JAMA 100 Years Ago Section Editor: Jennifer Reiling, Assistant Editor.
It is strange that the hospitals and dispensaries of this country should be so shamelessly flooded with pseudo-charity patients, having no claim whatever to gratuitous service. It can be explained only on two hypotheses: First, the working of that innate trait of human nature which prompts to obtain something for nothing, and, second, the lack of good business discrimination on the part of the institutions whose benefits are thus abused.
From the point of view of the profession the abuse is a serious one. Many a struggling young city physician is deprived of the opportunity of earning a living because patients, who are amply able to pay ordinary fees, stultify themselves by accepting hospital alms. The value, too, of medical service, in the eyes of the laity, is much depreciated; as, indeed, is always the case when things can be obtained without effort or sacrifice. The individual who, at a dispensary, has received careful treatment at the hands of one of the leading specialists of the city at no greater outlay than the time and trouble he took to present himself at the clinic, will hesitate a long time before paying from one to five dollars for the same service at the hands of one of the rank and file of the profession.
HOSPITAL AND DISPENSARY ABUSE.. JAMA. 2007;297(6):651. doi:10.1001/jama.297.6.651-a