On the reform of the out-patient department of our hospitals / by Edward H. Sieveking.

  • Sieveking, Edward H. (Edward Henry), 1816-1904.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: On the reform of the out-patient department of our hospitals / by Edward H. Sieveking. 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.

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    Assistant-Physicians’ rooms, and subsequently into the wards, as is generally done, appears to me to reverse the natural order of things. The student should first learn a general theory of disease, the outlines of diagnosis, nomenclature, and treatment, then see the typical forms as presented in the wards; and, not till then, correct his knowledge in the out-patient rooms, and extend his experience as to nosology and therapeutics by care- fully watching and—in part, at least—prescribing for the patients that may be entrusted to him, under the guidance and responsi- bility of a teacher. I would allow the cases to be followed home, that the student might learn the importance of domestic and hygienic influences, and that he might early feel the weight of responsibilities that attaches to a medical man. But the notes of the cases should be taken with care and regularity; and I would leave it to the judgment of the teacher to determine in how far the student should be allowed to direct the treatment. If my plan were approved of and properly carried out, none but third and fourth years’ men (I would prefer excluding the former) should be permitted to enter the out-patient rooms. I do not wish to weary you with details ; and, therefore, pass on to give you my views as to the position of the Teachers (Assistant-Physicians and Assistant-Surgeons, as they are commonly, but I think improperly, called) under the proposed scheme. If they took office for the sole purpose of carrying out their present work for a probationary period of two or three years, I should say nothing against it. But I hold it cruel to condemn a man of education and superior acquire- ments for ten, fifteen, twenty, and more years, to the wretched system of out-patient prescribing, as it at present exists. It is soul and body killing, without benefit or reward after the first few years have elapsed, and fraught with many disadvantages both to the hospitals, to the patients, and to the medical officers, to which it is unnecessary to allude any further at present. Give the latter a higher interest in their work, impart to them the noblest of all privileges, that of training the student by the means at their disposal, and you relieve them of unnecessary drudgery, while you infuse a spirit into their work which will make it intellectually as interesting and as profitable as the posts that connect them exclusively with the in-patients at a