American College of Surgeons - Yearbook (Chicago, IL)

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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

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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

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Hospital Standardization 7 profession have a right to shirk the task to meet squarely such considerations as these. The Regents realized at the outset that so intricate and com- plex a task could not wisely be approached in haste. There was no precedent in the history of medicine which might serve as a helpful guide in their proposed course. They realized that with some impatience the Fellows of the College looked forward to an active campaign throughout the continent for the betterment of hospitals. Then came the war and its quick eflfect to vitalize a high ideal of service not only in the profession and among hospitals, but tliroughout every phase of our national life. In the fluid state of mind thus created, soldiers, sailors, and the general public realized with new force that they are entitled to the best in medical science; and the profession in turn by this awakening was struck with a keener sense of the debt which the practice of medicine demands. Almost in a single morning all shadows of doubt as to whether a continent-wide standardization of hospitals could be entered into with continent-wide good will were cleared away. In outline the hospital program of the College was presented to the American Hospital Association. The program was unani- mously endorsed by the Association and a committee composed of Dr. Winford H. Smith, Superintendent, Johns Hopkins Hospital, Baltimore, Dr. Warren L. Babcock, Superintendent, Grace Hos- pital, Detroit, and Dr. Frederic A. Washburn, Superintendent, Massachusetts General Hospital, Boston, was appointed to cooper- ate with the College. The officers of the Catholic Hospital Association, together with His Eminence, James Cardinal Gibbons, also endorsed the pro- posed standardization plan of the College and offered their cooper- ation and aid. Cardinal Gibbons ' statement in this matter, addressed to the Secretary General of the College, reads as follows, — It is a pleasure to assure you of my interest in and approval of your plan, as explained to me, for the standardization of the hospitals of the United States. We should make every reasonable effort to reach the highest state of efficiency possible in each hospital; and bend every effort to bring about such uniformity as makes for progress.