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June 10, 1974

Obsolescence in the Hospital

JAMA. 1974;228(11):1393-1394. doi:10.1001/jama.1974.03230360023016

LARGE hospitals have become disquieting places, as anyone who has recently been a patient there can testify. To begin, the appointments are more expensive than can be afforded, and in general, they hardly can be considered to be arranged for the benefit of the patient. In the hospital family, the patient is usually low man on the totem pole in an organization that is largely for the convenience of others. To put aside for the moment the mundane reasons for the discomfort known to everybody, the business philosophy of obsolescence is abroad in the land, with prosperity contingent on waste. This pervasive need "to be rid of" has extended to human beings. Patients are obsolete, mesmerized—as we have become—by the business ethic because they can no longer contribute to the gross national product.

The deterioration of the spirit of the extended family contributes to the widening of the gap between