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April 14, 1993

What Are We Teaching About Indigent Patients?

Author Affiliations

New York (NY) Medical College

JAMA. 1993;269(14):1788. doi:10.1001/jama.1993.03500140040018

To the Editor.  —The article by Miles1 in JAMA paints a tragic portrait of the deviation of medicine from the Hippocratic oath. Do we x-ray the pocketbooks of all who enter our portals and cast aside those lacking gold bullion? Is the only altar and yardstick medicine now uses the almighty dollar? There may be some justification in limiting your private practice, but refusing to render emergency service at a not-for-profit hospital is immoral and inexcusable.It is paradoxical that despite the proliferation of departments and committees on medical ethics, self-centered, dollar-inspired medical behavior increases.How to address the problem? Carry a big club. Hospitals that permit dumping or refuse urgent medical care should lose their not-for-profit status. Physicians such as the orthopedist who refused to treat a Medicaid patient with a fracture should be censured and on repetition lose their hospital privilege.These avaricious physicians should note that