The Employment of Sanitarium Physicians
With the consideration of the relation of the work of the medical superintendent to that of the business manager, the question of proper remuneration to physicians was raised at our medical conventions last spring. We now give the substance of some of the discussions:— Dr. H. W. Miller presented the topic by stating that in some places, physicians were employed in sanitarium work on a commission basis. While beginning with surgery, the principle had entered other lines of medical work, and was even beginning to show in other departments of the institutional work. He said:— “I cannot conceive of a successful superintendent who does not give his whole attention to the institution. I do not know how he can divide his time between his own interests and those of the institution. I cannot understand just how he would draw the line between personal interests and those of the institution. I should not wish to be in a position so trying as that, and offering such temptation to serve one’s own interest. “I recognize that our doctors do not receive a high remuneration, but every worker in this denomination is paid a low wage as compared to salaries of the world. Our work is operated on a missionary basis, and as missionaries we are to sacrifice. So the question becomes one of operating our sanitariums in harmony with the spirit of our work and message. “It is essential for any worker to live with an institution and sacrifice for it. I see no reason for the percentage basis for the superintendent or for the surgeon. A percentage should not be given to one unless it is given to all. If it is right for one, it is right for all. If it is an incentive to better work on the part of the physician, it should be the same for every other worker in the institution, and in every other line of our denominational work.” I. H. Evans: “Very few things succeed of themselves. A thing to succeed must be managed. It will not run well if its head is engaged in outside interests. A school cannot prosper without the undivided attention of those who are directing its efforts. That holds true in sanitariums. “Sanitariums are a part of our organized work, and require the same care and attention to make them succeed as does any other part of the work. The head physician in the sanitarium is more important than any one else. He, above all persons, needs to give it full attention. The manager cannot be a substitute for the doctor. The institution cannot be expected to succeed unless it has the doctor’s undivided attention. “The institution cannot get along well unless it has some one to suffer with it. This suffering is a necessity. There is a great difference between a sanitarium with a God-fearing head physician who suffers, toils, and prays for the institution, and one that is left entirely in the hands of the man who is working only for money. In the latter, one can expect only trouble, debts, and failure. “The doctor who really makes a sanitarium a success is the one who is in touch with everything in it. His whole time is needed. We invite failure under any other condition. I do not believe we can ever make any of our institutions succeed unless the men who are responsible can stay right with them. The growth and strength of an institution lies in the head and leader. There has to be a great motive power put into it to make it grow. The head of the institution must give his undivided time to the development of the work. “The relation of the medical superintendent to the business manager should be that of cooperation. These two should work in the closest sympathy. Friction between them will make success difficult. It is hard to run anything without cooperation. The business manager can strengthen the physician if he has the physician’s sympathy, and vice versa. “The head of the institution should lead. Our medical men should be strong, spiritual, godly, genuine Seventh-day Adventists, loyal to every principle of the third angel’s message. Their whole lives should be given to the carrying out of the ideal, the attaining of the object the denomination has in operating sanitariums. It is difficult to reach perfection, but we can aim at it. Our goal should be high. “The sanitarium should run on both medical and business principles. Medical work can be conducted on both professional and business principles. That does not mean speculation or commercialism, but simply the use of proper business methods. We cannot afford to run any of our sanitariums on a strictly worldly basis, yet we can adopt business methods. We can carry our sanitarium work on good, sensible, courteous business principles. No business manager ought to make it hard for the doctor, but should do his utmost to aid and help him. The medical men should not assume and carry on the business of a sanitarium where there is a business manager. Doctor and business manager should study courtesy, and seek for methods that will be helpful to all.” F. M. Wilcox: “It is true that nothing militates more against the success of an institution than friction between responsible workers. To avoid misunderstanding they should keep in close touch with one another. We lack frankness. We fail to come in close relation with one another. There are no problems in sanitariums that cannot be settled by a frank understanding. We ought not to allow a day to go by with difficulties unsettled. Little misunderstandings will start great misunderstandings. “Should our medical workers be regarded as gospel workers? Should they operate on a missionary basis or on a commercial basis? When these foundation principles are settled, these other questions will adjust themselves. They lie at the foundation of the whole thing. I fail to see how a physician can be given to commercial work and that spirit not pervade the whole institution. The very position the superintendent occupies, if he follows that principle, puts that spirit unconsciously into the hearts of all the workers in the institution.”17 W. T. Knox: “There ought not to be much trouble between the medical and business sides of the house. Where there is, it is generally due to thoughtlessness to begin with, and to oversensitiveness in keeping it alive. It is very easy for us to go over the line. If we have the right spirit, notwithstanding we make mistakes, we can avoid trouble. We may even avoid making mistakes. “The superintendent is to be the inspiration of the institution. He is particularly responsible for the character of the institution. There is not room for a division of his service. As a minister of God’s grace, he must stand in his place, loyal to his one work and its interests. “As touching the question of service, it seems to me we must have a clear, definite policy. We do not have to go very far nor wait very long to find clear lines of policy laid down as governing our brethren and sisters who are nurses. It is evident that they should give their whole service to God. They should not debase their talents to simply selfish motives. There is no place in this work for the service of self. “This question of compensation seems a hard one. It has caused more discussion in the medical than in any other work. It has been settled, and it is still unsettled. I cannot but believe that the denomination has arrived at a right conclusion on the subject; but if it has not, we ought to find it out. As a result of the right position not being fully maintained by all who have connected with medical work, some sanitariums have been brought down to the level of hospitals. Today we have institutions among us where this thing is the cause of great perplexity to their constituencies. “The General Conference at one of its recent councils adopted a series of resolutions, not especially aiming at the medical side of our work, but endeavoring to help all phases of the work. There were present at the council adopting these resolutions several physicians. The action is on the equalization of the wage scale, and I read from it the following:— “‘We recommend, That our sanitariums do not arrange for the medical work of an institution to be done by a physician from without, having a private business of his own, but that the medical work be in the hands of a physician wholly in the employ of the sanitarium.’” “The series of resolutions deals with the departments of our work and with various questions arising in it. This resolution was not the result of a sudden impulse, but of days of study. It sets forth our ideas of the basis on which we all work—that is, as workers together on a missionary basis. It guards against some things that experience has shown to be detrimental to the true missionary spirit. “We cannot give place in this work to the spirit of self-serving. The cause of God will go down under that, and the cause of self will be the cause cared for. If the brethren who have studied this action and have looked at it from the other standpoint find we are wrong, we ought to be corrected. “The Spirit of God has made plain the importance of the medical work in its relation to the closing work of God in the earth. The medical work was not established for any mercenary motive. The question of possible financial profit did not enter into the original establishment of sanitarium work. The missionary end of these institutions was the one thing in view. “Our sanitariums have been established to assist the work of God, and are a part of his work. They should be so conducted. Every one who enters the service of God, in whatever capacity, does so for the opportunity to help build up the kingdom of God, and not for personal gain.” G. B. Thompson: “The real question is, What is best to do in carrying on institutional work? The very best thing for one branch of the work would be good for every other branch of the work. Would it be best for the president of the General Conference to devote a portion of his time to outside work? The same question would apply to all other workers. Would such a course have the best influence on the denomination, on the individual, and on the institutions? “If it is proper for one person to receive special privileges, it is proper for everybody else to receive them. If it is proper for the superintendent, it is proper for the business manager, the cashier, the nurse, and every other sanitarium worker. And if our sanitariums can operate that way, our schools can do the same. How could our schools then train missionaries? The thing savors too much of commercialism.” A number of others, ministers and physicians, spoke to the question. The following resolution was adopted:— “Resolved, That we hereby express our approval of the general wage scale adopted by the General and North American Division Conference Committee, and advise the various institutions in this field to adopt this scale as early as consistent. “Resolved, further, That we accept the recommendation of the above committee in disapproving of employing workers on a percentage or commission basis; and that workers be employed to give their undivided time and attention to the interests of the work in which they are employed.”