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November 1988

A New Golden Standard for Residency Training

Author Affiliations

Department of Psychiatry and Preventive Medicine University of Illinois College of Medicine 912 S Wood St Chicago, IL 60612

Arch Intern Med. 1988;148(11):2343. doi:10.1001/archinte.1988.00380110007001

In what might be described as the golden age of American medicine, 1900 through 1920, American hospitals served patients who were primarily poor, transient, or who otherwise could not arrange private nursing accommodations for home care. Doctors and their young apprentices attended to the care of these charity patients who represented the entire spectrum of medical problems. The patient would present with acute or chronic symptoms and be kept in the hospital until he or she was able to resume daily living outside the hospital setting. "Private" patients were admitted into the hospital primarily for surgical procedures or when the personal circumstances of the patient required, in the doctor's opinion, a respite from the home setting. The lack of technical sophistication coupled with the presence of a large number of nonacute cases afforded the practicing physician and his apprentices considerable time to get to know each patient personally and to

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