Evening star., 1948-12-03
Rutland Plans
Follow Up for
Chronic Patients
Program of Clinic
Visits Mapped to
Cut GoIIinger Cost
By GEORGE Beveridoe

is planning new program to "fol'
low up" chronic disease patients
after they leave Gallinger Hospital
with special care in their home!
and in private hospital clinics.
The program, aimed at reducing
the number of patients who con.
tinually return to Gallinger fol
treatment of the same ailment, wa!
outlined by District Health Officer
George c. Rutland last night a.
a discussion sponsored by the Dis.
trict Chapter of the Physicians
Forum.
1t costs the city about SO to trea1
one patient one day at Gallingel
now And most of the patients ir
medical wards at the hospital have
chronic diseases, such as arthritis
heart ailments and diabetes, DR.
Rutland said. After these patient:
are sent home, nothing further /!
done for them and many soon re-
turn for more treatment.
This isn't good medical practice
and it isn't good for the taxpayers
who have to pay for the hospital
DR.. Rutland declared.
Provides Complete Data.
Under his proposal, complete data
on each patients medical condition
and home life would be compiled
Each patient then would be as
signed to a clinic operated by the
District or a private hospital for
regular "check-up" visits, or would
be seen regularly in his home by a
health department doctor.
The health officer said he felt
certain this care would lessen the
chance of a breakdown" that would
send patients back to Gallinger
land at the same time it would free
beds at the hospital for other pa
tients who need care"
DR.. Rutland said he had dis
cussed with medical school deans of
George Washington, Georgetown
and Howard Universities the posi-
bility of sending senior medical
students into the homes of these
patients to help complete the rec
ords. This, he said, also would give
the students valuable experience in
seeing the effects of home condi-
tions on such ailments.
The health officer said he hoped
the clinic phase of the program
could be developed with the nine
private hospitals here which have
been offered contracts for treating
INDECENT patients eligible for care at
Gallinger. The hospitals would re-
ceive 81 for each clinic visit as pro-
Yided in the contracts.
Letters sent to each hospital, out
lining the program, so far have gone
unanswered, DR.. Ruhland said. He
added that he planned to call a
meeting of the nine hospital admin
istrators intthe near future to dis
cuss it.
Additional funds would be needed
for the program, particularly to hire
nurses for the follow-up program,
Dr. Rutland said.
ut appears now, however" he
added, that our budget for the
forthcoming fiscal year will be no
larger than the one for our pres
ent year"
DR.. Ruhland has proposed already
that the Commissioners allow his
department to pay private hospitals
for treating emergency, District
resident patients who can pay only
part of their own hospital expenses
AS they do at Gallinger. The con-
troversial proposal is under study
by the corporation counsel.
DR.. Ruhland's only comment on
this proposal was that I'VE are right
now in an embarrassing situation
because there is no clear-cut defini-
ton of. what an INDECENT is" Con-
gress, appropriating $69O,000 to pay
the private hospitals, said it was to
be used for treatment of "indigents. u
In another address, DR.. Francis
Schwenkter, professor of pediatrics
at the Johns Hopkins Medical
School, Baltimore, outlined a plan
in his city under which indigents
on city welfare rolls can get year.
around care by private doctors at
city expense.
Patients Select Doctors.
After complete examinations In
special clinics at Johns Hopkins
and the University of Maryland
Hospital, these patients select doc
tors who agree to participate. For
S8 year the doctors agree to pro-
vide home and Office care for each
patient. About 40 per cent of the
10000 indigents assigned to the
Johns Hopkins clinic are children.
Because not enough doctors are
participating to handle this load,
DR.. Schwenkter said, Hopkins is
planning next mouth to begin a
program under which pediatricians
in the hospital clinic will take re-
Sponsibility for some of the chill
dren's care
Meanwhile, the recently estab-
1ished Community Chest Fedora
tion's disqualification Fund Com
mittee held its first formal organ
ization meeting last night at the
American Security & Trust Co.
Chester Morrill,, chairman of the
committee, appointed several sub
committees to deal with various
problems. These issues include in
digents, hospital operations and
deficits, group and cooperative
plans.
The committee, 1t was explained,
took no action on the controversy
over the Hospital Service Agency
A proposal had been advanced for
hospitals to take over the main
functions of HSA, which determines
whether patients can be aided by
Community Chest funds, and pays
hospitals for treating them. HSA
also collects from these medically
INDECENT" patients what it de-