Evening star. [volume] (Washington, D.C.) 1854-1972, 1898-01-03

April o.
Exclusion of Family Physicians.
"Rules I. II. III. and " appear to have
met with his approval, but he objected to
rule v. which reads: That members of this
association shall be entitled to the privilege
of attending private patients occupying pri-
vate rooms In any Of the public hospitals
Of this city, His objections, stated on
pages 24S and 249, are, in our opinion, not
sustained.
I'm the first place it should be remem-
bered that members Of this association are
legally qualified practitioners of medicine,
and 1t Is not to be assumed that members
Of the attending STATS Of hospitals are the
only qualified practitioners in a city. Many
OF the pay patients in hospitals become
inmates thereof on the recommendation of
their family physician, in order to factli-
tate treatment. or for the purpose of an
operation, which could not be properly per-
formed at home. To deprive such patients
OF their first choice is not only an injustice
to them. but also to the attending physi-
clan, and to insist that they must accept
the services of the hospital staff is legis-
lating for the benefit of a special class
The instances where young man would
dare to perform an operation without con-
sultation must indeed be rare, but all we'll
regulated hospitals have, or ought to have
rules that no capital operation, except in
emergency cases, shall be done without the
consent of the consulting staff, and as these
rules are applicable to all inmates, injudi-
cious operations could certainly be avoided
without depriving the patient or family
physician of their just rights. This rule is
not applicable to municipal or government
hospitals, and there is of course, no good
reason why they should have accommoda-
tons fer pay patients, except in hospitals
for insane.
THE seventh and eighth rules were
members of the staff while insisting on
proper discrimination in limiting hospital
and dispensary facilities to the dependent
classes, and On proper remuneration for
services In pay rooms when such patients
are clearly able to pay for the same.
Effect of Free Medical Treatment.
There is no good reason why pay wards
should not be pay wards as well to the
physician or surgeon as to the funds of the
hospital Indiscriminate dspensary treat
ment keeps many a fee from the hard
working and poorly-paid practitioner, and
If a patient can hire a room, with board
and nursing, in hospital for from $40 to
$40 week, without extra charge for pro-
fessional services, the hospitals will flour
ish at the expense Of the medical profess
sion.
I'VE cannot formulate rules for, or die
tate to hospital and dispensary boards or
those intrusted with the disbursement Of
pubic funds, appropriated for the relief of
INDECENT sick, how this money shall be eX-
pended; but we claim the right to make
rules for the guidance of our professional
brethren, which, If enforced, will not only
protect their interests, but incidentally also
the public treasury.
IF proper control had been exercised,
hospital and dispensary abuses would not
exist, and these rules would never have
become necessary, and, as the remedy lies
perhaps within the scope of your inyesti-
W IA 70 Srth fhn foil
views for your consideration.
THE subject of hospital management in
this city might be simpllfied by placing all
hospitals (owned and supported by public
runds) under the control of the municipal
government, preferably under the immedi-
ate supervision of a board of charities with
a competent executive officer
The hospitals under this category are
the Freedmen's, the Columbia Hospital for
Women and the wards connected with the
almshouse, and admission to these should
only be made by competent authority
AS the accommodations in these hos
pitfalls are insufficient to care for all the in
dlgent sick. other provisions are necessary.
RccOmm en ln lions.
These, in our judgment, ought not to be
n ade by making specific and direct appro-
priatons for any particular hospital but
an adequate sum should be appropriated, to
be expended under the supervision of a
central agency (such as board of char
ities), ard 1t should be the duty of this
board to determine which of the existing
hospitals are properly equipped. and then
pay stipulated amount per day for every
poor patient admitted by it's order: such
orders should constitute the vouchers of
the hospital for monthly bills. 1t is pre-
sumed, of course, that this central agency
requires evidence of dependency, and Will
satlsfy itself by frequent inspections that
the public patients are properly cared for
There should doubtless be an emergency
department connected with the various hos
pitfalls, one In the east, west north and
SOUTH and because of the peculiar nature
of such service the actual cost of main
tenance should be betrayed from public
funds. the central agency should also rec
ormend appropriations for the support of
free dispensaries, located, like the hos
pitals in readily accessible sections with
cue regard to their respective population
ard needs, and should prescribe such rules
as will limit tie work to the dependent
classes only. Under no circumstances should
the system Of charging small fee be in
troduced. as it will be a hardship to the
real poor, and guise for fraudulent appli-
cants.
Public hospitals, like the Freedmen's.
Columbia and the wards connected with
the Washington Asylum. should be open to
medical students for clinical Instructions;
since they are, after ALL rot only intended
for the reception of the sick and wounded.
but likewise constitute the training school
for the future family physician.
Inc (HlIuTeH s. IdTHelQ ana PROVIDENCE
Hospitals, although owned by corporations,
are practically open to medical students.
ION the whole, the committee believes
that the plan thus briefly outlined will be
a satisfactory solution of the hospital and
dispensary question in this city. The gov
eminent would be the gamer, because it
would not be under the necessity of erect
ing municipal hospital, and duplicate as
1t were. the work of existing wellequipped
hospitals, nor would it discourage benevo-
lent enterprise. for in spite of many abuses
it must be admitted that immense good has
been accomplished by charitably disposed
men and women in providing for those who
naturally shrink from being regarded as
objects of public charity.
I'm our opinion, private charity would be
seriously impeded If the government as
sumed all the burdens.
Properly equipped municipal or county
hospitals are expensive institutions, and,
apart from the odium connected with being
an inmate of a county hospital, it is much
better to have the sick poor cared for in
hospitals located in different sections of the
city, because of easier access and the pre-
vention of crowd poisoning, which can
scarcely be avoided when so many sick are
aggregated under one roof.