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JAMA 100 Years Ago
October 25, 2000


Author Affiliations

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Editorial Assistant.

JAMA. 2000;284(16):2029. doi:10.1001/jama.284.16.2029

The method of organization of the medical staffs of our hospitals is a matter of great importance. Naturally the same plan, even though quite ideal, is not applicable to all hospitals, because their scope and nature differ greatly. In the case of those large or medium size, whether supported by some branch of the government or by endowment, the general conditions are usually quite similar, and it would seem natural that the medical staffs were appointed and organized according to some well-considered plan which had gradually met with more or less general approval. At present, this is far from being the case. In most of our city and country hospitals the positions on the medical staffs are prostituted in the interests of practical politics. There is no reasonable certainty in the tenure of office; there is no esprit de corps in the staffs so constituted, and no successful attempt can be made to organize them into harmoniously working bodies, because of the total absence of high motive and of proper training in most of the appointees. Such hospitals are usually scientifically sterile. The limitations of the authority of the attending physicians and surgeons and of the non-medical officials are illy defined and not infrequently lead to occurrences of whose disgraceful character the least said the better. Naturally, there is but little discipline among the internes in such hospitals. Fortunately, there are institutions in which better systems prevail, and it seems that the conditions in general are slowly improving in most of the large cities.