Public Hospitals Matter

Recent events in this country pose major concerns. Police shoot unarmed blacks, gun-wielding malcontents ambush policemen, white supremacists march, gays are murdered, gender inequality pervades our workforce, and sexual harassment and abuse are surfacing in many segments of our society. In reaction, various social movements have sprung up, including Black Lives Matter, White Lives Matter, Blue Lives (policemen) Matter, Gay Lives Matter, Girls for Gender Equity (GGE), #MeToo, and Time's Up. To that list, I add another battle cry: Public Hospitals Matter.

On pages 119–120 of this issue, Mark Scheid provides a splendid review of an important book about New York City's oldest and most celebrated hospital: Bellevue.¹ Written by David Oshinsky, Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital chronicles that medical institution's history in an amazingly detailed, comprehensive, and informative fashion. On nearly every page, there is something admirable, and often striking, that Bellevue has accomplished for humankind. Here are a few examples:

• Bellevue has never turned away a patient in its almost 3 centuries of existence. Because it was a dumping ground for patients whom other hospitals didn't want, it soon became synonymous with bedlam, receiving criminals, their mangled victims, vicious psychopaths, and hopeless derelicts. In fact, most of its patients—the poor, the mad, and the despised—have had no other place to go.²

• The hospital's resultant image as a “madhouse” belies its immense achievements in clinical care and medical research, made possible by a long line of eminent physicians and a close affiliation with the Cornell, Columbia, and New York University medical schools.

• These schools sent medical students and house officers to Bellevue for training and placed faculty members there to teach and perform research. Like many other public hospitals in America, Bellevue “has borne witness to every imaginable disease and public health scare, every economic swing and population upsurge, [and] every medical breakthrough and controversy.”¹ There has been no better place to learn medicine than in public hospitals affiliated with medical schools. All of my training, for example, and most of my professional activities took place in city-county hospitals, and I remain ever grateful for those opportunities.

Bellevue's biggest challenge today is keeping its doors open. Many other public hospitals across the land face the same challenge. Financial support for these institutions ordinarily comes from local, state, and Federal sources, but those funds have diminished substantially in recent years. And the prospect of relief seems slight at best.

Public hospitals in general, and Bellevue in particular, have helped and continue to help their respective communities in ways that private and university hospitals cannot or will not help. Although rarely getting the respect and appreciation that they deserve,

Public Hospitals Matter!