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Making a Medical Living


  • Page extent: 372 pages
  • Size: 228 x 152 mm
  • Weight: 0.72 kg

Library of Congress

  • Dewey number: 362.1/0941
  • Dewey version: 20
  • LC Classification: R486 .D54 1994
  • LC Subject headings:
    • Medicine--Great Britain--History

Library of Congress Record

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 (ISBN-13: 9780521345262 | ISBN-10: 052134526X)

  • Also available in Paperback
  • Published August 1994

Manufactured on demand: supplied direct from the printer

$175.00 (C)

Making a Medical Market begins with the first voluntary hospital in 1720 and ends in 1911 with national health insurance. It looks at different forms of practice--public appointments in hospitals, office under state welfare systems, and private practice. From the 1750s medicine became more commercialized. Doctors were successful in raising demand for their own services but were unsuccessful in restricting competition. Many medical practitioners struggled to make a living by seeing many patients at low fees, so that "five minutes for the patient" is not a new feature of health care.


Introduction; Part I. The Professional Structure of Practice: 1. Medical practitioners; 2. The context of practice; 3. Medical encounters; Part II. The Economic Dimensions of Practice: 4. The creation of surgical general practice; 5. The GP and the goal of prosperity; 6. Physicians; Part III. Patients and Doctors: 7. Medicalisation and affluent patients; 8. Office, altruism and poor patients; 9. Expanding practice with women and child patients; Part IV. Synthesis: Reflections.


"...Anne Digby brings an impressive grasp of the literature of medical history and the social history of medicine and an imaginative search for fresh sources. ...this is a delightfully written and appealing example of modern scholarly work." Journal of Economic History

"Now that the government is bent on reintroducing market principles into medicine, Anne Digby's original and informative analysis of the business of medicine before state intervention this century is especially timely. Drawing upon diaries, account books and other fascinating sources, she shows that traditional medical practices rarely corresponded to the neat-and-tidy hierarchical model set out in the old history books..." Roy Porter, New Scientist

"Anne Digby's valuable study does the profession a service in showing that it had more honour and conscience than could be expected from the conflicting demands of altruism and entrepreneurship." Anne Crowther, Times Literary Supplement

"Anne Digby's 'Making a Medical Living' is...a welcome and important book. It combines a synthesis of existing literature with much new research, especially in English provincial archives, to provide a richly detailed picture of how doctors made a living from the Georgian period until the National Insurance Act of 1911." Lisa Rosner, Albion

"Anne Digby's book is a solid, well-researched account of the English medical marketplace in the period between the founding of the first voluntary hospital and the inception of national health insurance....On the whole, this is a kindly book that leaves the reader feeling sympathy for the common run of doctors who invested much hard-won capital and many years of training in the effort to win a place in an overstocked and challenging profession." American Historical Review

"This is a thoroughly researched, solid, workmanlike volume that readers can look to with confidence. Certainly the book's most impressive feature is Digby's re-creation of the working lives of provincial doctors and their interactions with patients and colleagues. What is most refreshing is the author's open-minded point of view, steering clear of rigid orthodoxies, and letting the sources speak for themselves. Consequently we see medical practice as a job, and doctors, not as heroes or exploiters of humanity, but as reasonably decent people trying to make reasonably decent lives for themselves....Perhaps in future years Digby will use her well-honored research skills to further elucidate this fascinating and important topic." Judith Lewis, Journal of Social History

" Anne Digby reminds us that while physicians in the past treated patients, invented new medical theories, compounded medicines, and made discoveries about the human body, they also made a living...much of Digby's story is familiar to us - marginal men delivering babies, taking care of the mad, treating the poor, and praying for wealthy patients. However, by putting medical economics at the center of her tale, she forces all of us to see what we thought were familiar developments in a new and sharper light." Bull. Hist. Med.

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