Temple University School of Medicine - Skull Yearbook (Philadelphia, PA)

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Only slowly has come the realization that it is not enough to be aware of the social and health needs of individual patients while ignoring the ecology of their origins. The Department of Psychiatry has recognized this fact and therefore has pushed its interests out into the community. With the establishment of the John A. Kolmcr Chair in Community Medicine in 196.'}, Comprehensive Medicine further extended its efforts in this direction. The administration’s interest in this field has been stimulated, moreover, by the broad vision of Professor John J. Hanlon and Vice President Leroy E. Burney. Hopefully this innovation will lead to the integration of Public Health and Preventive Medicine and the multiple disciplines of Comprehensive Medicine medicine, psychiatry, social work, and pediatrics. Finally, several of us in Comprehensive Medicine had examined some of the fundamental premises on which medicine is based and have developed a more substantial philosophical foundation for teaching and practice. Concepts of disease, of casuality. and of science in general are useful, but. like all concepts, somewhat limiting. These limitations need to be appreciated for medicine and its practice to advance. The student is hardly in a position to appreciate the great amount of thought and effort that has gone into our teaching, but without him, his cooperation, his needs, his enthusiasm, his friendliness, his questions and his stimulation, Comprehensive Medicine would not exist at Temple. To him wc arc grateful. William A. Steiger, M.D. John A. Kolmcr, Professor of Community Medicine

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TEMPLE’S COMPREHENSIVE APPROACH TO MEDICINE i Comprehensive Medicine began hesitantly in the General Medical Clinic twelve years ago under the direction of Dr. Richard A. Kern and the late Dr. John A. Kolmcr. I was at the time in charge of the General Medical Clinic, being the only full-time teacher assigned there. My collaborators were Dr. A. Victor Hansen, Jr., of the Psychiatry Department, and Miss Gertrude O'Connell, a psychiatric social worker. Dr. Harold L. Hyman joined us soon thereafter. AH of us had a great deal to learn about comprehensive care, but the student’s high praise for the efforts encouraged Dean Parkinson to suggest a more continuous experience in patient care. This suggestion led to the organization of the Junior Year Family Practice Clinic. It was the anxiety of Juniors meeting patients for almost the first time in the responsible doctor role that led us to inaugaratc the Doctor-Patient Relationship course in the Sophomore Year. When Dr. Kolmer became Professor Emeritus in 1957. one-half of the Freshman and Sophomore correlation conference hours were assigned to the Department of Comprehensive Medicine. It was at this point that Temple University President Robert L. Johnson persuaded the Commonwealth Fund to visit our medical school. Impressed by the significance of this experiment in medical education, the Commonwealth Fund granted Temple $300,000 to hire personnel and to transform the General Medical Clinic into the Comprehensive Medicine Clinic. We were then able to move from our initial dingy quarters in the medical school to new and spacious accomodations in the present Out-Patient Department. By its selection for description by Dr. Peter V. Lee of the University of Southern California in his book, Medical Schools and (he Changing Times, Nine Case Report on Experimentation in Medical Education, 1950-60, our program in Comprehensive Medicine gained renown for Temple University. It has attracted a number of visitors from various medical schools, such as Harvard, University of Pennsylvania, Duke, and Indiana University, and many foreign countries — Great Britain, France. Brazil, Japan, and Indonesia. Although under the administration of the Department of Medicine, Comprehensive Medicine has always been a joint effort of Medicine and Psychiatry, to the benefit and stimulation of both. Comprehensive Medicine at Temple rests on the solid foundation of studies in psychosomatic illnesses made by the late Dr. Edward Weiss and Dr. O. Spurgeon English. Their writings in this area are, as too few here appreciate, one of the most significant medical contributions to come from Temple University. 20

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 The Emerging Concept in Medical Care The concept of the conscience” of the hospital is cf recent origin. More and more the coi imunity is depending on its hospitals for leadership and guidance in the bewildering search for medical help. Several reasons account for this: the reluctance of physicians to make house calls, the increasing sophistication of the population in regards to health matters, the moving of people into vast impersonal cities, the increasing cost of medical care. Often after a visit to the doctor’s office, another visit must be made to the hospital to have particular studies performed. This is why hospitals are assuming many duties formerly in the province of the general practitioner, why the emergency room is supplanting the house call, and why the hospital clinics are supplanting the doctor’s office. This increasing acceptance of and dependence on the hospital makes it mandatory for the hospital to pick up the challenge. No longer can it afford to remain entrenched behind high walls, aloof to all except those who seek its help. The community today is demanding that its hospitals. symbols of help and repositories of medical knowledge, lead the search for solution of the community’s medical and social ills. « —