Hardly half a century has passed since hospitals for the treatment of private patients were first established. Previously hospitals were maintained for the benefit of those who were destitute. Obviously such hospitals depended for their support on public appropriations or on voluntary gifts. Services of the physician were freely contributed without thought of compensation. Asepsis, which made possible elective operations, and a radical change in our domestic economy, initiated fundamental changes in the situation. Now all classes of society have become accustomed to resort to the hospital both for diagnosis and for treatment in minor as well as in major illnesses. The hospital today frequently derives a part, sometimes all, of its income from paying patients. Increasingly hospitals sell their services to the self-supporting members of society.
This transformation of the economic status of the hospital has not been achieved without evidences of maladjustment, as emphasized by Dr. Miles Atkinson
THE PATIENT COMES FIRST. JAMA. 1941;117(8):621. doi:10.1001/jama.1941.02820340043012
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