Trinidad's Doctor's Office by Vincent Tothill

Author:Vincent Tothill
Language: eng
Format: mobi
Publisher: Paria Publishing Company Limited
Published: 2014-03-05T23:00:00+00:00

CHAPTER IX: Fees and Foibles

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IN October, 1928, I returned to Trinidad from England and resumed my private practice in San Fernando. I re-entered my office over the Rum Shop as though I had never been away. It seemed surprising, after three years’ absence, to find a dozen patients waiting for me on the first day. My income for that first month was the same as it was for the last month before I left. I had the advantage, of course, of being much better known as so many thousands of new people had been through my hands at the Usine. Many Usine people came to me in San Fernando simply because they knew me.

During the next ten years the Usine had several changes of doctors and sometimes long intervals without one. During these periods I acted as their M.O. and during all my association with them, there were the same harmonious relations. During 1936 and 1937, instead of getting another whole-time doctor, they gave me a retaining fee and I did their work as well as my private practice.

This retainer was at the rate of £500 per annum and, with the addition of my private practice, made my income a very good one. Most people thought I was a millionaire; I wasn’t, but I was nevertheless quite well off. So many people think doctors are overpaid, but they have little notion of what the fees are if they are spread over the year and divided by the number of patients seen. The small fees per head would surprise many people, and the number of people a doctor has to see per annum to make £1200 is also surprising.

Fees in San Fernando were one dollar, without medicine. Medicine cost half a crown to three and sixpence. I used to charge the same dollar fee for an intravenous injection of Salvarsan, providing the patient bought the Salvarsan himself. It cost him the same money as a bottle of medicine, usually three and sixpence a dose, or one dollar a dose, according to the number of grammes.

I used to see 7000 attendances per annum in my San Fernando office, which represented 3600 individual cases. My income from these people was $3600 per annum. That gives an average charge of half a dollar, or two and twopence. Surely that is not an exhorbitant fee to charge humanity for expert work? Added to this I made another £200 a year by running my own dispensary. When I had deducted my running expenses from my total income of £1400 a year, I consider that I earned every cent I received. In my later years I believe the total number of attendances was considerably higher, as I used to encourage people to come back by telling them they would not be charged another fee. I wanted to check up my results and to see if they really were better. I learnt much this way, and eventually I could wean some of them successfully from the bottle of medicine fetish and try to make them spend their money on food and the right kind of cooking.

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