DR. MacEAGHERN'S OPINION. THE WELL-TO-DO PATIENT-, PROVIDING FOR -ALL CLASSES. In his address to the conference of the Eiritisfi Medical Association in Nelson the noted American authority, Dr. Malcolm T. MacEachern said it would be presumptuous for him, newly arrived in New Zealand, to definitely lay down a new and better hospital policy for the Dominion than that they had at present. What ho had to say must not be taken as a policy which would apply in its entirety here. He was going to deal with principles only. It was impossible for any country to jylopt the policy of another country in its entirety, and particularly was that so in regard to hospital work. It would be impossible to standardise hospital policies, but it was quite possible to lay down standard principles, which could be worked out in a practical and adaptable manner for any country or community. Previous to his visit, through contact with various people from New Zealand, and from reports received, he had been greatly impressed with the hospital system now in vogue, and was delighted to have an opportunity of studying it in detail. • "A hospital to-day should serve the community in the very broadest aspect, and provide the necessary accommodation for the necessitous poor, the part-pay, and the full-pay type of patient," continued- Dr. MacEachern. '.'The first call on the hospital is for the necessitous poor, which is generally taken care of by a carefully selected honorary staff. Added to the same institutions are the pay-wards, which may be either of two types—closed or open; the closed type offering its services only to the members of the honorary staff, whereas the open type extends privileges to all reputable doctors acceptable to the hospital boards. The Middle-Olass Patient. "At present, many hospital systems fail through not providing the nefcessary accommodation and facilities for the middle-class patient. Consequently, in many instances, they are debarred from proper scientific hospital care. These cases should be able to secure hospital accommodation at a price suited to their means, and make their own financial arrangements with their doctor, and secure the excellent services of the well-organised, fully-equipped public hospital. "The greatest example in Canada of the value of the voluntary community hospital is that of the Royal Victoria Hospital in Montreal, an institution now representing a capital expenditure of possibly over 20 million dollars, all the result of philanthropy. "The citizens, realising that they can use this up-to-date Complete hospital for their families when ill, are anxious to support it, and these great benevolent gifts have made it possible to. promote a great institution and advance research in medicine. History reveals that all clinical research done in connection with the hospital is the most valuable type. v , "This is a vital question to be considered if we want to promote clinical research in New Zealand. Is it going to be- possible to, get the money and the stinitilus to carry research on in connection with taxation-supported hospital 1 Should we not in some way revive philanthropic effort in this direction at least, and can we not do so by interesting our best citizens in giving them the. advantages of an up-to-date, scientific institution, when they or thoir family are. ill? -
Those Able to Pay. "There, is no question, that the best hospitals to-day are .the great public institutions of. this and other countries, which are evidencing; their' class distinction in catering only to ons type of patient, _ supposedly the necessitous type. If hospitals would offer services to all classes of people, then they could not be accused of class distinction, as opposed to serving one class, as at presents "If you take a trip on any of your intercolonial or trans-Pacific steamers, you will find, first, second and third-class accommodation, but all getting the same service. If -you go to your races, you will find accommodation of the first, second and third type. All through every activity, thero is a certain amount of grading to suit circumstances.
"Why not apply the same principle to our great hospitals, and let those who are able to pay take advantage of the services which they have helped to build up ? Doctors should continue to give their services free to those who cannot afford to pay, but should not be expected to render free services to those who can well afford to contribute to the cost of scientific care."
JUSTICE TO THE PATIENT.
HONESTY AND SINCERITY. "The hospital of the future must be characterised by justice—to the staff, the personnel,-and above all, to the patient," said Dr. M. T. MacEachern, the noted American surgeon,, at Nelson. "This implies the doing of everything that may in any way help to get . the patient back to health in the. quickest, most comfortable manner, and with as permanent a physical result as possible. When patients go to a hospital they are 'obliged to place themselves wholly in the hands of the institution. What a trust the hospital staff has—one .which cannot be properly discharged- witrfout always keeping justice in mind. This means a course of action glided by honesty, thoroughness ana fearlessness. * Lack of honesty and sincerity in. hospital . proceedures is a matter of most serioißs consequences. It takes so little frequently to turn the tables in border-line cases. The nurse who charts an ungiven medicine, who advances bedside clinical observations, is not honest. : The doctor who applies instruments to his obstetrical case in order to save time for himself or keep a golf engagement is not honest or sincere, and is unworthy of membership" in the medical profession, Throughout the entire service in the hospital of the future we must have evidenced more strongly the qualities _of honesty, sincerity, and all bub era which mean justice to the patient."
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HOSPITAL FACILITIES., New Zealand Herald, Volume LXIII, Issue 19258, 22 February 1926
HOSPITAL FACILITIES. New Zealand Herald, Volume LXIII, Issue 19258, 22 February 1926
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