Daniel Webster Cathell MD (1839–1925) began writing his book “The Physician Himself” in 1882 to help new physicians in America prosper. His book was so popular that it was in its tenth edition in 1892, last revised in 1922 and republished in 1931.¹

In those days, before the reforms in American medical education driven by the Flexner report of 1910, it was easy to become a physician—many men did so, but only a few prospered in this competitive world of private practice. These struggling practitioners were Cathell’s readers. Cathell wrote so well it is best to quote him directly.

In 1890 he wrote: “The standard has fallen lower and lower, until we have at last reached a point at which the ... brainless bumpkin ... who is following the plow ... thinks he can find a place where he can be metamorphosed into an MD tomorrow and that a sign or doorplate with his name (and the prefix Doctor) on it and a buggy at his door is about all that is necessary.” (1890, page 9)

At the court of public opinion Cathell said the doctor had to behave with dignity, look the part, and show himself properly to his hoped for patients. In 1890, when home visits were at the center of practice, the doctor either walked or went by horse to see his patients.

“If you unfortunately have a bony horse and a seedy looking ... buggy, do not let them stand in front of your office for hours at a time, as if to advertise your poverty, lack of taste or paucity of practice.” (1890, page 22)

By 1922 Cathell was recommending a car which, unlike the buggy horses, did not get tired going up hill.

“Clean hands, well-shaved …