November 10, 1917


Author Affiliations

Attending Surgeon and Associate Attending Surgeon, respectively, New York Hospital NEW YORK

JAMA. 1917;LXIX(19):1599-1603. doi:10.1001/jama.1917.02590460025006

In modern industrial organization, the highest degree of efficiency is attainable only by intense systematization. In hospital management the interdependence of efficiency and systematization should be recognized. Yet, this conception has been slowly grasped, reluctantly accepted, and compromisingly adopted by the medical profession. Although a mechanical and inelastic system is not suggested for the care of the sick, the advantages of a systematic plan of service, so far as this is consistent with the development and application of medical skill, are striking.

Until a few years ago, hospital services were relatively small, diagnostic methods simple, the staffs small, and the turnover slow. Consequently the details were simple, comparatively few, and readily kept in mind. The treatment of the individual patient was, in general, conscientious and satisfactory.

With the large service of the present day, however, the complicated methods of diagnosis, the large staffs and the rapid turnover, systematization has become

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