© 1988 by Society for the Social History of Medicine
Articles |
The Profits of Practice: the Wealth and Status of Medical Men in Later Medieval England1
*History of Parliament, University of London, Institute of Historical Research, Annexe 34 Tavistock Square, London WC1H 9EZ
Historians have long recognized that the practice of medicine in late medieval England was highly profitable, not only in financial terms, but also with regard to social mobility and status. This paper shows how doctors, retained either by formal contracts similar to those used for the recruitment of administrative or military personnel, or else employed on a short-term basis to cure a specific complaint, could move from one powerful patron to another and supplement their incomes with handsome rewards. Service with the nobility, or better still with the Crown, brought grants of land, well-paid offices, and preferment at court. Proximity to the monarch carried with it the possibility of political power; and some doctors abandoned their calling to hold government posts. Physicians in holy orders were able to accumulate benefices, but there were many surgeons, too, with impressive incomes on a level with leading gentry landowners. But there were drawbacks, most notably with regard to the collection of fees from patients who expected to be given extensive credit facilities—or even to avoid payment altogether. Doctors had frequently to allow for the likelihood of expensive litigation when setting their scale of fees and asking for securities before they commenced treatment. A wide range of manuscript material, including local records, has been used to document both the profits and the losses of medieval English practitioners.
Keywords: apothecaries; annuities; Chancery; Court of Common Pleas; law suits; medical incomes; medical fees; patronage; physicians; public medicine; royal household; social mobility; surgeons
1This paper was first given at a conference held by the Society for the Social History of Medicine at Oxford in 1985, and later at seminars at the Institute of Historical Research in London; and I would like to thank all those who took part in the discussions. I am particularly greateful to Dr Linda Clark and Dr Richard Smith for reading and commenting on the finished text.