The Hawaiian gazette. [volume] (Honolulu [Oahu, Hawaii]) 1865-1918, 1877-11-28
EDITORIAL CORRESPONDENCE. No. 1
The Medical and Surgical Monopo.
Iy at the Queens Hospital.


entitle me to speak with some degree of au-
thority The first topic to which l invite
the attention of my readers is the one named
at the head of this article, viz: THE MEDI-
CAL AND SURGICAL MONOPOLY AT THE
QUEENS HOSPITAL.
In the first place l would remark that the
legitimate functions of public hospitals are
two-fold. Throughout Europe and America |
these institutions are everywhere regarded |
not only as charitable establishments for the |
benefit of the patients treated therein, but also |
as fields of observation and study for the |
benefit of the medical profession, and through |
them for the benefit of the entire community;
and though the primary purpose of these in
stitutions, as charities, is regarded as para
mount and controlling, their secondary tunc-
ton as schools of practice is everywhere
recognized as equally legitimate and second
only in Importance to their primary humani-
tartan uses.
1t would be great mistake, however, to
suppose that it is the young and Inexperienced
only, or even chiefly, by whom these facil
ties are sought and priced. The foremost
men in medicine and surgery now living, men
whose names are known and whose authority
is recognized throughout The civilized world,
though burdened in many instances with
the cares of large private practice, are
rot only willing to take, but even eager to
get, hospital and dispensary appointments in
the large cities of EIrope and America, and
that, too, entirely without compensation.
In the part of the world where had the
honor TO receive my professional education,
number of medical men are always associated
together in the management of every large
public hospital. The putting of an institu
ton of this kind under the exclusive control
of any one man, is something which no Hos
pital Board would attempt, and to which, even
if attempted, the profession would not think
of submitting.
In the comparative isolation of professional
life in these islands, cut off entirely from the
vast advantages afforded by the hospitals and
dispensares of older and larger communities,
and cut off moreover from other professional
advantages not necessary to be here specified !;
both justice and expediency unite in dem; nd
ing that such facilities of this kind as the
comparatively limited resources of this coun-
try do afford, should be made as free as posi-
BILE to those practitioners desiring to avail
themselves thereof. The popularity of the
circumstances in which we are here placed,
calls for the exercise of the largest liberality
in such matters.
Now what is the policy which actually does
prevail? Under the present arrangement, the
entire medical and surgical practice of the
only public hospital in the country is made a
virtual monopoly in the hands of one man,
who, in addition to the liberal remuneration
received for his services, reaps the exclusive
advantage to be derived from the extensive
field of study and practice, which the hospital
affords. have io hesitation in saying, that
leaving out of account altogether the question
of justice and courtesy to other physicians,
the present system is one decidedly unfavor-
able to the highest usefulness of the hospital
and certainly not calculated to promote the
best interests of the public generally.
So far as the welfare of the patients is con-
cerned, the practical effect of the present
system is to deprive them of the benefit of the
united Judgment and skill of several ply
sicians, which they might easily have, and
confines them instead, to the comparatively
| limited resources of one. l have, more
over, abundant reasons for asserting most
positively that the popularity of the hospital
can be greatly increased and its ministrations
made much more acceptable to the class for
whom it is chiefly intended, by an enlarge
ment of its medical staff Concerning the in
/ terest which the public have in this matter, l
consider it only necessary to suggest that it
is the manifest interest of every member of
this community, that the men in whose hands
the life and health of themselves and families
are liable at any moment to be placed, shall
have granted them every possible facility for
improv ement in their arduous, responsible
and difficult calling
This, the present system of monopoly, effect
ually denies and prevents. That system be-
ing unjust and injurious alike to the patients,
to the members of the medical profession and
to the public at large, l hereby, in the name
of all the interests involved, ask for reform
1t should be remembered that in asking fol-
an increase in the medical and surgical staff
of the hospital and the adoption of a more
liberal policy toward physicians not officially y
connected Herewith, 1 simply invite the
Board of Trustees to put the institution in
these respects, on the same basis which in
other countries is fully recognized as being Oh
the whole the most desirable. feel assured
that majority of the members of the Board
honestly and earnestly desire the best inter-
ests of the hospital, regardless of any per-
sonal considerations whatever, and that they
will be willing to adopt any measures and in
stitute any reforms by which the efficiency ot
the institution can be increased, whenever
those measures and reforms can be fairly
brought to their notice and their true bearing
and operation discussed and explained.
am well aware that many objections will
be raised and many difficulties suggested ii
the way of carrying out the proposed reform
but cen confidently assure the Trustees, as
| he of !, 81,