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March 5, 1932


Author Affiliations

Director, Bureau of Medical Economics, American Medical Association CHICAGO

JAMA. 1932;98(10):808-815. doi:10.1001/jama.1932.27320360003008

Contract practice is not a new development in medical care; it began as an essential feature of many pioneering projects in mining, railroad construction and lumbering; it is now assuming new forms, becoming highly competitive, using unethical methods and involving a large number of physicians.

Ever since men achieved the first stages of civilization, there has been nothing they have refused to do to obtain health when they have been sick. They have been willing to be half drowned, to be buried alive in earth up to their chins, to be pierced with needles and branded with hot irons, to have leeches suck their blood and to swallow vile tasting concoctions—and to pay for all this—in the hope of attaining cure from disease and of regaining health.1 Now it may be added that many are willing to bargain with the lowest bidder on a contract basis for incomplete and