The doctor's time

My grandmother lived in a small house without plumbing, electricity or gas. There was an outside lavatory shared between three houses and a pump at the end of the road for water. Rooms were lit by either oil lamps or candles. Cooking was over an open fire. She was a sort of unqualified nurse who went round looking after people in the neighbourhood and relied on gifts to live. She died in 1948, old before her time.

My father had TB as a teenager, which cut short his education; was apprenticed to a tailor, followed the military to practise his job, and ended up as a bar steward in an officers’ mess. He moonlighted doing alterations for tailor shops and before he died had accumulated one thousand pounds in savings. He died from a medical mistake.

I was fortunate to be brought up in a country with free universal education and no barrier to a working class child rising to the top of one of the great professions. I have never been hungry, never cold or unsheltered, never the victim of more than trivial crime, never unloved, never friendless, never the subject of prejudice or unfairness. Although I lived through part of one of the worst wars the world has seen, I have never been bombed or shot at and never lost a relative through war. When I have been ill I have been expertly treated without charge. I have lived in a safe, generous and peaceful country in which to marry and bring up my children.

The idea that I should measure the time that I spend helping people and calculate how much I should charge them for knowledge that has cost me nothing is alien to me.

I heard of a doctor who was tired of being approached at parties with requests for remedies for bad backs, rashes or fatigue. He shared his moan with his friend the lawyer. The lawyer replied, “You should do what I do. I give them the advice they need and the next day I send them a bill.”

The doctor was thrilled with the advice and the next day at work set about sending accounts to all the would-be patients who had accosted him at the party. He was interrupted by the arrival of the post which included an invoice from his friend the lawyer for ‘advice given to deter medical enquiries – 50 guineas’.