To the Editor.—I read with a good deal of interest your editorial, "Fees: A Perspective" by Robert M. Goldwyn, MD, in the August issue of the Archives (107:127, 1973).
I have been practicing orthopedic surgery for 39 years and have done hundreds of operations.
I think that one thing that should be kept in mind when discussing surgeons' fees is the strain under which a surgeon works. Whenever one of my patients is given a general anesthetic for a surgical procedure, I always enter the operating room apprehensively.
Now that we have blood banks and blood easily is available, the great strain of the big hip and spine operations, which we used to have years ago, has virtually disappeared. Then it was a race between the surgeon and death as to who would win.
The other factor to be considered is malpractice. In just about every instance it is