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450 ELMER: FIRST FIVE YEARS. in the ward voltaren topical which is under the care of your senior, and after that a class of medical students to teach leaves generic for voltaren you barely lime to see one or two of your own patients who live in widely separated parts of the city, and returning; to your office at nightfall, tired after your arduous day, you have a voltaren 100 mg retard patient coming for a blood count or a physical examina- tion when you are too weary to take much interest in his case. And yet, after just such a day's work, you may not have earned more than five or six dol- lars, and there is no assurance that voltaren xr 100 this will be paid. Your classmate in the country or in the small town has patients come to him because he is the newest arrival in their voltaren in usa community and therefore they generic name for voltaren know- that they may have his services for a small fee. And so he voltaren rapid 25mg sees as his private patients the same class of persons whom you attend in your out pa- tient clinic free, It makes a great difiference to be out of reach of the large hospitals in this particular. A young physician told me recently that he had just completed his first year in practice and had the names of six hundred and fifty dififerent pa- tients on his records. This young man at the end of his second year is busy from morning till night. He is, however, working in a district fifteen miles away from the centre of Philadelphia. Contrast with this the statement of the most emi- nent neurologist of London, that he was forty-two years of age before he was earning sufficient money from his practice to support his family, even though at that age he was known throughout England as a leading authority. How much money must you earn in order to be self supporting? That is a question which some of you must consider carefully. I have calculated that the lowest possible figure to cover all one's expenses voltaren in canada in the centre of Philadelphia is voltaren 75 sr eleven hundred dol- lars, the chief item being for rent, for suitable of- fices in a good location are very desirable. It re- quires the strictest economy to keep within this lim- it. In New York, rents are much higher and living expenses are also somewhat greater,"and four hun- dred dollars should be added to the amount stated. In small towns or the country one voltaren ec thousand dollars should suffice. A single man can live very com- voltaren xr 100mg fortably in Philadelphia on eighteen hundred dol- lars. You must, therefore, average about two pa- tients a day among the best class, or from four to six among the persons of moderate means. Now and then an operative case may yield you from twenty-five to two hundred dollars, which brings up the average very considerably ; or it may be some special blood study or voltaren for sale stomach work or uranalysis for an older physician which may yield you a ten or even twenty-five dollar fee. Anjcsthetics pay very well, if you can secure the opportunity for giv- ing them occasionally, and will pay you from five to twenty-five dollars, according to the nature of the case. In New York the fees for anaesthesia by an expert go as high as voltaren generic name two hundred dollars. This is, of course, very unu.sual. If you are fortunate in obtaining a permanent connection with one of the large hospitals, if you have several friends on the attending staff, voltaren ec tablets 50mg and if you are possessed of an infinite patience, you might well consider the prospect of a city practice. You will probably require financial assistance to help out your earnings for two years and perhaps five, according to your location and opportunities. Your classmate in the small town or country district will probably be self voltaren sr 75 mg tablet supporting in three months. If you decide upon the centre of a large city eventually, you should at the end of five years in general work decide upon some special line and fol- low that voltaren sr 100mg at every opportunity and perfect yourself in every detail of it. For the successful men in the centre of our large cities are for the most part known especially in some special department of medicine or surgery, and all of them hold teaching or hospital positions. Under these circumstances there is little room for the outsider. Have I discouraged you with the picture? I do not mean to. Your goal is difficult, far too difficult for some, but it is well worth the efifort. It is won only after years and years of work and patience. Those men who succeed quickly and brilliantly voltaren xr 100 mg are fortunate in having in addition to' their exception- al ability an opportunity for success voltaren 50mg diclofenac which is an absolute guarantee for the future. This good for- tune does not fall to the voltaren ec 75 mg lot of everyone. A promi- nent man retires and his work falls to his assistant. .V young man still in his thirties receives a profes- sorship or is elected attending physician or surgeon

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