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City Hospitals: The Undercare of the Underprivileged

Gert H. Brieger, MD
JAMA. 1983;249(7):951-952. doi:10.1001/jama.1983.03330310069040.
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Slowly but surely, American hospitals as medical and social institutions are finding their historians. Dr Harry F. Dowling, long-time professor of medicine at the University of Illinois, and author of previous historical works on therapeutics and on infections, has now turned his attention to one of our most critical problems of medical care. The city hospitals of the United States, beginning as public welfare institutions in many instances, grew to the status of major medical centers by the 1950s. A generation later, some, such as The Philadelphia General Hospital, closed their doors, and others were in dire straits. Unloved, underfunded, and overworked are all true descriptions, unfortunately.

In the context of using history to assist in the making of public policy, Dr Dowling has undertaken to trace the story of the municipal hospitals, a story rich in both accomplishment and turmoil. He divides his history into four periods: the poorhouse


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