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MEDICAL EDUCATION

tablishing a separate osteopathic board with power to license osteopaths—who will treat all diseases, and quite possibly in all sorts of ways—according to standards and methods fundamentally at variance with the main statute already outlined. The creation of separate boards is thus a roundabout method of recommitting the errors that the main currents of scientific thinking and effort are endeavoring to remedy. Our forty-nine states and territories have now eighty-two different boards of medical examiners. The province of the state in this matter is plain. It cannot allow one set of practitioners to exist on easier and lower terms than another. It cannot indeed be a party to scientific or sectarian controversy. But it can and must safeguard the conditions upon which such controversy may be fought to its finish. The mooted points concern only therapeutics; in respect to all else there is complete agreement. If matters in dispute are omitted from the examination, enough is left for all essential purposes. A single board should subject all candidates, of whatever school, to the same tests at every point. The license of the state is a guarantee of knowledge, education, and skill. The layman is in no position to make allowances. The state's M.D. and the state's D.O. offer themselves for essentially the same purposes. The state stands equally as guarantor of both. No citizen can indeed be wholly protected by the state against his own ignorance, fanaticism, or folly. A man who does not "believe" in doctors cannot be forced to call them in or to heed them, any more than a man who does not "believe" in wearing rubbers can be compelled to don them in slushy weather. The state is powerless there. But having undertaken to visé practising physicians for the protection of those who summon them, it must see to it that the licenses to which it gives currency bear a fairly uniform value. Between the graduate of Harvard and the graduate of the Boston College of Physicians and Surgeons, the layman could not judge even if he knew the origin of each; as a matter of fact, he rarely knows so much. But in the act of licensing both for one purpose, the state assures its citizens of their substantial equality. It is shocking to reflect that, what with written examinations and separate boards, the divergencies run all the way from a high degree of competency to utter ignorance and unfitness.

There is no question that in the end the medical sects will disappear. The dissenter cannot live on high entrance and educational standards. Pending his disappearance, the combination board is the least of the evils to which we are liable. The terms upon which these boards are now obtainable throw a strong light on the backward state of public opinion. In New York state, homeopaths, eclectics, and osteopaths, making together but a negligible proportion of the practising physicians of the state, have together a majority on the state examining board.

Under existing conditions, though the state boards might well be constituted on a uniform plan and with the same powers, a certain degree of diversity is unavoidable; but a certain degree of inevitable diversity is no excuse for hopeless confusion. The variations now found both in the laws and in their administration are fairly chaotic. In one state the board can and does fix entrance requirements; in the next