Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others. 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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    E E P 0 E T. The Sub-committee appointed to inquire into tlie out-patient department of the General Hospitals have held several meetings, to which the members of the various hospital staffs have been invited. They have also received some very im- poi’tant communications in reply to the questions upon which discussion has been held; and they feel it due to Mr. Whit- field, of St. Thomas’s Hospital, who has devoted great atten- tion to the subject for many years, to acknowledge the very valuable paper he has forwarded, and their indebtedness to him for some of the most important suggestions contained in their Report. They also acknowledge with thanks a very valuable letter from Dr. Steel, of Guy’s. The Sub-committee commenced their investigation by endeavouring to determine the nature of the out-patient work as now carried on from a professional point of view, particularly in its relation to the kind of practice which is consistent with the respective status and interests of general ]oractitioners and consultees. (1.) The Sub-committee have arrived at the conclusion that a very large proportion of the ouc-patients of general hospitals (variously estimated at from three-fifths to nine-tenths of the whole) consists of trivial cases which do not require any special skill, and might be properly left in the hands of ordinary medical men. The overwhelming; num'ber of uninterestino; cases wastes the time of the consultee,, wearies the attention of the students, and fosters a habit of hasty diagnosis and care- less observation, which tend to erroneous and ineffective treatment. In fact, out-patient work, as generally conducted, neither conduces to tlie sound advancement of professional knowledge, nor to the advantage either of the students or the public. And, bearing in mind that the staff consists ex- clusively of consultees, and that clinical teaching is one of the most important advantages derived by the public and the profession from the institution of public hospitals, the Sub- committee are of opinion that some special claim ought to be made out for perfectly gratuitous hospital advice, such as sudden emergency, surgical requirements, long continued ineffec- tive treatment, peculiar, obscure, and complicated disease, unforeseen and unavoidable distress, or some other special