Cottage Industry

David A. Rothstein, MD
JAMA. 1976;236(14):1578. doi:10.1001/jama.1976.03270150016019.
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To the Editor.—  After the criticism which has been heaped on the profession of medicine for being managed like a cottage industry, I feel impelled to note that the Industrial Revolution wiped out the former cottage industries (Time, July 14, 1975, p 54).My hope is that our social planners will not wipe out medical cottage industry and create "dark Satanic mills" to process "health" as a "commodity." I was reminded of this by a recent advertisement sent out by American Express. Whatever the true artistic value of the items may be, the promotion material took pains to point out how the items were created by expert silversmiths in India, working in the fashion of "cottage industries" of another age, with the kind of old-world care and pride of "cottage industries" as the only way such true artistic excellence and lasting beauty could be realized.


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