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April 14, 1993

What Are We Teaching About Indigent Patients?

Author Affiliations

Tufts University School of Medicine Springfield, Mass

JAMA. 1993;269(14):1789. doi:10.1001/jama.1993.03500140040021

To the Editor.  —I think that Miles1 was exceedingly charitable in his comments about the orthopedist colleague who refused to treat an indigent patient. This vignette should provoke to action the governing bodies for academic medicine, the Accreditation Council for Graduate Medical Education and Association of American Medical Colleges.A physician does not have the obligation to care for all patients, as discussed in the article. However, various residency review committees have repeatedly emphasized that physicians must earn the right to participate in the instruction of students and residents. I do not understand how the surgeon described in Miles' article could pretend to have the cognitive, ethical, and common sense abilities that would justify his using the title "teacher."Perhaps it should be a credo that physicians who participate on teaching services will not turn away indigent patients who require urgent services.