The relation of the visiting and house staff to the care of hospital patients / by W. Gilman Thompson.

  • Thompson, W. Gilman (William Gilman), 1856-1927.
Date:
1906
Catalogue details

Licence: In copyright

Credit: The relation of the visiting and house staff to the care of hospital patients / by W. Gilman Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    it is possible to spend so much time in the laboratory- in a microscopical quest for the ticks on the lost sheep, that the ninety and nine may die meanwhile of pleuropneumonia in the wards above. To offset this increasing difficulty in the relation- ship of interne to patient, some hospitals have de- vised a system of pathological externeships—i. e., of entering young men upon the staff, who serve in part as assistants in the strictly pathological work of the hospital, and in part relieve the house staff of clinical laboratory work in uranalysis, blood and sputum examinations, etc. This system, when care- fully supervised, has certain advantages, and ad- mits of more extensive research work, but if not so supervised, it reacts in turn upon both patient and house staff. For example, it was a recent personal experience to find a single patient, having a probable tuberculous enteritis, whose blood, secreta and ex- creta had been examined in the brief period of seven weeks by no less than twelve different appointees of the pathological department of the hospital and members of the house staff. Upon further inquiry, the fact was elicited that fully three hours daily of the junior interne’s time was consumed in transcrib- ing upon the various ward patients’ history charts the results of clinical laboratory analyses—purely duplicate clerical work that could be avoided by the use of a simple copying apparatus. If that young man were required to spend those three hours daily in studying the proper diet of the patients, the heat- ing, ventilating and lighting of their wards, and se- curing in manifold other ways their comfort in beds, by the time he became house physician or surgeon he would know something of these matters and de- velop into a much more skillful practitioner. Twenty years ago the clinical laboratory examina- tions consisted of little more than a search for casts and albumin, or sugar in the urine. To-day the armamentarium of the interne comprises tonometers,