The medico-chirurgical tariffs issued by the Shropshire Ethical Branch of the British Medical Association.

Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: The medico-chirurgical tariffs issued by the Shropshire Ethical Branch of the British Medical Association. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    ‘ Of your courtesy, we pray you read the Prefaced (old tlay.) FREFACE TO THE MEDICO-CHIRURGICAL TARIFFS. MEDICAL TARIFF.—The Council of the Shropshire Ethical Branch of the British Medical Association in issuing a revised edition of their Medical Tariff, and appending thereto, in deference to the wishes of numerous practitioners, a scale of Surgical Fees, deem it their duty to disclaim the slightest wish or intention to dictate to the members, in the matter of professional charges—which, so long as the medical and surgical, unlike the legal and other professions hesitate to base their title to remuneration upon the abstract value of their services, must, they feel assured, remain an open and vexed question. Though, in the opinion of your Council, a fixed, compulsory scale is undesirable, (inasmuch as the charges must, as a general rule, he more or less regulated by local circumstances, and the social and pecuniary position of patients ;) they believe that a recommendatory Tariff will not only prove useful as a guide to the junior practitioner—- often in doubt as to the remuneration to which he is fairly entitled—but serve as a reference in cases of dispute : and thus tend to prevent litigation, and promote a friendly arrangement. The scale (a purely recommendatory one, be it noted), after much thoughtful consideration, and consultation with the general body of practitioners throughout the county, and adjacent districts, has been drawn at such a rate that the humblest member of the profession need not hesitate to make it the basis of his charges—a late calculated, indeed, rather in accordance with past usage, than what is essential to the maintenance of the proper status of the profession—due regard being had to the diminished value of money, the increase of wealth among the several classes of the community, and the enhanced cost of medical and surgical education, consequent on the prolonged scientific and collateral studies enforced by the General Medical Council, in the interest of the public. Ere many years have elapsed, a higher Tariff will doubtless be necessary. In the meanwhile, your Council would venture to express an earnest hope that every member, who, from seniority, or high professional status, may be in a position to do so, will not fail to charge higher fees, whenever the circumstances of the case justify them. Your Council, while freely admitting that the income, rather than the *house rental of patients, may be the true principle on which to found a Tariff, have never- theless deemed it expedient to make the latter (as the least open to objection,) the basis of their division into classes. Exceptional cases, they need scarcely remark, will of necessity occur, in which the practitioner must use his own discretion :—as, for instance, in the case of farmers, lodgers, and tradespeople,—from the rental of which latter a liberal deduction maybe made, when not incurred solely for personal or family convenience. At the same time, it will be well to bear in mind that £30 and £50 houses are not infrequently inhabited, either from choice or necessity, by persons of relatively, if not actually, greater wealth than others living iu more highly rented ones. Such cases, however, must be left to the local knowledge and discrimination of the practitioner, and the charges regulated accordingly. In fine, a fair and equitable remuneration, accordant with the patient'' s position and ability to pay, • In the opinion ot the framer of the Tariff, there is no such practical evidence of a man’s available means, his power of bearing taxation, as his house rent—which probably bears, on the average, a fairer relation to the income of the tax-payer than the income tax itself; and fuither, that, exceptional cases apart, the house rent may in general be set down at about one-tenth of the income.