Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    13/16 (page 9)
    should be allowed to receive benefit either for himself or any member of his own household. Pending this proposed reform, the Sub-committee are of opinion that a qualified medical officer should be appointed for the purpose of sifting the cases for out-patient relief, and refusing those who are suffering from trifling disorders, and others who may be as properly attended at Poor Law or provident institutions. (7.) With respect to the duties of the out-patient service, the Sub-committee are of opinion that the medical officers ought in no case to be called upon to attend for more than three hours at a time. That, with due regard to proper registration, careful ob- servation, and clinical instruction where there are students, the number of patients should not exceed from twenty to twenty-five per hour, it being understood that between one- fourth and one-third of the whole number will be new cases. With respect to a proposal of granting to medical practi- tioners the opportunity of obtaining gratuitous consultations for patients, who, though able to pay for ordinary advice and medicines, would yet be embarrassed by the payment of a fee, the Sub-committee are of opinion that, under certain restric- tions as safeguards against possible abuse, a system of gratui- tous consultations at hospitals may be established with great advantage to the poorer classes, and be a means of improving the present system of medical education. That in order to the proper working of this system, the general practitioner who seeks a gratuitous consultation at a hospital is bound to see that the privilege is not abused by persons for whose benefit the consultation is sought. The Sub-committee are sure that in practice no consultee would desire to deprive a general practitioner of his patient, either by taking the only fee he can afford to pay, or by forcing him to become a gratuitous patient at the hospital. And it is in precisely such cases that free consultation would become the truest eharity. One of the greatest sources of hospital abuse, is the ignorance too frequently displayed by medical men engaged in the routine of ordinaiy work. The deep-seated disease has not been fairly recognised as it would have been if an early consultation had been held. But the ordinary medical attendant fears to tax his patient for a eon- sultation fee, and he blunders on until the resources of his patient are seriously crippled, or the disease is allowed to pro- gress until it is beyond the possibility of cure. Moreover, the patient is often tempted to the hospital by the superiority of the advice he is supposed to obtain, and a sort of antagonism naturally springs up between the general practitioner and