HOSPITAL TRENDS

Poverty Bay Herald, Volume LXV, Issue 19699, 3 August 1938, Page 3

HOSPITAL TRENDS

WORK OF SPECIALISTS USE OF SOCIAL SERVICES PSYCHOLOGICAL FACTOR IMPRESSIONS OF PHYSICIAN Overseas developments in hospital practice were described by Dr. C. R. Burns, of Dunedin, who has been appointed chief of the division of medicine at the Auckland Hospital, when he returned by the Karamea from Liverpool, after spending a year in England and the United States. Dr. Burns previously studied abroad in 1924 and 1925 and again in 1932. Dr. Burns explained that the general experience was for advances in medicine to begin in the hospitals and then percolate into general practice. One of the primary changes was the striking growth of what he termed departmentalism, every system of the body being taken up by specialists, who concentrated their interests, research and practices on one particular branch. It was important to note that these departments were not created and a personnel thou selected; rather did they grow as the result of certain individuals .specialising in a particular phase of the work and building up departmental activities. Burden of Specialised Work In London and certainly in the large American cities various departments specialised in almost every system of the human body. They had been established as the result of certain practitioners becoming known for their knowledge and specialised skill and then forced by the burden of the work that was offering to form a department. "I think everyone agrees that if is a bad thing for a man to practise nothing but one speciality," Dr. Burns said. -'Under such conditions his vision may easily become narrowed, and in the hospitals of the United States specialists are required to undertake a certain amount of general work. This is the authorities' endeavour to prevent them from becoming narrow-minded and stilted in their outlook. The best-staffed hospital is the one where there are general physicians and general surgeons, each of whom is capable of practising some speciality." Years ago the work of the hospital doctor ended when he prescribed a treatment, no account being taken of the patient's means or of his ability to carry out the instructions. To-day the sick were studied as individuals and it was somebody's business to find out whether a person had the intelligence and the means to carry out a course of treatment. Activities of Almoners This work was done by means of various organisations, which could be more or less summed up as social services. They were becoming so much a part of hospital organisation in England and the United States that many departments had an almoner or a social worker attached to them. It was the task of these officers to interview patients and to determine the possibility of the treatments being carried out properly, investigating, if necessary, conditions in the home and taking other related factors in to consideration. Controlled by the surgeon or physician of the department, these activities were an intergral part of medicine. Discussing the increasing importance of psychology Dr. Burns said a great deal had been done in unravelling previously obscure lines of treatment. It was not so much due to the advance of knowledge on the subject as it was the result of applying medical psychology to general work, allowing doctors to better understand their patients and to assist them to effect a cure more quickly than might be possible by purely physical means. Psychology and 'the study of the personality of patients were entering more and more into the work of the general physician and surgeon.