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History of Medicine |

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

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

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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.

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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.

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