Evening star. [volume] (Washington, D.C.) 1854-1972, 1896-11-18
TOO MUCH FREE MEDICINE
A Committee Of Doctors Criticises the Hos
pital Service.
Charity Safd to BE Abused-Many Who
Are Able to Pay Treated
s'<-f Without Charge.

| t. inquire into the methods pursued nv the
various hospitals of tine city, has reported
at great length upon the subject and thu.
consensus OF their findings is that the local
uispeHsaries ana hospitals are abusing pub
TIC cnarity. Inc association, in appointing
| the committee, declared that IT did no, in
tend to be antagonstic to any of the ex
celleht medical institutions but desired to
protect Its members from imposition The
| association received the report November
10, and after eliminating many radical fea
tires, authorized its publication. The vol
luminous document recites the manner In
which the committee proceeded with the
| inquiries. and then declares that there is
| great abuse OF medical charity in all the
| hospitals and dispensaries." The commit
| tee furthe r declares that this abuse is esne
c;ally great in the central dispensary, mean
ing the Emergency Hospital, and asserts
tEat the majority of applicants here and
eiseWhere are able to pay for medical
treatment The course followed by the DO
nee IN removing sick and injured people
aHeh from the streets to hospitals instead
oi 10 their homes is condemned and the
Recommendation is made that non-residents
De charged small fee for treatment in
hospitals or be excluded from them
The Emergency Hospital is particular ;,.
cLiucised by the committee, which asserts
that 1T cannot be denied thai IL has ION,
SINCE ceased to be an institution of charity.
IN past years." says the report .ss
Wen as at the present time this las in
stitution the Emergency is referred to) has
operated to the greatest injustice to both
. . community and the profession. Injus-
tce 10 the community by educating them
mat they are entitled to the services of III.
gentlemen attached, free of charge at the
same tlme 1t assists in pauperizing the re.
clplents of those services for which they
could and should pay; Injustice to tho nro-
Iesslon by taking from their hands ca ses
OF sick and injured persons who rightfully
belong TO them, that the number of admls-
sions TO the hospital may be increased in
order to influence the appropriation com
mlttee OF Congress Cases have been
brought from Maryland and from Virginia
Tor neutrality-suspicious., fractures stab
wounds gunshot wounds disocations and
others-and II published accounts are of an,
value In this matter. they have never been
rejected; the records of the hospital will
show this. Only recently a man was
brought from Maryland; railroad en-
ploye, past villages where competent physI-
clans, members OF the Baltimore and Ohio
relief service, resided, and of which SER
wee this man was also a member any Of
whom would have willingly undertaken the
care OF the case. This man was entitled
TO the services of the company's surgeon
and as his injuries were of serious char
acter, he should have been sent to Provi-
dence Hospital, where the railroad company
pays the expenses Of treatment, but under
the rules of the police department, as laid
GOWN Dy the emergency Hospital this man
was not taken where he rightfully belonged,
but was brought to its wards. Here was a
fragrant injustice to many physicians along
the line of the route. Here is another }.
w. Rice, who resides at Bailey's Cross
Roads, Va, while digging a well, Saturday,
| was struck by a falling tub of dirt weig Ching
thirty pounds. Rice was seriously injured
internally, and was brought to the Elmer
-gency Hospital for treatment. These men
died of their injuries. 1t is useless to multi
ply cases of abuse. In the opinion of your
committee. the emergency department of
| any hospital should be operated upon the
same lines Of charity that would govern
individual charity. That man is sick or
wounded does not constitute any moral,
legal or financial right in his claim TO the
charity of community; II does not entitle
him to treatment without charge unless
such a right Is established in the first in
stance; neither does it tend 10 make him re-
tain his self-respect his independence of
spirit nor his standing in the community
for him to receive for nothing such services
as those for which he can pay"
Discussed in Later Years.
Continuing, the committee declares that
during late years the question of hospital
and dispensary abuse has been discussed
very extensively; SO far with more or less
relief in other cities. The remedy is only
to be found in harmonious conferences of
physicians attached to the institutions of
charity. Without harmonious action on the
part of the medical and lay directory of an
Institution, friction occurs and opposition
to mutual benefits is developed. The first
lesson to be learned is that the system of
admission is radically wrong. This is ap-
parent to any one who looks at figures.
The present uncontrolled system of free ad-
| mission does a great injustice to the pro-
fession and demoraliZes the patients. The
hospital managers are not free agents
neither are the medical men; they both
have received the trusts from their prede-
cesSorS, without question as to the abuses
which they were continuing. The lay mem
bers cannot enforce economy and institute
checks based upon business principles since
the staff would object to such an aSsump-
ton of authority: the medical members
cannot institute reform in admissions as
the lay members would think such reforms
were based upon improper motives, but
there is no question that by mutual con-
cessions and harmonious conferences every
abuse with which they may be charged
can be corrected. Antagonisms would van
ish, the profession would regain its re-
spect and pauperism be checked. The elee-
mosynary medical institution works a
grievous hardship upon the young physi-
clan, since ii compels him to render service
gratuitously upon their board wait idly
to gain such experience as he needs. If the
eieemosynary institutions are abolished
the management will be free to remedy the
abuse.
The statistics of the various patients
given hospital and dispenSary treatment in
the local during me year end
ing June 30. 1885, are given, showing that
a total of IS, $50 were treated including To-
80 by the physicians of the poor, and the
&C mmittee declares that at least 30 per cent
of these were free cases The committee
concludes that there is great abuse of med
ioal charity: that the majority of appli-
cantS at dispensaries and hospitals are able
| to pay a physician a fee, to be regulated by
! the amount of wages received, and that the
working man is able to pay his physician.
The RecOmmcn nd atfOns.
| The recommendation made by the COM
mittee are as follows:
| First-That every institution require writ
| ten evidence, in the form of q certifica te
| from every applicant for free treatment at
| every institution. supported in part or in
whole by the government.
| Second-That there be a central dstri-
| button bureau, where all applicants for
| free medical aid be required to apply, pre-
| sent their evidence, and receive the certi-
| ficate necessary to their admission to any
| charitable medical institution, such cer:ifi-
| Gates to continue in force for thirty days.
| Third-That this bureau be in charge of a
| salaried medical officer, whose record of
| applics nts shall be open for public inspec-
| ton under certain restrictions.
Fourth-That cases of sick and injured
persons found upon the streets, in the
Icta nr ole -har ioh i,1-a