American College of Surgeons - Yearbook (Chicago, IL)

Page 31 text:

Hospital Standardization In case of death all unpaid balances are canceled. ENDOWMENT FUND hereby subscribe Five Hundred ($soo) Dollars to the Endowment Fund of the American College of Surgeons, the amount to be paid in installments as follows: Date Amount Date Amount Date Amount 1 $ t S S t I further agree to pay interest on unpaid balances of this pledge at the rate of 5 per cent per annum. Date - The Regents propose to bring the Endowment Fund up to one million dollars as rapidly as may be. To this end they earnestly request Fellows of the College who have not already done so, and who can do so without hardship to themselves, to subscribe to the fund rather than to pay annual dues. From time to time unexpended balances in the treasury of the College are transferred by the Regents to this fund. Subscription cards may be had on appUcation from the Secretary General of the College. HOSPITAL STANDARDIZATION The admission of Fellows to the College made necessary at once that the Regents adopt a sound standard of surgical train- ing. From this fact it followed that the Regents must necessarily acquire accurate data with regard to the training of surgeons not only in the medical schools, but also in hospitals. But this approach to hospitals involved the Regents in more than a con- sideration of the training of surgeons in these institutions. The training of the internist is also the training of the surgeon, and in fact every procedure of a hospital designed for the welfare of its patients is inseparable from the training of a surgeon. Further, at an early date the Regents were convinced the usefulness of the

Page 30 text:

4 American College of Surgeons Some further account of the endowment fund and of the finan- cial side of the College is here given. In order to provide means for the organization of the College an initial Fellowship fee of $50 from each Fellow was voted at the first meeting of the College. This sum was payable, $25 on admission, and five dollars annually thereafter for five years. Realizing that the income to be derived in this way was but temporary, and desiring to place the College on a safe, independent, and financially adequate basis, the Fellows in June, 1914, voted to raise an Endowment for the College of one million dollars. This plan provided that the Endowment should be invested in perpetuity, the income only to be used for the budget of the College. It provided, further, that each Fellow be asked for a subscription of five hundred dollars on condition that all subscriptions should be contingent on the raising of five hundred thousand dollars by December i, 1914, the first payment on the subscription to be made January i, 191 5. Subscriptions to the amount of $113,000 were pledged at the first meeting, and it was the intention to push the plan among those Fellows who were absent from that meeting after the summer vacations. But because of the outbreak of war, the Regents de- cided to ask those who had made subscriptions to give their consent to extend the time for obtaining the subscription one year. This extension was, with few exceptions, agreed to. As already stated, the first half million dollars in due time were more than subscribed. Those who subscribed five hundred dol- lars to this fund are fife members of the College and are not sub- ject to the pa5anent of any further dues whatsoever. But, in the meantime, the work of the College called for expenditures beyond the income provided by the interest of the Endowment Fund, and the Fellows of the College, in annual meeting held in Phil- adelphia on October 27, 19 16, voted that those who had not sub- scribed $500 to the Endowment should be assessed by annual dues of $25 each under pr ovisions as above stated. At any time a Fellow of the College may become a life member by subscribing $500 to the permanent Endowment Fund of the College. Subscription cards used for this purpose are of the form given on the following page.

Page 32 text:

6 American College of Surgeons College could find its most adequate expression in a continent-wide standardization of hospitals. A sound analysis of hospital conditions was, therefore, not merely a task which the College may do. It was a task which the College must do, for the College is a responsible society of about 4,000 surgeons which aims to include in its Fellowship all who possess practical scientific knowledge of medicine and surgery, together with honor, trustworthiness, and strong moral character. In so far as the problem is concerned with hospitals, it is compli- cated by the fact that among hospitals there is wide discrepancy in the educational opportunities offered; there is confusion as to the value of all phases of these opportunities even among hospitals of like or comparable equipment. The Regents of the College were therefore confronted with two questions: First, what are the actual standards in the practice of medicine and surgery among hospitals? Second, what is an acceptable standard in the practice of medicine and surgery among hospitals? This second question involves the larger question as to whether the standards among our best hospitals are too good for the humblest patients anywhere on this continent. Both as an obligation of their trust, therefore, and as a con- structive service to the profession and to the public, the Regents of the College entered the field of hospital standardization. They believe that those charged with the care of the hospitals of this continent will welcome a broad, helpful, organized plan for ad- vancement. For example, thoroughness of diagnoses of patients, the fixation of responsibility in the care of patients, the continuity of the service of the physicians or surgeons responsible for the treatment of patients, matters of proper diet, of cleanliness, and of reasonable cost to patients are all indications of the value of a hospital to its community. Such matters are capable of analysis in definite terms. They are as figures on a barometer which indicate the degree of efficiency of a hospital or the degree of safety of a hospital to patients; they indicate the professional standard which the physicians and surgeons of the hospital set for themselves and which they transmit to the succeeding gener- ation. Neither the hospital governing authorities nor the