The times., 1897-06-22
The DOCTORS FOR The POOR
Health officer Woodwarfs Report
Defining Their Duties.
a Number of Suggestions Intended
To Improve the Service-A Closer
Supervision of Calls Desired.

The Commissioners have forwarded 70
ate District Committee, report OF Health
OFFICER DR. Woodward, on the duties OF
physicians to the poor and dispensaries
In the District OF Columbia, wi tn sug-
gestions relating thereto The fuI text
of DR.. Woodward's report is as follows:
1.-The work of the physicians to the
poor is supervised by the depar tment
through weekly reports submitted by them
and through prescr iptions issued by them
and returned TO the depar tInent as vouchers
by the druggists who have filled such
prescriptions Cases of alleged neglect
10 treat patients entitled TO the services
of these physicians are investigated Dy the
health officer, and, If there be any ap-
parent reason to suppose that cases are
being treated who are not enutled 10
such services, the Associated Cha riues LIS
called upon to investigate the matter.
.nNo physician whodesires TO secure l:iVate
practice would undertake TO tleat any large
number of poor patients at us offlce, Or
their presence there would keep d noie ue
sirable class away, chiefly by reason OF Tue
filthy condition of many such poor patients,
and partly through fear on the Iait OF lhe
better class being mistaken for paupers.
And in view OF the small compensation Ie-
ceived by the physicians TO the poor they
cannot afford TO maintain separate OF
fices for their official work. In further
view of such small compensation anu oi
the fact that dspensaries are inaintal
in various parts of the city, largely at
GoyeInnent expense, and ia ofdef U
diminish the work Of the physicians and TO
lessen the liability of - interfering Will
their opportunities OF securing private
practice, it has been tie Ioltcy OF this Dc
partiient to diminish such work as Tar as
possible by instructiEg them TO ueat Oh
ficialiy as office patients only such cases
as are unable to visit dispen safies FOR
treatment.
There is, therefore, in my judgment, very
great need for the establ siinent and nam
tenanee OF flee dispensaries in thus city
with the view of enabling the responsi-
lie officer to exercise closer supervision
over the work of the physicians TO the
poor, | respectfully suggest that all calls
for their services he taken either at the
uolice stations or at the various dispen
saries. already established or hereafter TO
in established, and that each Of them be
provided with telephone or that Their
compensation be sufficiently Increased 10
Justify the Commissioners in requiring them
to provide themselves with telephones.
The physicians could then be required to
call at these police stations or dispehsar ies
daily for routine calls as often as might
he found necessary, while emergency calls
could be transmitted by telephone from
such stations or dispensaries 10 the phys-
clans as soon as received. In this way a
permanent record would be made OF all
calls for the services Of the physicians to
the poor and of the time of their receipt,
so that any neglect or delay ia answering
them would be very easily detected.
..Such system would, furthermore, ex-
pose cases where any Of these physicians
decline TO treat without pay cases prop
eIly entitled to such treatment, or as
bid for private practice, treat private
patients Dominally ON the free list, SO as
to enable them To obtain medicine at
public expense. l do not desire to create
the impression that either OF these prac-
tices is common. but in particular Instances
the department. has had reason to believe
that they were being practiced, and has
found it practically impossible to either
verify or dsprove such belief
1.-THE superiority OF the dispensary plan
over the suggested arrangement OF provid-
ing for the treatment of all poor patients
by the physicians to the poor, lies in the
fact that the dispensary staffs include the
leading men in the medical profession. and
their equipment includes, or should include,
| the latest appliances for the diagnosis and
| treatment of the various forms of disease,
| while the physicians to the poor are usually
| taken from the younger practitioners whose
experience has been comparatively limited
who have not in their private work, and
cannot IN their official work, acquire special
| knowledge in any one branch, and who's
| financial resources would not, ordinarily
| justify them in providing ali the appliances
| afforded by institutions treating much
larger numbers of patients
| 1.-The dispensary system is, therefore
| in my judgment, a necessary part of
| any scheme for the medical relief of the
poor It's abuse arises from the failur'
on the part of those responsible for its
financial support to properly limit is
| facilities to the dependent classes, by
requiring evidence OF such dependency il
| order to secure treatment Money is, ar
| parently, often appropr lated or denatet
| for the support of these institutions upor
| the basis of the amount OF work done
| without sufficient consideration as to the
| limitation of such work to the dependent
| classes
''1n my judgment, the most beneficial
| results In the medical relief of the poo
| through dspensa ries can he obtained wheI
| the management of such institutions
connected with that of some hospital o
hospitals, and those in charge are author
| ized to grant certificates OF admission Z
| them
This permits the prompt disposal o.
such cases as may upon application tt
the dispensary for treatment be found b,
! the examining physician to require hos
| pital accommodation. The connection o
dispensary with a hospital, in addition
to facilitating the entrance of patients
into the hospital, provides the latter in
stitution with better facilities for treatin,
cases during convalescence. Such con
nection furthermore enables both insti
tutions To secure much more favorabi:
prices in the purchase of supplies.
..As matter of fact, however, the par
chase Of supplies for all of the institution
receiving goyernme Mt aid should, at leas
I Po~ frx- ffe if,,ra