Fee-for-service Professors, by James Howard Means

Sign in to access Harper’s Magazine

Need to create a login? Want to change your email address or password? Forgot your password?

  1. Sign in to Customer Care using your account number or postal address.
  2. Select Email/Password Information.
  3. Enter your new information and click on Save My Changes.

Locked out of your account? Get help here.

Subscribers can find additional help here.

Not a subscriber? Subscribe today!

Get Access to Print and Digital for $23.99.
Subscribe for Full Access
Get Access to Print and Digital for $23.99.
October 1960 Issue [Article]

Fee-for-service Professors


In the eighteenth and early nineteenth century, students in medical schools paid fees directly to their professors — a fee for each course of instruction. The great John Hunter’s fatal attack of angina pectoris was induced by a quarrel with the other members of the staff of St. George’s Hospital over a problem of fees paid by students to teachers. At Harvard also in the 1840s, students paid fees directly to their professors for courses. For the course in anatomy and operative surgery by Dr. J. C. Warren they paid $15, and for that on materia medica by Dr. Jacob Bigelow the fee was $10, and so forth. But all that is long past history except perhaps in the case of certain graduate courses. Therefore, we may ask, if a better way than fee-for-service has been found for paying for instruction, why should not a better way than this be found also for paying for medical

—James Howard Means, M.D., in the George W. Gay Lecture at Harvard Medical School, May 13, 1959

More from