on the staff. These men have been selected with great care and they are paid salaries that amount to at least as much as they would ordinarily earn in successful private practice. They have, none of them, any financial interest whatsoever in any patient, and a patient may not be treated by a doctor from the outside. We gladly acknowledge the place and the use of the family physician. We do not seek to supplant him. We take the case where he leaves off, and return the patient as quickly as possible. Our system makes it undesirable for us to keep patients longer than necessary—we do not need that kind of business. And we will share with the family physician our knowledge of the case, but while the patient is in the hospital we assume full responsibility. It is "closed" to outside physicians' practice, though it is not closed to our cooperation with any family physician who desires it.
The admission of a patient is interesting. The incoming patient is first examined by the senior physician and then is routed for examination through three, four, or whatever number of doctors seems necessary. This routing takes place regardless of what the patient came to the hospital for, because, as we are gradually learning, it is the complete health rather than a single ailment which is important. Each of the doctors makes a complete examination, and each sends in his written findings to the head physician without any opportunity whatsoever to consult with any of the other examining physicians. At least three, and sometimes six or seven, absolutely complete and absolutely independent diagnoses are thus in the hands of the head of the hospital. They constitute a complete record of the case. These precautions are taken in order to insure, within the limits of present-day knowledge, a correct diagnosis.
At the present time, there are about six hundred beds available. Every patient pays according to a fixed schedule that includes the hospital room, board, medical and surgical attendance, and nursing. There are no extras. There are no private nurses. If a case requires more attention than