Formerly this was not so, and as a rule the early years of practice lay chiefly amongst the working classes; by degrees the wealthier came, and the former were dropped as the latter increased. As an esteemed teacher used to say, the doctor climbed over the backs of the poor into the pockets of the rich. This method of making a practice has now all but vanished, owing to the introduction of the National Health Insurance Act. Every insurable person (and they are by far the majority) has allocated him or herself to a particular panel doctor, and so if a new practitioner establishes himself in this locality, he finds very few working-class folks available on whom to exert his skill. It is necessary, therefore, for him to possess sufficient capital to maintain himself for a few years, or until he draws a practice amongst the better or uninsured classes to himself.

If, on the other hand, he has but a little capital, then he is almost forced to expend this on the purchase of a panel practice, when he will at once be in receipt of an income from the State. Without the purchase of the whole or of part of a panel practice, it is extremely hazardous to commence on one's own account in a working-class district. The panel patients have already been allotted to various practitioners and it is very unlikely that they will change their doctor unless there is some grave reason. The patients whom one would be likely to get in such a locality would probably be those uninsured, who were either unable or unwilling to pay for medical attention.

Choice of a Locality.-One should be very careful

in selecting a locality in which to commence practice. It may be a matter of indifference to the young unmarried man, but it may be very different if he is married. His wife may not care to be isolated in some village or small country town, and instead of the "pure pleasures of the rural life," might prefer the more active joys of the city. Again, one has to consider the needs of a family. When the children are very young, the country school or governess may suffice for their needs. As they grow older, however, a higher school education has to be given, and this entails either railway journeyings or boarding them from home. These and many other points have to be considered before one finally settles down, because it is very difficult to change one's locality later on in life.

There is little prospect of success, at least not for a very considerable time, if one settles down in the residential district of a city which is probably already only too well supplied with medical practitioners. If such a locality be selected, then immediate success can only be obtained by joining as partner an older and already established practitioner.

For a young man who does not wish to be associated with another, but prefers a noble independence, then a growing suburb is a much more promising locality in which to commence, and more especially if the inhabitants consist largely of the working or lower middle class.

It will depend on the taste of the practitioner as to whether he prefers a town or country practice. In the latter case, he will lead a far more natural and healthy life though perhaps a harder one. The

distances he has to travel are often great, and he can seldom get the help of a brother practitioner.

On the other hand, there are opportunities for many outdoor amusements, boating, fishing, shooting or hunting. As regards expenses there is, perhaps, not much difference; the cost of running and upkeep of one's car is high in the country, and there is also the cost of educating one's family away from home. On the other hand, in towns house rent and rates are high and there is the constant temptation of shop windows, concerts, theatres, etc., to induce a transference of owner to those coins which our labour has gained.

Choice of a Dwelling-house. If one is engaged in panel work, then it is not absolutely necessary that one should live in the locality where the chief part of one's work lies; indeed, in many cases this would be very undesirable. It is, however, necessary to have a surgery in the locality to which the insured persons may go for advice or treatment at appointed hours. The dwelling-house ought, however, not to be too far away, as it gives the insured added trouble when he requires medical help out of the usual hours or during the night.

When, however, the practitioner does not undertake panel work, then it is a matter of choice where his dwelling place is situated in the locality. By preference, however, it ought to be conveniently placed for his patients, and in a street more or less public. The ordinary patient will seldom put himself to the trouble of searching for a doctor unless he has been specially recommended.

In selecting a house, choice should be made of

one which, though it need not be imposing, ought yet to be of a superior and dignified appearance. The doctor's house ought to stand out from its neighbours-indeed, to have an air of distinction.

On the gate or door one's name ought to be fixed, usually on a brass plate, with the prefix " Dr.," or, if you prefer, the affix "M.D." following the name. Licentiates of the colleges legally are not allowed to use the term doctor, but in practice this courtesy is extended to them, and it is usual for them to style themselves on their door-plate and elsewhere as Dr. So-and-so. In the case of one who practises surgery only, it is customary to style oneself merely Mr. So-and-so, Surgeon.

It is unusual in this country to designate oneself as the exponent of any speciality, as aurist, oculist, etc., nor does one add to one's name Fellowship qualifications.

The former appanage of the red lamp above the doctor's door has now almost entirely passed away.

Management of the House. In the great majority of cases the doctor's dwelling-house contains also his business premises-his consulting-room and one or two waiting-rooms. The former ought to be a good-sized room, and well furnished. Nothing impresses patients so unfavourably as a badlyfurnished and unattractive consulting-room. It ought to be kept very tidy and clean; an untidy room, with journals, books, papers and instruments lying about, will not prejudice your patients on your behalf. A couch is necessary for the proper physical examination of your patients, and a table lamp for

the investigation of eyes and throats, etc., must be provided. In a closet or room leading off, there ought to be a basin with hot and cold water supply.

The waiting-room also should be comfortably furnished and kept well warmed. Too often one sees a cold, bare, gloomy room set apart for this purpose. This is quite unnecessary; it ought to be a bright, cheerful apartment, so that one's patients will not become depressed in spirits while waiting their turn, which is often a long time in coming.

As regards the domestic arrangements, one has to see that the maidservant who attends the door and admits the patients is polite, tidy and active; patients do not like to be kept waiting at the door. When you become prosperous, or if you desire to make a deep impression on your patients, and more especially if your practice is confined to the aristocracy, you will, no doubt, make an addition to your troubles in the shape of a manservant. Be under no delusion, however, that he requires no supervision. Every servant requires and, indeed, expects that you superintend him or her carefully.

If you have a family of children, they must not be allowed to run about the house when patients are being shown in. Remember that your house is your business premises, and what would we think if we saw children running about our lawyer's office? The presence of children gives too homely a look to the waiting or consulting-room.

The patient, when he enters the doctor's house, should be impressed by the politeness of the servitor, by the orderliness of everything, by the usefulness