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JAMA 100 Years Ago
March 11, 1998

THE ABUSE OF MEDICAL CHARITY; A CRITICAL REVIEW OF RECENT LITERATURE.

Author Affiliations
 

Edited by Brian P. Pace, MA, Assistant Editor.

JAMA. 1998;279(10):734N. doi:10.1001/jama.279.10.734

Dr. Frederick Holme Wiggin of New York read a paper with this title before the New York State Medical Association, Oct. 12, 1897. His object was not so much to present individual views as to cull from recent literature, both lay and medical, the opinions of many writers. He said that it was easy to demonstrate conclusively that as at present administered medical charity is demoralizing to both the recipients and the donor. Some idea of the alarming growth and extent of this evil might be obtained from the carefully prepared report of Dr. Stephen Smith to the State Board of Charity. Here it was shown that during the year 1895, 837,971 persons applied for and received free medical treatment at 105 dispensaries in that city; that 1,418,847 free visits were made by these applicants to these dispensaries; and that 78,000 persons received free board, lodging, nursing, drugs, surgical dressings and treatment; in other words, that something more than 49 per cent. of all who live within our borders had claimed in one year to be unable to care for themselves. This should be contrasted with another statement by Dr. Smith to the effect that during the period from 1791, when the first dispensary was established in New York, to about 1870, the applicants for charity bore a ratio to the total population of 1.5 per cent. Dr. Wiggin then went on to quote from an editorial in the New York Herald to show that Greater New York spent fifty millions of dollars every year on charities, and that according to a conservative estimate fully 50 per cent. of the donors' money was diverted from the purpose for which it was intended and was practically filched from the poor to whom it rightfully belonged. Again, according to one author, Dr. J. B. Huber, one might find in large numbers at dispensaries such people as actors, opera singers, gamblers, bartenders, policemen, farmers from out of town, prosperous business men and those owning houses, lawyers, and perhaps even a street railway president. According to another author, Dr. George F. Shrady, fully 50 per cent. of the applicants in the reception room of a well-known institution, which he dubs "the diamond dispensary," were well dressed, 10 per cent. were finely dressed, more than half of the men bore no evidence of poverty, and among the women there was an attractive display of fine millinery; yet all obtained the free treatment supposed to be given only to poor persons. . . . Surely, the author continues, these instances "certainly show the spirit in which charity is asked for and accepted; it is largely a desire to save money, without apparently thinking that self-respect is lost in the effort, or that a wrong is done to the really poor and to the physician, who is certainly as much entitled to his hire as the clergyman, or other members of the community, as he too has social obligations to fulfill. . . . "

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