Making a medical living

How did doctors make a living? Making a Medical Living explores the neglected socio-economic history of medical practice, beginning with the first voluntary hospital in 1720 and ending with national health insurance in 1911. It looks at private practice and how this was supplemented by public appointments.

In this innovative study, Anne Digby makes use of new archival sources of information to produce a compelling picture of ordinary rather than elite doctors, and of the dynamics of provincial rather than metropolitan practice.

From the mid-eighteenth century doctors travelled to see ordinary patients, developed specialisms and expanded institutions. Despite limitations in treatment, doctors raised demand for their services as illuminating case studies of women, children, the poor and the affluent show. But doctors did not limit their own numbers, and were largely unsuccessful in restricting competition from other practitioners, with the significant exception of women.

Consequently, many GPs struggled to make a living by seeing numerous patients at low fees. Doctors' entrepreneurial activity thus helped shape English medicine into a distinctive pattern of general and specialist practice, and of public and private health care.