Philip Rieder
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‘Making a living’
Accounting and the medical market in and around Geneva, 1760–18201
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Accounts related to private medical practices and held by the practitioners themselves are both a part of medical activity and vehicle of information about healers’ practices and outlooks. This chapter is based on the ledgers written by three healers active in the last decades of the eighteenth century in the Geneva region: a country surgeon, a physician established in a small town, and a physician working in Geneva itself. Each practitioner imagined a structure and a code in order to elaborate and keep information about his practice and payments made. In proceeding thus, he surrenders information relevant to the meaning the accounts had for him and the organisation of his practice. The items listed inform both on the services offered, the value given to them, the expediency of clients to pay, and the different medical strategies adopted. Sometimes bills and accounts are clearly related, elsewhere emphasis is on certain types of clientele and, in one case, accounts aimed to estimate the progression of practice and, ultimately, the physician’s success. Comparing accounting practices carries information on the varying nature of medical services from one practitioner to another, on the value of medical counsel, and the social uses of medicine. Town and country practices are complementary, and practitioners from each environment bill different types of services. Contrasting these account systems enables us to understand how practitioners adapted to the demand and reveals something of the nature of the relationship the practitioner established with his patients and the type of medicine he offered.

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Accounting for health

Calculation, paperwork, and medicine, 1500–2000

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