The full content of Annals is available to subscribers

Subscribe/Learn More  >
History of Medicine |

The Choice: Lewellys F. Barker and the Full-Time Plan

Charles S. Bryan, MD; and M. Shawn Stinson, MD
[+] Article, Author, and Disclosure Information

From University of South Carolina School of Medicine, Columbia, South Carolina.

Presented in part as the Osler Oration, Osler Club of London, Royal College of Physicians, London, United Kingdom, 12 July 2001, and to the American Osler Society, Kansas City, Missouri, 24 April 2002.

Acknowledgments: The authors thank Nancy McCall, Andrew J. Harrison, Marjorie W. Kehoe, and Gerard J. Shorb of the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions for access to archival materials.

Requests for Single Reprints: Charles S. Bryan, MD, Two Medical Park, Suite 502, Columbia, SC 29203; e-mail, cbryan@richmed.medpark.sc.edu.

Current Author Addresses: Drs. Bryan and Stinson: Department of Medicine, University of South Carolina School of Medicine, Two Medical Park, Suite 502, Columbia, SC 29203.

Ann Intern Med. 2002;137(6):521-525. doi:10.7326/0003-4819-137-6-200209170-00013
Text Size: A A A

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.


Grahic Jump Location
Figure 1.
Lewellys F. Barker (left) with William Osler in 1909.

Courtesy of the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions, with permission.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Franklin Paine Mall, principal architect of the full-time plan.

Courtesy of the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions, with permission.

Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.