Is the Practice of Medicine a Profession or Trade?

Selected writings of A. Jackson Howe.

Unfortunately it is too true that the practice of medicine is both a profession and a trade. One will make the professional aspect predominate, while others prefer to commercialize. Yet in it all the necessary means of existence must be obtained and the complete divorcement of profession and trade is rare. The physician who keeps out the element of trade as far as possible comes nearer the ideal which has been established for the professions. Taking it all in all, we believe the better class of physicians prefer the higher plane and strive to make of medicine a profession. And what are the actual differences between trade and profession? Let Professor Faunce, of Brown University, set the standard. He says: "Trade is occupation for livelihood; profession is occupation for service of the world. Trade is occupation for joy in the result; profession is occupation for joy in the process. Trade is occupation where anybody may enter; profession is occupation where only those who are prepared may enter. Trade is occupation often taken up temporarily, until something better offers; profession is occupation with which one is identified for life. Trade makes one the rival of every other trader; profession makes one the co-operator with all his colleagues. Trade knows only the ethics of success; profession is bound by lasting ties of sacred honor." —Ed. Gleaner.

IS THE PRACTICE OF MEDICINE A PROFESSION OR TRADE?— The senior of a literary college asks himself whether, upon graduation, he is to adopt a trade or a profession—he queries whether he is to study law, theology, or medicine, with a view of becoming a professional man, or is he to learn a mercantile pursuit with the purpose of engaging successfully in trade? He feels that it would be a fearful risk to embark in a commercial venture without serving for a season as apprentice in the kind of business selected as a vocation. To put money into drygoods, groceries, lumber, coal, iron, cordage, or into any branch of traffic without having some practical knowledge of profits and losses incurred in each specific transaction would bankrupt anybody. Novices in the jobbing of peanuts generally fail. The crop turns out larger than was expected and the price declines correspondingly; or, if the crop proves to be a short one, he sells before the price has attained a profitable figure. Such is trade!

The perils of a profession are such that he who enters upon the peculiar career must rely for success upon his education, aesthetic taste, tact, and discretion—he must utilize subtle ways to carry his points—he must become master of arts that both please and persuade; at the same time he should, to secure a lasting and profitable reputation, avoid deceit in his dealings with mankind. To be professional is not to be an adroit trickster. Honesty and honor adorn each of the professions. A lawyer who cheats is a shyster; a preacher who degrades his high office to the gratification of selfish ends is a hypocrite; and the physician who lowers his professional standing by indulging in questionable arts is passed upon for what he may be—his title will not shield him from fairly just criticism. If the recent graduate in medicine indulge the thought that the world is not sharp enough to discover shams, he is a victim of self-deception.

It is presumed that many medical men pursue their vocation for what money they can make out of it—they never rise above the idea of pelf, barter, and trade—they care little for the literature and philosophies of medical science—they affect to despise its grand theories—they never stop to inquire into causes—they can name a few diseases, and may believe that a set of drugs in their portable pill-sacks will cure anything curable. Such practitioners are traffickers in medicine—mere traders in a stock of drugs, dispensing them for what they will fetch. They can lay no just claim to enter the higher walks of the profession and revel in the grandeur of medical dynamics, ethics, and aesthetics. To banter and barter may be reasonably profitable, considering the capital invested, whether in money or brains, yet there is a higher, a more exalted work in the profession of medicine; and the ambitious and laudable career is keenly enjoyed by the student of the history of medicine, by the investigator of its principles, and by the speculator in its possibilities. Medicine is so comprehensive in its ranges that parts of it may be carried on as a trade, and other parts may become a source of intellectual ratiocination and scientific indulgence, profit having no lot nor share in the matter. But, as pecuniary recompense is so often a necessity in life, the majority of medical men can not avoid being amphibious—practicing both a trade and a profession. The safest and most successful practitioners are they who aim to be pecuniarily recompensed. —HOWE, Eclectic Medical Journal, 1890.

The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.