Dr. Corey begins his talk by stating that the medical profession does not enjoy the same public respect as other professions, namely law and divinity. The public distrusts doctors and views them as a last resort, not as a primary advisor. Corey seeks the factors that have contributed to this "deep undercurrent of prejudice and suspicion pervading the popular mind." The feeling of alienation that he describes is commonly felt among his colleagues and he describes the disconnection as stemming from "some mysterious influence" that is difficult for doctors to distinguish because they are ingrained with their own defective system. "Circumstances are against us," he says, referring to the moral dilemmas unique to the medical profession. Therefore, physicians incur more popular suspicion than other professionals.
Doctors' ability to make a living depends on people falling sick, making practitioners more vulnerable to accusations of unethical practices there may be temptations to "give false or exaggerated diagnoses; alarming prognosis, to encourage dependence; ... pretending to discover disease without the required examination;&pretending to cure incurable diseases; unnecessary attendance for the sake of fees; disputing facts when proclaimed by a rival." He says money is a doctor's reward for falling into these moral traps. In defense of doctors, especially young physicians with educational debts to repay, Corey says "so every legitimate influence is eagerly sought which tends to bring a paying patient." Because some doctors fall to such temptations, and the public bears the harm of these physicians' immorality, they justifiably label the whole profession as crooks looking to swindle their patients. Especially for the non-medical public, it is difficult to discern moral from immoral physicians. He describes the vastly insufficient education of American medical students, and cites the resultant inadequacy as one of the reasons behind popular distrust in the medical profession.
Corey then launches into a discussion of the developing germ theory of disease and its implications for doctors. Knowledge of this field allows for the prevention and/or cure of infections. Therefore, doctors are presented with another moral predicament. Their duty is to provide to their patients all available means of curing and preventing illness, but in doing so they lose their major source of income. Corey branches into a discussion of the developing sphere of public health. Public health is greatly connected to the field of medicine in practice but, he says, there is tension between physicians and the area of public health because of its implications for their future. Corey asserts that this friction "can never evoke public confidence until philanthropy and self-interest are made to walk hand in hand." He maintains that in spite of these threats to their future role, doctors must perform preventative treatments on patients.
However preventative or curative measures benefit those around the treated patient, and therefore they should bear some of the financial burden of the patient. The citizens of Massachusetts do not pay enough to support their physicians and this discrepancy must be righted in order for physicians to make available to the public the new preventative medicine. He suggests "the State should educate and support a medical profession." Though most of the citizens who would be paying the small tax to support these schools would be healthy individuals, the system would be in their best interest because it would mean widespread administration of preventative medicine. State-funded medical schools would considerably decrease the problem of ill-educated physicians because there would be no pecuniary incentive or the schools to accept a larger, less-qualified student body, nor to graduate the students early, thereby producing better-quality M.D.s.