Medical schools of the better class are usually, though not invariably, located in large communities and here the study of medicine tends to be centered. The examination of the dead is an important part of this study; hence one finds the autopsy work largely concentrated in these centers. Conversely, most of the smaller communities have no medical schools nor any direct connection with them. Furthermore, the patients are for the most part private, pay, patients; the family doctor is more or less intimate with the members of his community; he is not stimulated by a great teaching institution and the research spirit it engenders; he may even shrink from exposing the mistakes which he and all of us make. These things tend to make the autopsy the unusual rather than the routine precedure in these communities.
Even the large standardized hospital frequently has difficulty in obtaining permission for the postmortem
COVEY GW. THE AUTOPSY PROBLEM: ITS SOLUTION IN SMALLER COMMUNITIES. JAMA. 1933;101(16):1209–1211. doi:10.1001/jama.1933.02740410011003
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