Chapter 26 Historical Notes on Medical Economics

I am at a loss as to what the good old days of medicine looked like and how the scenery was different.Of course, I know that science and technology have changed dramatically over the years.Today, doctors are able to cure so many diseases and relieve so many disabilities that I could not have imagined when I was young.But there is another difference, which I have forgotten. I found it a few days ago when I was looking in my yearbook from Harvard Medical School in 1937.Albert Coons was the editor of that yearbook.The yearbook contains the usual size photographs of prominent figures and administrators in the faculty, as well as smaller photographs of each of our grades, each accompanied by a biographical phrase including the graduate's career plans.By the way, Kuhns spent his whole life in immunology research, starting with the discovery of a method of labeling antibodies with fluorescent dyes, which is called the Kuhns technique.He stated in the phrase below the photo that he intended to go East to practice medicine as an internist.In fact, almost all of my classmates who later embarked on the road of scientific research and teaching were quite sure that they would become medical practitioners when they graduated.

I'm pulling away.What I'm trying to say is that, as an editor, Coons originally intended to do more than record grade statistics.He decided to do something more ambitious for the yearbook.He prepared a long list of questions and sent them to male alumni who graduated from the school ten, twenty, and thirty years ago.I remember the discussions when those questionnaires were sent out, and especially the feeling we all shared at the time that we were sampling extreme seniority: the Class of 1927 and the Class of 1917 were distant figures to us up.And the class of 1907 was as distant as Galen.

No one expected that 60% of the 265 male alumni filled out the questionnaire and sent it back.This is a pretty good result for those of us who are new to sociology. The most interesting discovery is the net income of alumni recorded in detail in the annual yearbook.Those figures, by the standards of the time, were significantly higher than the average income of American physicians according to the American Medical Association.This is a reassuring agent for our grade nine.We know that interns and residents get room and board, but not salary.We are very happy to know that Harvard graduates can do better in terms of income once they go to practice medicine.Of course we'd love to tell ourselves that it's not the money that counts, just because, if it's concluded that if they make more money than other people, they're probably better physicians.That would be fair.

Then again the difference and surprise.The average net income of the 165 Harvard students who graduated ten to thirty years ago was between $5,000 and $10,000 per year.Only five exceeded 20,000.There is a surgeon who has graduated for 20 years and earns 50,000. In the class of 1927, seven graduates earned less than 2,500 yuan. Alumni are also invited to fill in their own comments in the "Comments" box provided on the question sheet, on the understanding that since so many items on the question sheet are aimed at finding out how much money they make, they may wish to Talk about the life of a doctor in general.As a result, most "reviews" are also about money.A typical comment would look something like this: "I'm perfectly content with medicine as a life's career. But I only recommend it to people who have a lot of money to back them up. Many people who do it never make a lot of money."

Forty-one years ago, that was the way it was.