds of service to the sick or injured? We trow not, for there are many reasons which operate against such a desideratum. First of all, there can be on the part of the profession no organization approaching the nature of a "trust," competition being too sweeping and too general. Much of the aid also is supplied by the State or corporations, and very much more is gratuitously rendered for the sake of acquiring skill or reputation. Add to these demoralizations—we use the term in its least offensive commercial sense—the unintended charities of the younger members of the profession, who are obliged to take greater risks in the matter of compensation, and we continue adding more figures to the over-long list.

Overcrowding, about which so much is written, cannot well be controlled except by the survival of the fittest,

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