THE MERCHANT DOCTORS
Mintz, Morton
THE MERCHANT DOCTORS by MORTON MINTZ A mong the American Colonies only one, Virginia, tried to impose limits on various aspects of medical practice. The effort was made in 1736 in the form of...
...Anthony told about a lawsuit in which four Spokane eye doctors who do sell spectacles stipulated that each prescribes 2,200 pair a year, or 1,000 more—eighty-three per cent— than their non-dispensing counterparts...
...If the American College of Surgeons "continues in that opinion," he said, "I will resign...
...The director of the AMA's Department of Ethics, Edwin J. Holman, replied with engaging frankness, "I could only answer that by saying I know some physicians are guilty of violating the Federal income tax laws...
...Their offerings included products containing penicillin, an antibiotic to which about one person in ten is sensitive or allergic, and which can trigger reactions ranging from mild to severe or even fatal...
...The American Medical Association provided an illustration...
...During part of that period the ban had aroused no controversy, because thousands of ophthalmologists were taking kickbacks from opticians and had no interest in dispensing—until the kickbacks were outlawed...
...Another witness, Maven J. Myers, an assistant professor at the Philadelphia College of Pharmacy and Science, told of a survey he had made, in a large but unidentified city, of so-called repackaging firms that buy drugs in bulk and merchandise them under private labels...
...Generally, the bill is intended to prevent physicians from selling and profiting from the drugs, eyeglasses, and devices they prescribe...
...and yet do demand excessive fees, and exact unreasonable prices for the medicines which they administer, and do too often, for the sake of making up long and expensive bills, load their patients with greater quantities thereof, than are necessary and useful...
...Paul T. Southgate, a Long Beach, California, ophthalmologist who opposes the Hart bill, testified that he is a member of the American College of Surgeons...
...A Spokane, Washington, ophthalmologist, who does not dispense eyeglasses, Dr...
...Dr...
...The Act, which endured only until the Assembly met again, is described in The Apothecary in Eighteenth Century Williamsburg, published by Colonial Williamsburg...
...Its ethics say that eye doctors "cannot ethically provide glasses" except in hardship cases, and "cannot derive income from merchandising and still be considered on a professional level...
...Marc Anthony before Senator Hart not long ago...
...Of every thousand prescriptions written by the doctor-owners, Myers testified, 104 were for penicillin products—a rate two and one-half times the national average, and eight times that among a closely-matched control group of prescribers...
...but from 1949 to 1954 dispensing was a violation of the AMA's ethics...
...At times in the Hart hearings the revelations seemed less surprising than the reactions to them...
...The effort was made in 1736 in the form of "an Act, for Regulating the Fees and Accounts of the Practices of Physic...
...Southgate was asked how he happened to have been dispensing during the years when the AMA said that to do so was unethical...
...They kept it pretty quiet," he said...
...It has an ethic flatly prohibiting physician ownership of drug repackaging firms, but the evidence is overwhelming that the ethic has had little impact on the practice it condemns...
...Certainly there are parallels between the problems and attitudes that led to the enactment of the Act of 1736 and that now have led to the proposal of the Medical Restraint of Trade Act by Michigan's Democratic Senator Philip A. Hart, chairman of the Senate Antitrust Subcommittee...
...The complaint in the Virginia law that physicians overload patients with medicines found a modern parallel in, for example, the testimony of Dr...
...Frances O. Kelsey of the Food and Drug Administration prevented marketing of the baby-deforming drug, thalidomide...
...The Act affords, writes Herbert Clarke, the apothecary of today's Colonial Williamsburg, "undeniable parallels to some current problems in the cost of medicines and medical care, and to the role of government in serving the interests of the 'consumer.' "In its first section, for example, the early Eighteenth Century Act performs an ethical massage on those "who often prove very unskillful in the art of a physician...
...Mintz is now writing new material to update his book, "The Therapeutic Nightmare," which will be published this fall in hard cover by Houghton Mifflin and in paperback by Beacon Press under the new title, "By Prescription Only...
...THE MERCHANT DOCTORS by MORTON MINTZ A mong the American Colonies only one, Virginia, tried to impose limits on various aspects of medical practice...
...Four of the enterprises were owned by fourteen physicians and osteopaths...
...How could he reconcile his membership with selling glasses...
...Dr...
...Southgate has dispensed for more than thirty years...
...He said he prefers to take "my opinion of ethics" from the AMA, which has "stood longer for the fact that we can dispense our own glasses...
...Senator Hart asked whether his proposed law would be "more respected than your ethic...
...MORTON MINTZ, a reporter for The Washington Post, won the Heywood Broun, George Polk, and Raymond Clapper national awards for his 1962 story of how Dr...
...Anthony accounted for the difference as being mostly exploitation of patients whose old glasses "are really O.K...
...He "did not know" of the ban...
Vol. 31 • October 1967 • No. 10
