Evening star. [volume] (Washington, D.C.) 1854-1972, 1898-01-03
Recommendations by the Medical
Association Of the District.
OBLIGATIONS OF TEE PROFESSION
How the INDECENT Sick Should Be
Cared For.
DETAILED SUGGESTION


tiles and reformatory institutions of the
District of Columbia in regard to abuses in
hospitals and dispensaries here, as dis
cussed in the hearings before the joint Sc
iect committee last spring. The commit
tee representing the association and COM
municating it's views comprised doctors
S. c. Busey, W. w. Johnston, G. Lloyd Ma
gruder. Llewellyn Eliot, Geo. NJ. Kober
end G. Wythe Cook, their statement, which
follows, having been unanimously adopted
by the association.
Z In regard to the views of the association
expressed last spring the committee says:
In the hearings. held by the joint Sc
lect committee April %. 1897, certain rec
concentrations adopted by the Medical AS
ISOLATION Of the District of Columbia Feb
ruary 16. 1897 and which had in view the
correcting of existing abuses in the adj
ministration of hospitals and dispensaries
were discussed and some of the rules SUBJ
Jected to adverse criticism. The Medical
Association appointed, therefore, a special
committee to correct any misapprehension
as to the meaning and intent Of their
recommendations. and also to represent
the association before your committee in
matters relating to hospital and dispensary
abuses"
The report then says:
Before proceeding with the argument we
medical profession to the public which
have been clearly defined in the system
of ethics adopted by the American Medical
Association over fifty years ago.
Duties of the Medical Profession.
Art. L. par 1. reads: AS good citizens
it is the duty of physicians to be ever Wig
liant for the welfare of the community
and to bear their part in sustaining Its
institutions and burdens; they should also
be ever ready to give counsel to the pub
lie in relation to matters especially apper-
tanning to their profession, as on subjects
of medical police, public hygiene and legal
medicine. 1t is their province to enlighten
the public in regard to quarantine regula-
lions, the location. arrangement and die
taries of hospitals, asylums, schools, pris-
onS and similar Institutions; in relation to
the medical police of towns as drainage.
ventilation, etc, and in regard to meas
uies for the prevention of epidemic and
contagious disease; and when pestilence
prevails it is their duty to face the danger
and to continue their labors for the al,evi-
alton of the suffering, even at the jeopardy
of their own lives
Par. 3. &" There is no profession
by the members of which eleemosynary
services are more literally dispensed than
the medical, but justice requires that some
limits should be placed to the performance
of such good offices. Poverty. professional
brotherhood and certain of the public du-
ties referred to in the first section of this
article should always be recognized pre-
senting valid claims for gratuitous ser
Art. VII. Some general rules should be
adopted by the faculty in every town or
district relative to pecuniary acknowledge
ments from their patients; and 1t should be
deemed point of honor to adhere to these
rules with as much uniformity as varying
circumstances will admit.
accordance these
Medical Association of the District of CO.
lunbia adopted a table of standard fees,
subject. however. to the several rules
some of which are as follows:
They shall be diminished at the discre-
ton of the physician when he believes that
the patient cannot afford to pay the regu-
lar fees. and yet is able to make some
conversation. 1t shall be considered,
however az unprofessional to diminish the
standard fees, except from motives OF
charity and benevolence. II Is no.
designed by these regulations to prevent
gratuitous services to those who are inca
pable of making remuneration without
distressing themselves or families
1.-The letter and spirit of these regulations
are sufficiently broad and benevolent put
the majority of hospital and dispensary
boards of management seem to have lost
sight of these dictates of humanity, and as
a result their annual reports vie with each
done without any consideration as to how
much of this work was done for the beneht
of the real dependent classes. or how much
was done at the expense of the profession
at large.
while it is clearly the duty of the state
ard of society to take care Of the INDECENT
sick, it is also their duty to prevent impo-
sition and abuse, and this, we regret to
say, has not been done. and the evil has
grown here, as elsewhere with rapidly
which threatens the impoverishment of the
general practitioner.
Abuse of Medical Charity.
1.-The causes of this evil are manifold.
There is always large class OF persons
who pretend to be poor, when in reality
they are simply seeking good medical at
tendance without pay; Christian charity, or
a want of business methods on the part of
hospital and dispensary authorities pre-
vents a systematic inquiry into the actual
needs of such applicants.
1T is possible that liberal public and pri-
vate support Of these institutions are fac
tors in the abuse of medical charity. for
were they obliged to practice strict econo-
my, self-preservation would compel them
TO require evidence of dependency, and the
work would be limited to the deserving
sick. But whatever the cause, the facts
are that the true purpose Of these insti-
tons has been mistaken one, and, with
view of placing limit on the perform
al ce Of unrequited services. to Sift charity
from its abuse and to keep the hospitals
and dispensaries from absorbing patients
who are able to pay for medical or surgi-
cal treatment, the Medical Association of
the District of Columbia appointed a COM
mittee in October, 1896, to investigate the
subject.
This committee in its report presented
November 10, showed that during the fiscal
year ending June 30, 1895, there were treat
ed in the hospital and dispensaries 5000
applicants. while the physicians to the poor
treated 49, $50 patients. This makes
grand total Of IS, 1SO patients treated, and
percentage to population of about p.
Mr.. Wilson, the secretary of the board of
Associated Charities, testified before your
committee that about per cent of the
cases inv estigated for the Central Dispen-
sary proved fraudulent.
THE report of our association committee
contained certain conclusions and recon-
mendations which were discussed in two
general meetings, but the association. to
avoid hasty action, referred the subject to
another committee. and this second COM
mittee formulated the recommended ons Of
February 10. 1897. These were unanimous
ly adopted as amendments to the regula-
lions May II. 1897. copy of these
rules was mailed to every hospital and dis
pensary board in the city, but so far only
the Eastern Dispensary has expressed
willingness to cooperate in the effort to
check abuses. (See annual report, juno 80
1919
AT n meeting Of the association hold