Medical staff

“ Is it not obvious that there should be a staff of medical officers and orderlies, detached altogether from any association with the treatment of disease, who should devote themselves entirely to the problem of prevention? ”

“ REQUIREMENTS FOR ALL HOSPITALS 1. The hospital should maintain a service whereby at least one resident physician is on duty at all times. 2. There should be an organized medical staff composed of men competent in their respective fields of medicine and actively meeting their responsibilities for the direction of the professional policies, for the medical work of the institution and also for the professional care of the patients in the hospital. 3. Provision for examination and treatment by dentists and specialists in eye, ear, nose and throat and genitourinary work. ”

“ That the custom has its advantages in an hospital like the one we were describing is indisputable—to the medical staff. Where a system obtains by constant worrying and painful, or at least unpleasant physical examinations, it is of great assistance to doctors and nurses to have at hand an unfailing means of putting and keeping the patient in good 133 humour and benevolent docility. ”

“ The staff is so appointed that every medical man in the city has in turn the advantage of hospital practice; whereby the best medical and surgical skill is fairly equalised through the whole community. ”

“ The specialists in surgery on the staff of the Bureau shall be recommended by the medical sanitary department, with the consent of the Board of Directors, preferably from among the surgeons connected with the hospital fund, and shall be confirmed by a general meeting of the office.
3. During the examination of a person at the Bureau of the Medical Commission, all persons who have applied for the examination may be present.
4. An application for the determination of the loss of working ability may be made by any person or institution. ”

“ I don’t believe that the problem is going to be solved in any other way because there are not enough men outside who are willing to come into the Government service, who are interested.
DR. MILLER: We have a specialist at Oteen who lectures to our entire medical staff Tuesday and Friday of each week. They are very much interested in it and we think it is a very great benefit to the institution and the patients. ”

“ The Surgeon-in-Chief, however, pays regular visits to the island, performs all necessary operations, which amount to a considerable number annually, and gives all directions and instructions to his assistant.
Hospital businessThe Hospital itself is visited regularly every morning by the resident medical staff; prescriptions are sent to the apothecary, and all directions regarding the diet or care of patients given to the attending nurses. Whenever required, two or more daily visits are of course made to patients by the attending physician or surgeon. ”

“ Major operations comparable to those in any other institution are performed, and there is no limitation whatever, either medical or surgical, to the functions which the staff of the hospital undertakes. ”

“ Let us take, for example, a State hospital of one thousand patients. The staff would consist of a medical superintendent, five assistant physicians, and a woman physician. In a hospital of that capacity there would never be more than one hundred patients who would be considered curable, and the number would probably not exceed sixty. More than nine hundred patients would be hopelessly incurable, for the most part the wrecks of past disease, who practically need nothing but kindly custodial care with incidental medical treatment. ”

“ We salute the Nation's emergency medical services personnel: those who staff the ambulances, those who provide medical control, and those physicians and nurses in the trauma centers whose daily efforts are devoted to emergency medicine. We all depend upon their skills and dedication. ”

“ We have a medical department well equipped with all the facilities of a first-class hospital. The regular staff of that department consists of four physicians and two trained nurses who live on the grounds, besides specialists who visit the institution at regular intervals. In addition to this we have a staff of consulting surgeons and physicians, each of whom visit the department at least once a week. No better attention is given patients in any hospital than our inmates receive. ”

“ While not permitting any member of our professional staff to travel and solicit practice, yet we are always willing to accommodate and send a specialist to visit important or critical cases in consultation, or otherwise, or to perform important surgical operations as explained on page 971 of this book. ”

“ Every inducement is held out for sick folk to attend the out-patient department of a large hospital. The great majority of the cases may present no new feature, but there will certainly be a fair proportion of strange and curious maladies, inviting the attention of the penetrative skill of some member of the staff. You see, you are sick of some grievous disorder which your family doctor fails to cure. You demand to see some specialist who has had larger experience of your class of case. He sends for such a one who has passed half his life hunting up this malady in its every phase ”

“ In every way, it is kept in advance of the age. The staff of physicians and nurses spare no pains to make the visit of every one pleasant as well as beneficial in the highest degree. I would urge all sufferers afflicted as I was, or with any chronic disease, to avail themselves, without delay, of the skillful treatment to be obtained of the specialists of the World's Dispensary Medical Association, for I am confident that they will receive all the benefit that can be obtained from medical or surgical treatment and care. ”

“ When the staff has dined, the house physicians and surgeons, accompanied by their clinical clerks, dressers, and nurses, go their rounds. All the fresh cases that have come in during the day have to be examined. All that Tom Smith has undergone in the out-patient department goes for nothing, and the process is now still more carefully repeated. ”

“ The officials controlling the Medical Department in ninety-five per cent. of our prisons and workhouses do not provide a proper equipment or staff of trained surgical and medical specialists, and they fail to recognize the importance of the medical department in educational and reform work. ”

“ A great hospital, with its large medical school, its staff of professors, its physicians, 223 surgeons, assistant physicians and assistant surgeons, its nursing sisters, nurses, dressers, and students, makes up a world in itself, of which the interests, occupations, and pursuits seem to those engaged in it to be almost the only ones of any consequence to them. ”

“ Sometimes very terrible accidents arose in this way, but nothing ever came of the investigations that followed. The staff of the hospital, with their great names and solemn opinions, were always at the service of the students to extricate them from a difficulty; and had they amputated a patient’s head while serving their hospital, there were plenty of good men with a string of letters to their names, who would have been found to swear at the inquest that the treatment was justified on high medical authority under the circumstances. ”

“ On the other hand, children and adults of both sexes go week after week to the out-patient department, when every time they leave their room for the purpose, the exposure, the necessary fatigue, the long waiting in draughty and over ventilated rooms, does them more harm than any medical treatment they can receive, under such circumstance, can do good. All this happens within the perfect knowledge of the staff, who, so far from discountenancing the system, encourage the patients to attend regularly, and seldom dissuade them till the last days of the poor creatures’ existence. ”

“ With such a staff of Physicians and Surgeons, efficient and trained nurses, and with all the most approved sanitary, medical and surgical appliances which study, experience, invention and the most liberal expenditure of money, can produce and bring together in one institution, the Invalids' Hotel and Surgical Institute affords the afflicted unusual opportunities for relief. ”

“ Our Medical Corps is especially entitled to praise for the general effectiveness of its work both in hospital and at the front. Embracing men of high professional attainments, and splendid women devoted to their calling and untiring in their efforts, this department has made a new record for medical and sanitary proficiency. ”

“ Changes which take place after the visit of the medical attendant, should be immediately reported, and in all that regards the administration of the medicines, and the general system of treatment, the nurse should scrupulously obey the instructions of the medical advisers, not only as the most likely means of promoting the speedy recovery of the patient, but to remove from herself all responsibility and blame. ”

“ At the head of each is a doctor-in-chief, assisted by an adjunct physician. The medical service comprises treatment of the patients for their mental affections and the incidental maladies attending them, correspondence with administrations or families, concerning their moral and physical condition, the direction and observation of the guards of section in all that concerns the medical service, surveillance of the nourriciers in points regarding the hygiene, food, and lodging of the patients intrusted to their care, and as to their own conduct and devotion to the welfare of their wards. ”

“ There will not be complete success until means are discovered for training and enlisting every medical practitioner as a medical officer of health in the circle of his private or public practice, and of securing his services not only in the early and prompt detection of disease, but also in the systematic supervision during health of the families under his care, and in advising them as to habits or methods of life which are inimical to health. ”

“ I have already pointed out the difference between the province of the purveyor and the surgeon; and it is remarkable, that it is precisely at the point where the general and regimental hospitals meet, that the duties of a purveyor become paramount and indispensable, while the duties of a medical officer are in no degree changed, except in so far as he has to treat a disease which, having been acute in a regimental hospital, may probably have become chronic in a general one—a change for which surely every medical man is prepared. ”

“ This corps is in charge of a chief surgeon and chief medical examiner, both prominent in their professions; and although the number of men in their charge exceeds forty thousand, any complicated or persistent disability of an employee secures the personal supervision of the chief surgeon. ”

“ Were all these changes made there is no doubt that the efficiency of the administration would be increased and the burden of the work lightened.
As regards clinical work other desirable changes might be made. Senior men who have been in full practice, and who come to a base hospital as physicians or surgeons with the rank of lieutenant-colonel, are apt to be entrusted with the detailed administration of medical or surgical wards. They are often unfitted by training for such administration and are frequently disinclined [192] to undertake the work. ”

“ A Physician will reside in the house, and one or more Physicians, of established character and experience, will attend regularly, and afford medical aid in all cases where the general health, or the particular cause of the patient's insanity, may require it. ”

“ Two physicians are attached to the institution under whose care the patients are placed alternately in the order in which they are admitted: there is one assistant physician whose duty it is to perform the office of the ordinary physicians when either of these may be incapable of attending, and there is besides a medical officer resident in the house. ”

“ The second and most urgent element consists in the organization of hospital and consultative expert services for all, which, while greatly increasing each patient’s prospect of prompt recovery, will enable the general practitioner to escape from the soul-destroying inefficiency of unaided medical practice. ”

“ There is no doubt that the commander of a hospital must be a medical practitioner, and there is no doubt that in all matters relating to his hospital his authority must be final. In the last resort he must decide whether a patient is to leave the hospital or to stay; who should be admitted, and what the treatment should be. In a good organisation he will probably be very rarely required to express an opinion respecting these matters, but in the event of a conflict of opinion between say the consulting surgeon or physician and himself, there can be but one final arbitrament. ”

“ The physician may do very much for the welfare of the sick, more than others can do, although he does not, even in the major part of cases, undertake to control and overcome the disease by art. It was with these views that I never reported any patient cured at our hospital. ”

“ The organization is complete and excellent. There is a supervising Surgeon-General, who has great powers and great responsibilities, a medical purveyor, surgeons, passed-assistant surgeons, and assistant surgeons. These treat an immense number of cases, and not a few have lost their lives in combating epidemics. These officers are selected by examination and entirely removed from any politics, and are bound to go wherever they are ordered, and obey regulations. ”