The evening times., 1900-01-17

Congress appointed a Joint committee
some time ago to enquire into the work
ings of the charitable institutions in the
District. The committee invited the pub
lie 10 give it information, and among the
most valuable papers on the subject that
1he committee received was one from the
Medical Society of the District.
The document at first recites the regu-
lations of the society as to the charging
OF fees for visiting sick, concluding by
saying: 1t shall be considered, however.
AS unprofessional to diminish the standard
fees, except from motives of charity and
benevolence." The statement follows:
The letter and spirit of these regula-
tions are sufficiently broad and benevo-
lent but the majority of hospital and dis
pensary boards OF management seem To
have lost sight of these dictates of hu-
manity, and as a result their annual re-
ports vie with each other in statements OF
the amount Of work done without any CON
sideration as to how much Of this work
was done for the benefit of the real de-
pendent classes, or how much was done at
the expense Of the profession al large
Dhty 10 Indigent sick.
'While it is clearly the duty OF the state
snd Of society to take care Of the indi-
gent sick. it is also their duty 10 prevent
imposition and abuse and this We regret
10 say. has not been done and the evil has
grown here as elsewhere, with rapidity
which threatens the impoverishment Of
the general practitioner.
Tho causes Of this evil are manifold;
there is always a large class Of persons
who pretend to be poor when in reality
they are simply seeking good medical al
tendance without pay; Christian charity,
or a want OF business methods. on the part
of hospital and dispeusary authorities pre-
vents systematic enquiry into the Sctdal
needs of such applicants
1t is possible that liberal public and
private support of these institutions are
factors in the abuse of medical charity,
for were they Obliged TO practice strict
economy 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 institutions has been a mistaken
one, and, with a view of placing a limit
on the performance Of unrequited services,
10 sift charity from its abuse. and TO keep
aitf laIo Alt'0 anu t-t'--ilotti t'-- lltln
sorbing patients who are able TO pay for
medical or surgical treatment the Medi-
al Association OF the District of Colum-
hia appointed committee in October,
1896 TO investigate The subject
This committee. in its report presented
November 10. showed 1hay during the
fiscal year ending June 50. 1886. there
were treated in the hospital and dis
pensaries As .0S0 applicants. while the
physicians 10 the poor treated la,l50
patients. This makes 4 grand total OF
5S,lS0 patients treated. and percentage
to population of about y. Mr. Wilson. the
secretary of the Board Of Associated
Charities. testified before your commit
tee that about > per cent of the cases in
Nestigated for the Central pispensary
proved fraudulent
The Associations Conclusions.
The report of our association commit
tee contained certain conclusions and
recommendations which were discussed
in two general meetings. but the associ-
alton, 10 avoid hasty action. referred the
subject TO another committee and this
second committee formulated the recon-
mendations of February Is. 1884,; these
were unanimously adopted as amendments
to the regulations on May H. 1872. copy
Ol these rules was mailed TO every hOspi-
tai and dispensary board in the city. but
50 far only the Eastern Dis0ens2ry has
expressed a Willingness 10 cooperate in
the effort to check abuses.
AT meeting OF the Association held
November . 1897. the secretary was
directed to mail copies Of these amend
ments to the hospital and dispensary
boards, and also a copy Of resolutions re
quirug members OF the association who
may be members OF the medical staff of
such institutions TO comply with the rules
hy January l. 1SsN.
II all the hospitals and dispensaI les had
proper medical representation On their
boards Of management. many of the abuses
could be corrected by a fair presentation
aud discussion, but il so happens that some
OF the boards are composed wholly Of lay
members, who are disposed 10 force i'm
position OF every kind upon The medical
satf.
In the first place, it should be remem-
bered that members Of this association are
legally qualified practitioners of medicine,
and it is not to be assumed that members
OF the attending staff of hospitals are the
only qualified practitioners in a city. ManV
of the pay patients In hospitals become
inmates thereof on the recommendation OF
their family physician. in order to facili-
tate treatment or for the purpose of an
operation which could not be properly per
formed al the house To deprive such pa
tients of their first choice is not only u
injustice TO them. but also to the attend
ing physician. and to insist that they mUs.
accept the services CT the hospital staff is
ICgislating for the benefit Of a special class.
The Instances where a 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,
injGdiciOus operations could certainly be
avoided without depriying 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 accommodations for pay patients.
except in the hospitals for the insane.
Ray Of Physicians.
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 Indiscrminate dispensary treat
ment keeps many a fee from the hard
working and poorly-paid practitioner. and
ii a patient can hire a room. with board
and nursing. in a hospital for from $40 to
$50 a week without extra charge for pro-