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Gerald E. Thomson, MD; Seymour M. Glick, MD

Arch Intern Med. 1970;126(4):673-678.

Abstract
It is perhaps symptomatic of the approach to municipal hospitals that many of the discussions focus on the hospital rather than on the patient. The patient is almost forgotten in the erudite and often thoughtful discussions of the institutional fate. Patient care at local governmental hospitals continues to be woefully inadequate in spite of the acknowledgement that medical care is a right and not a privilege, and in spite of an increase in governmental funds earmarked for indigent patients. A variety of forces, often at opposite poles of the political spectrum, combine, in effect, to deny proper care to the municipal hospital patient.

The Basic Problem
The major factor contributing to the second-rate quality of medical care given to patients in local gov- emmental hospitals has been the prevailing community attitude towards indigent patients. The municipal hospital, a direct descendant of the poorhouse, has traditionally provided care that was "good

Author Affiliations
Brooklyn, NY

From the Medical Services of Coney Island Hospital affiliated with the Maimonides Medical Center, Brooklyn, NY.

Footnotes
Received for publication Feb 23, 1970; accepted April 29.

Reprint requests to Coney Island Hospital, Ocean and Shore Parkways, Brooklyn, NY 11235 (Dr. Glick).

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