Brief History of the Osteopathic Hospital of Maine • In order to understand the situation in this hospital I think it is necessary to detail the background of .u... uwn factors which have influenced the growth and ser'li.ce of this hosjd.tal to date and the elements which will cause its demise. Altho this drama has piD11W11 K parallels in many hospitals 'both MD and DO )one must always bear in mind that there are considerations in an Osteopathic Hospital which do not exist otherwise, or at least to the same degree.
The total history is one which is really known only to one who has lived thru and participated in SYery EJYent which has changed the course of the hospital. The hospital really started as a result · or a number of things. In the 1930's in Maine a tu1l practice law for OOs had been in effect !or only a few years. MDs were refusing to consult with 00s on patients. Patients who were seen by MDs were r.ever seen again by their DO. There were isolated instances where individual relationships existed particularly in Laboratory, X-Ray and Surgery, however distinctly minor • .A. fw internships were aTailable in Osteopathic Hospitals sought after and prized by the lucky ones who were accepted. OOs with hospital training began to come to Maine to add to the pressure of discontent with the then current situation. An Osteopathic surgeon from Massachusetts became very actiwe in consulting on the cases of Maine DOs raising hopes that surgery could be done here in an Osteopathic hospital instead of trans!ert:l.ng the patients to iwapta• Boston. During this period a so called round table luncheon was held at the Columbia Hotel, nov the Portlander, f!IVery Wednesday noon with most of the local 00s attending. Many things were discussed, patients, medical papers, football, golf and the frustrations of DOs in an MD dominated medical world. At this time and in this atmosphere the AMA dropped the bomb of forbidding laboratory or X-Ray reports to DOS on pain of loss of AMA appron.l. This was the stimulus which needed only a leader to carry the torch. The leader was ready with a buUt in personal reason for establishment of a hospital. He was an Obstetrician who had for years done home deliveries and who nov found himself wU}wlMK without any place to have his Caesarians done. An Osteopathic Hospital would provide him with a place to send his surgical Obststrics and would also provide on the job training for him so that he would eventual.ly' take aver on his own. He could probably be called the founder of the Osteopathic Hospital of Maine.
Altho the official. history of the hospital starts with the hospital ~ this,• ne s perated in uth rtland in a small printe hospital formerly run by a local MD. Here the surgery was done by the Osteopathic Surgeon from Boston, c02llllltlding as requirede-tbis lasted a very short time when the opportunity to parchase a large wood trame building on Pleasant .A.Yenue formerly' a mu'Sing home. Here soon after it was opened a surgeon and a roentgenologist was added to the starr. The rest of the starr vera general practitioners only a few of whom had \1ad any hospital connection or wxpwd ••K experience of any kind. The Board of Directo•s was composed or the older members of the group who had had the money ( Y~ to put into the hospital. Thera was no democratic process at that _ il '{{wtime as the Board was completezy in colltrol of all aspects of the '-:·"'; hospital and its functions·. From this Board .arose the strong man " who controlled the Board and thereby controled the hospital. There were no departments·. These wera the days when in many hospitals the major effort was surgical and what staadards of practice were set were largely restrictive in nature as to who would or woul.d not practice major surgery. There weee few recognized specialties. Commonly the X=Ray man also consulted in medical probl
n Pleasant A. ~nue, pri r
Y
As the surgeon predicted the reconciliation would bring trouble which it
did. A movement to change the Board of Directors composed of Jitysicians to a completel.;y lay Board of Trustees was started by the Internist led party with the veey strong opposition of the strongman and his revived Jal!ty.vkll Arter months of violent fighting the lay Board was voted favorably. This was the end of the strongman as a political force. New By r.ws were written which established the Board of Trustees and a system by which two Advisors without vote would be elected }l;p:t::lmnbta.. f'rom the starr. To assure that both political parties would be represented one was to be elected by the staff and one appointed by the Board deliberately seeking representation of different political persuasion. The losing party deliberately set out to sabotage the lay Board by refusing to name any laymen to the Board and at the same time stating that nine men could not be round to fill the Board. As a result the original Trustees were nominated by the winning party most of them by the Internist, determined to r•rute the defeatist attitude or the losers •• Soon the building inspectors, fire inspectors, plUIIlbing inspectors were swarming aver the hospital Jdd:xxk which had operated for years without such interest on the part of the city officials. It bas always been considered possible that their interest vas stimulated. An illpossible requirement was demanded of the hospital, that a fire wall be erected between the hospital and the house next door. This led to a return to the Brighton Avenue location. The first Business Manager-Administrator had severed his connection with the hespital and the Jtadiol.ogist and Interrd.st discussed the advisability of getting an Administl!ator. It vas the feeling that at the time trained Administrators were hard to find and would demand a sal.ary beyond the ability of the hospital to pay. The Radiologist had seen one or the Ass •t Managers of a Portland Hotel who had impressed him. This he mentioned to the Internist who agreed that basically the training of a hotel manger would be a good start toward Hospital Administration.· The ld: hotel man was willing since he was locked into a situation where promotion to Manager was unlikel.;y for ma.ny years e' He was willing to accept the challenge, was suggested to the Board ana hired • '!'here followed an intensive period ab of Education of the Administrator in the ways of docotrs and hospitals by the Radiologist and the Internist. The Osteopathic Hospital, its organization and its enlightened care of patients bec&llle a model for Osteopathic Hospitals all over the country. Its l•ding }ilysicians and Administrator were sought after a consultants to hospitals needing help. The fisrt new construction of the hospital into a modern fireproof structire was largel.;y fina.noed by the }:ilysicians who pledged and paid for it. starr •embers could identitY themselves with the hospital and because iaa their own effort and 1110ney had gone into it•.U.H) x M Ld;lw••a•J ••• 'nle second step in growth was financed by federal funds •""'*•K•MX and some private donations·. The starr which had before been w:Jl11ng to be assessed to i'ina.l'lce developement now 11as umdlling to be assessed and to the present has been disinterested in volnn~ sul:mdtting to assessment to get the facilities and eqipmeut we need.•Jt\+xtatax~•a•\••••••KKW*t*~KX The third new construction was firlaaced, planned and built with pracUuUJ•MnX 18pthe staff neither asked nor asking to be a part. Something for nothing with no personal sacrifice had its usual effect in loss or the staff identit.ioation • with the hospital •• Thru many of these years the Internist had served in various providing interne·, staff, and Board education finally to be named
•:rs
in
Chairman of the Educational Council and Director of Gradutae EdllC&tion. The educational programs became noted and copied. In this program 11t1.rJY or the most noted Jilysicians f*tUwl:pwt•iu: in the country participated•· The idea was fostered by the Radiologist that the hospital had grown out of the part time ability of anyone to adequately carry out an expanded educational JU"Ogr&m• The Internist resigned as Director of bD Graduate Education, the Radiologist wrote a Jobdescription for a position entitled the Medical/Educational Director with a price tag of $25,000 • This job was tilled very quickly with a recent :bp:i:x intern-, a classical scholar but totall.y inexperienced in hospital administration. At the conclusion or his three year contract the Med/Ed Directoi) resigned to teach in a college. Quicklyanother individual was named to this post; a General practiceProctologist who had only a short time before been Administrator of a small Osteopathic Hospital in Kittery, Maine, a job from which he had been disaasociated fer some reason.-
There were early conflicts between the Board and the younger group eager to deTelope more areas of service and ~ •t na specialized knowledge on the grounds that this constituted too fast progress. Because of 111ness of the original surgeon another surgeon was added to the staff with the result that for the first time there emerged two political parties grouped aroun8 the two general surgeons. The strong 1ll!ln of the hospttal identif'hd with the second surgeon and the younger, more restl.ess group aligned themselves with the first surgeon. The roentgenologist in conflict with the strong man affiliated with the party of' the first surgeon which generally opposed the strong man. The yomtgest member of the starr al.reaey anxious to train in what was then a young specialty Interna.l Medicine af'f1l..iated with the party of the first surgeon and the B8 roentgenologist • ••" tltww: II rd;x••qwnx thereby constituting a triumvirate general.J.3 in opposition to the policies of the strong •n anddhis grouy. Great efforts were made to advance the professional developement of the hospital, but k they were largely defeated by the strong man and his ac:Dlerents. The thirty beds of the Pleasant AveRue hospital were outgrown and an opportunity presented itself tosvap properties and aquire larger quarters in a wood frame bui 1ding on Brighton Avenue formerly a private hospital for the 3 treatment or mental dirsorders , alcohol and drug addiction. At the Brighton ATenue location there was a carriage house and stable which was remodeled to be used as a public clinic, but it was never used for this purpose.• '!he strong man continued in power altho the opposition party now was able to score an occasional triuatil• The Surgeon, the Roentgenologist and the now Internist constituted a powerful factor now m: Jdct with their party • The sW«@iMU infallibility was shaken by the strongmans discovery that one of the employeea whom he had trusted and defended against Jdzt attack had stolen a large but URknown amount of money trom the hospital. The capacity of the original buUding was :tzx t uWwqalt:•da exceeded and there was a waiting list. There were at the time aver 70 starr llE!IIlberS". At a Board meeting when the subject of' the waiting list 'HaS brought up the strongman suggested that since 10 men brought in most of the hospital patients that the solution would be to eJiwdnate aver 60 starr members thus solving the waiting list problem. 'I' his serious suggestion was greeted with a resounding negative~ but in it were the seeds of revolution-; and the parcha.se of another hospital of' 90 plus llbeds by the lD' iq x:dxii1ua party of the Surgeon-Roentgenologist -Internist followed. Prior to this the Surgeon-Roentgenologist-Interrd.st has bought back the Pl.easamt Avenue property ilutiJ••••••txtwwrc to absorb the overfiowe When the state street Hospital was p1oll'Chaeed the thought of using the Pleasant Avenue property again was discarded. "I The party of the strong man who held out a Brighton Annue was now reduced to about six members who were not members of the state street staff and who now sought to enlist specialists as counterparts of those who had moved to state street, with some success• Here at state street was the first democracy the staff bad eTer eKJ>erienced, here too was the first and last time that all staff members cooperated in evry way,' all being interested in the velf'are of all patients in the hospital aswell as their own. Here was the first Administrator other than a physician. • The first awtpd;i:awbwl hlwxw:x emergency room was operated here for pay continuing the outpatient services the public bad come to expect from ~ the hospital as it had been operated by its former owrter"e There was a spirit soon to be lost and never r••piJ recaptured• Secret meetings were fer bidden asa reaction to the former situation. It was established as a principle that general. practitioners would be able to practice privileges according to their ab111ties. staff members were enccraraged, and helped to improve their professional capabilities. This ,.s soon to end. '!'here was consideravle bitterness on the part of thos who had not chosen to go along with the majority to State street•• At this point the Roentgenologist storngly urged the Internist to convince the SUrgeon that aD effort should be made to reunite both factions into one starr. This was discussed with the SUrgeon who very reluctantly agreed to the effort. Reconciliation of the groups seemed impossible, however a resolution was prepared which accomplished this objective ••
-~----------------······································
.......................
~
~~~----
----------- --------
Meanwhile the tight of the MD GPs against the tmoeat of the closed hospital with curtailment or privileges infected the DO GPs who saw the S~st as a threat espec1ally the Internist *Dil who is seen by rq as the General Practitioner or the :ruture. Against this threat with the enccroragement of the AcadelliY of General Practice and the AD!. ti:x:&a:Jc t•••••ti•ti:o:: which re eammended the establishment or a Department of Genarl Practice in each Osteopathic Hospital the GPS organized for the first time into a political bloe under the leadership or a young GP. Organized in a democratic milieu the starr Executive Committe became dominated by GPs. To this domination was added the weight or the Radiologist, the other institutional specialists, the Med/Edueational Director and the Adndnistrator,mal all those who . . _ afloaid of progress and who hope for maintenance of the status Quo. JkaJ!Iawatws Into this situation was thrown the establisment of a l;jpowt:o:: new cODIIIittee the Joint Advisory Cammittee which el:iDdnated the adrlsors to the Board, took the place of the Planning Board and the Professional Devel.opement Committee and has smceeded in Lh•n•8h11 completely stopping any progress which might have been made. A tritllll}il for the forces of the status Quo. Unfortuna~ the Board of Trustees is not familiar enough with matters medical DJ<•Ir lwllJxwiUn: to make sound judgment concerning the items brought to them for approval. For this reason it is recODDilended that the Board read and study and seek advice before mald.ng important decisions. It is recommended that the Board take a part in short and long range planning. It is also recokmended that the Board seek an evaluation of this hospital from a a consultant who would be unpredjudiced and without any local axes to grtng. ihe last recODillendation being urged by two or the Jlembers or the staff.
t
Brief History of the c • In order to undersu
think it is
necessary to detail tt influenced the growth elements which will ca parallels in many hosJ: th&t there are conside exist otherwise, or at
deb have
, and the .s IDKD'a1e1sx AS0110 OP\J103
bear in mind hich do not
The total histoey is one which is r8ally known only to one who has lived thru and cipated in every event which has changed the course of the hospital. The hospital rea.lly started as a result · of a number of things. In the 1930's in Maine a full practice law for DOs had been in effect for only a few years: MDs were refusing to consult with DOs on patients. Patients who were seen by MDs were never seen again by their DOe· There were isolated instances where individual relationships existed particularly in Laboratory:• X-Ray and Surgery,' however distinctly minor•A few intern.e in Osteopathic Hospitals sought after and prized mo were accepted~ DOs with hospital training began I add to -the pressure Of diSCOntent with the-then ----------(theophylline, anhydrous) controlled-release tablets An Osteopathic surgeon from Massachusetts became ulting on the oases of Maine nos. raising hopes that ne here in an Osteopa.thie hospital instead of tients to Reapba Boston.•
Uniphyr Rmg
-;
~
r ll
I
d a so called round table luncheon was held at the the Portlander;' every Wednesday noon with most of :ling.- Many things were discussed' patients, medical 'lt and the frustrations of DOs in an MD dominated lis time and in this atmosphere the AMA dropped the Laboratory or X-Ray reports to DOS on pain of loss Ls was the stimulus which needed only a leader to ~ leader was ready with a built in personal reason ,_, OPU•oo ~ a hospital; · He was an Obstetrician who had for __ _____ ___... ~.........veries and who now found himself wU)tlw~ without ~ny place to have his Caeserians done. An Osteopathic Hospital would provide him with a place to send his svgical Obststrics and would also provide on the job training for him sG that he would eventua.ll;r take over on his own:· He could probab]Jr be called the founder of the Osteopathic Hospital of Maine•~
Altho the official history of the hospital. starts with the b.Qspital I prior to this ,one was operated in South Portland hospital f'ormer]Jr run by a local MD;~ Here the r the Osteopathic Surgeon from Boston': cOJIIIIltlllt:ln (theophylline, anhydrous) controlled-release tablets sted a very short time when the opportunity tG /"7 ~od frame building on Pleasut Avenue f'ormer]Jr a soon af'ter it was opened a surgeon and a t' LTV'~ cv ~ : adcded to th.e staf'~ The rest of the staff were 1rs only a few of whom had \jad a.ey hospital ir\ vf ["tv t ~ ~ UYj c~ ~·~>1,, Dux: experience of any kinde The Board of Directoes "\.;'Y )~ J n vY1 < _ iSc~ rr!J , older members of the group who had had the money 11("_ pital~ There was no denwcratic process at that W as completely in cemtrol of all aspects of the cy '; mtio~ From this Board· arose the strong man J., Board and thereby oontrojed the hospital~ There ~~ These wera the days when in many hospitals the !l'gical and what stallda.rds of practice were set OP\J"' .c tive in nature as to who would or would not _ _·e rf·' There weee few recognized specialties~ Commonly the X=&.y man also coru;ulted in medical pNblems .-~
II
$e.vvJ
f1
/rrfJrvr
+ytr 9y- 6c<tf: s
A50ro
DECE ffiER 20, 1977
History is a dry, sterili'l subject --useless, unless it is vie\ved from the
~R~~~~
~c\'~J."-\\j
~~~~
V
~~--
~-rspective of nlavers \vho have ~ ~ the boards of ~ stage of time. Having "-/3 fje~s '~i u rl'"'"' ~~~ ~ ~ e:. n ~ ~iMtr ho.se_d-~lp trod the boards for ~ t -. i x " S<Us" short of half a centurv9'and having been pre sent 0~~
vrhen t·he
ltosf:l~ vas
onlv a dream ) retro- spection still identifies the actors and
the roles that thev ~ plaved, pood, or bad, in the developement of the Osteopathic Hosnital of
faine. It is not mv intent to sinple out those rare plavers vrhose role ~ ~ y,ras .~ i ~to the point of self sacrifice, those part '''as a fortuitous
; aea.-\.sh"-
"
IN ,-t)..
mingling of their o¥Tn best interest as xzell -~ that of the Hospital, and those ~~
A\?lt -s>to
conceal themselves 'iThen there \vas
'ork to be done onlv to shm,r un for somethinp
40
~
their sole benefit .
IN ,II It is unlikely that vouJ- have heard ~ historv such as this until the actors are ''Y' lllh
.
-t'" c.-·~~~
.-1
long dead, uhen all we ~ have "is a faded program, vith names, dates, and ulaces, ~ no opportunitv to
~ private
pctro" •
motivations which lead to the pY(Y', ~~' ...e1Y.lr'a'tl.
Hov! did the hospital come about?
s
If one looks back to the earliest thoup.ht of A
~ )\')KSt ~~ e~.elel'\r.wl• ~~ t a hospital ,d~ that "an Institution is the lengtheninp shadmr of ,I ' I 11 -f /11 ~ c ll>S 'I.. 1\ (1)1
man" ~e
one
~eneral
\vould have to sav that that one man was a
~_p.-- ~ ~
d1.d nhstetrics and wh o ~~.~~~<J'· .] """""" -~~-t...:.,_..,.. "' L.""Lvu~ A to have a place deliveries, D&C's and Caeserians
v.r~e'<~
~....~. ~
b8
h e cou ld d o 111s •
~ nreviouslv~~
L.r<.X'~ )'1'1 (/- h 'e I) 0 j I b\ ~ f is desires ~ -uo.ss l.bl" hav e Re t
homes and nursinp homes.
Practitioner lvho also
i-t; Rot h QQR fo r ,.other factors sue
/ _,q. ,
at patio"'ts
eorue t o h tt itiatt lted
as ~ recent chanpe in the 0steopathic Practice
Act rvhich allovred the Osteonathic Phvsician in faine to "nractice as taupht in the {)~ /~ Medi c.,. ,\ S chools'', ~ recent increase in voung D.O.'s rith hosnital traininp , 1 o n or- J ....r- f'" c 1}1...( /'1 r~. . G-e-11 l;j ft'-;? b ~ tJ.:u~.l:.C...Yas t h e oFE:ler fr Ol't the N r.A not to do Laboratorv \vork for ~ D . 0. 's on
/1"'' G-"'1
A
/
pain of losinp t 11eir Hosni tal approval, ~~ the larcenous behavior of ~ <.D. s A
in not trying to return the patient to the referring vie
1
I
9{t"!J
that the
n.o.,
/ ~ the idealistic
atient ,.·ould l:e taf-eq .caze o f 1 etter in an nstcopathic I osnital, ~ C,..o;.'('4~ ~<
the constant harrassment l:v the Secretarv of the
/
llopathic Board, ~ tre
-!-o<.-1-\:.
availability of an outstanding Osteopat ic Surgeon \'illing to perform surgerv"
_?("/
Pa e 2 (t.!AS h ~ cataly st t h at tied all · t 1ese things _into action ~ t h e nednesdaY ~ luncl' eons
at t h e Columb ia Hotel of a b out 6 to 10 D.0. 's v h o talk ed ! f)._
lospital _until it b ecame
realitY at 166 Pleasant Ave nue , t he b uilding now occupied b " the offices of T'r .s , / ljYJ»l'farcucci E· Hardv. The hosTJital F as snall h ut adequatelv e(jui ped for t h e late ..atV~. It was run.f by a Board consistinf! of t h e older g roup of Doctors Pho lac ed h os ital training and Hh o \vere reluctant to allm.,r the voum~er ~ roup 1privilep.: es. u ere secret.
and a Surgeon.
Our first Sryecialist Has the GP-0 RS man follo'-'ed bv a
:Je
This
l
.
considered in those davs to he
~
Board meetings
oent g enolo~ist,
':;..,~A sneci a list
staff.
Thes e Soecialists did the consulting for t1e non- snecialists whether or not the "
illness appeared to be in one of the covered snecialties. f)H. r<-tf'•.J..,t r>< '- \ ov.. ~s s'"'<'f"'~ +-h .. Y. we. 1) ho)'U.. h~ ~ c""'!f .....-;s~rt. Our reputation grevJ ranidlv so that in a short time persons vho had never h eard of an Osteopathic 'Phvsician became our most ardent cham ions.
that
e had our firsu
scholastic I
standin~
.94!
:f,'f,,n
r 1
nterns.
Thev ••ere selected,
additionallv because of
A
Co"lf"'
Here it Has
course, because of t >eir
t~ ~.~ cause
l ,
~ was necessary to carrv the patients up and down stairs.
F e had no elevator.
)'nt.~"'~t.~
To mv ~~~ -vre onlv
lost one off the stretcher., \ ith no damage being done. i'Prn spite of the small size o f the hospital \ve operated a clinic for poor persons in the basement.
_ cJ~v~\v~~ (-> raon ) parties began to ~ e~ and ~ stirlul~t~ t l'l h z:t esu h:ee
-jon
Political imnrovement.S
Q.fff,,!> ;?e(!Cid Some of 'the staff members became very ac tive in the A ndt,,._._( + j_.,~...,l American Osteopathic Association, the Snecialtv Colle~es, ~ Poards and Committees and visions for the future.
"
with the result that the Osteopathic Hospital of ..faine became a model for Osteonathic
Hospitals ~ · cJl.(rv>A-~~ ..
Because of the overflou of patients, i t was decided to on ton of Brighton Avenue hill to provide more beds.
urchase a frame building
This huildinp,, like the P leasant
Avenue building, had been:>CJ erated bv a Dr . Clement Testcott for the treatment of Alcoholism and Drug Addiction .
The buildin{t nrovided space \vhich although huge to
us at that time was rea lly verv small.
At Brighton Avenu
cJv
we carried out a vcrv
ambitious Education urogram for the Interns, Residents, Board, 1-
,e.
Publicitv and Public Relations we uti ized full •
"
urses and the puhlic. -t-'
Pe r
eview, Clinical
athological
Pa~e
Conferences
~·lere
held regularly.
The garage \vas converted into a clinic
~ ~ ~·tr ~~~eft-;-~ .........~ ~~' t>h'O<J<" not .J/ popular
~
with the neighbor:?
...... ~
.
3
~·Thich \-las
Its use as a clinic Has discontinued
0
Here at Brighton Avenue we ~ haYf-
as the X-Ray Department was shifted to the garage.
Vh ~"'"'(-\'t1 ~ e. " a circular dininr- room \vhich was filled at noon \vith Physicians talking and discussing their cases.
It vTas at Brighton Avenue that \ve were embezzled with the result that Col(\" Mtlo e cc."'"'fi·-~)..E.d ~o..,. tu-~ a complete auditl'has probably ne-t be en po55:i:h l e l:il' to no~. llere also the Pinkham -t()lo~ ~\f.<.'"multiple birth ~-with national publicitv. ~ c\•\;c<• . 'p~ Again, the ~capacitY ~~ became critical. The t\vO part1es were diametricallY A
One felt that since ten
opposed in their view of the solution to the census problem.
j;;iif
doctors admitted almost all the patients that cuttinp admission privileges of all
'ol}-y
the ten favored doctors would solve the problem.
C'n the other hand, the opPosition
expand ,~ .
Proposed to buy a bigger hospital and
The building purchased was
u..rh·,c,y.... the State Street Hospital quicklY filled up to its 90 bed capacity.
~-r
"
dod~'f'6 o'f
N-o sf
,r. smal-l. number of
~e
patients continued !lAf Brighton Avenue as t-rell as the minoritY party. -fiJ fel-l i\
A
re~~th~-,y\ ~
.
o~
as<.
Doctors ~ ~ at Brighton Avenue recruited matching Specialists to th e:~ ~ ~o.~cr• 1"'~ at State Street. The la?~est ~azt ·~ 'lre group of Phvsicians owned both State Street and Brighton Avenue at that time but confined their activities to State Street . ~ ho we."-v·r' \~niting of the t\vo groups Pas considered unlikelv or impossible ) due to the urp,inp, ~
~
~lf"''j
fn'
one of the members of the majoritv group ~ an attempt vTas to be tried to ~e t:::hzAotr ~~~ 'fht- m<-~l.,f,C& •'1- ~bl~ 5Y0"'o~ • ) • p ar t 1 es together. er..r,J ut1on Has wr1tten and to our amazement Has successful. 'Pr 1.or ("e_d .m
A'''
to the decision to amalgamate
-~-~
t
~he staff).~:~te
Street
Hospital~~ the
happiest it
tCoca'.a.·n.\,11'Y\~ ~c-.'<''""-<>""~ w-e.-<. .-t\._~ o-rk< of-ti;c. Jc.';),.. had ever been ~ t~ ~ happiest it bas been to the present time.
~e
~~ notice had been made of <!J
Some
egim'!.ing of the emnlovement of business managers and
~~i~
administrators by hospitals.
appeared to be a practical approach to
_J};fs"
increasing business problems our first business manager Has hired. 1\
Almost imrnediatelv
h ~" ;,.,
he and the business managers of the other local hospitals joined f oreer to force Blue Cross to pav the Hospital what it \vas oued.
Our first administrator came to us
0....~
from a Hotel where he uas Assistant Hanager. II
He was Hith us for manv vears
us verv \·Tell and earning the resnect of the staff.
servin~
Although a laymen, he vias +
Page 4 voted a member of both the pathic
~faine
Osteopathic Association and also the American Osteo-
Ass~n.
~ Hospital Boards either in part or as a ~eb~ and after a spirited meeting ~ it was voted to replace Doctors with laY persons.
"
the consideration of the matter those oPposed agreed to first one, then all the potential positions on the Board were filled with lavmen.
t~To,
During
etc. until
It has been said
by one of our ex Board members that public pressure was the factor which forced n 路 t o e l ect a lay Board.
This is complete
misinform~tion
as there was no public notice
of the Hospital or pressure from anyone. i?Excessive demands by the City BuildinP, Inspectors resulted in the agreement that \-re would return to Brighton Avenue and there we
~10uld
electing lay persons to the Board was that t h ey would \-rould help us in business and social matters. occu ations. or
~od
looks
l. s
under take construction of an addition to the IIospital.t Our thought in bring ~
broad experience which
They \vould represent a varietY of
They \路Jere expected to be active and not elected for their money, prestige
J9
It \-ras not without fear that the lay Board might do--nothing or at other times might meddle excessively in matters beyond their competence. over the years to varying degrees.
TI1is has heen the case
From the beginning until recentlY the staff
contributedly generously of their real dollars before inflation in the various fund cam aif'ns. At this point, the election of the original Lay Board of Trustees is ancient history.
CTJrrent history involves so many events that
profitable study of each important occurance. to make the same mistakes again and again:
~ hours
ithout this
could he spent in
knowled ~ e
Pe are destined
The simple matter of definitions alone
has resulted in misunderstandings of monumental pro ortion. falacious unless we are able to sneak the same language.
Our
jud~ements
will be
.
Page 5
'
Some of the tenns \.Jhich should be studied in this highlv snecialized field are as follows:
Primary Phvsician
Familv Practice
Secondary Physician
~amily
Tertiary Physician
Purpose of Family Practice
Medical Center
Peer Feview
Community Hospital
PSRO
General Practitioner
Tumor Board
Family Practitioner
Shortage of Phvsicians
Family Nurse Practitioner
Image of the Phys ician
R. •
Department Organization
Nurses Aide
Fee for service
Practical Nurse
Contact Phvsician
National Health Insurance
Staff Executive Committee
National Health Insurance in Britian
Joint Advisory Conunittee
National Health Insurance in Russia
Privileg es
Instant Seniority
Supervision of
Credentials Committee
Certification
Coordinators
rational Eoard
Sub Specialty ~eneral
Practice Hospital
esidents
~.D.
Practice Residents D.n.
!' e"~>T
'ember
Primary Hospital Secondarv ospital r Tertiar"l' los ital
~,
C'lther s ub jects Fi ll suggest themselves as spin offs froM tine to tine.