The choice: Lewellys F. Barker and the full-time plan.
In 1914, Lewellys F. Barker, William Osler's successor as Professor of Medicine and physician-in-chief at Johns Hopkins University School of Medicine, resigned to enter private practice rather than accept the terms of a full-time plan, whereby professors in clinical departments would be salaried like other professors in the university. Barker had been an early proponent of the full-time plan. His decision reflected not only a personal desire for a larger income but also contradictions inherent in the Flexnerian ideal of clinical medicine as a research-oriented university discipline devoid of financial incentives to see patients. In private practice, Barker maintained a high profile as a teacher, writer, supporter of the Johns Hopkins medical institutions, and public figure. The issues raised by his difficult decision remain relevant and have not been satisfactorily resolved.
Bryan
Charles S
CS
Department of Medicine, University of South Carolina School of Medicine, Two Medical Park, Suite 502, Columbia, SC 29203, USA. cbryan@richmed.medpark.sc.edu
Stinson
M Shawn
MS
D015142:Baltimore; D015510:Clinical Medicine / Q000191:economics / Q000266:history*; D049673:History, 20th Century; D006785:Hospitals, University / Q000191:economics / Q000266:history; D012106:Research / Q000191:economics / Q000266:history*; D012456:Salaries and Fringe Benefits / Q000266:history