PAPERS OX MEDICINE AND PUBLIC HEALTH 443 



cense received from the state, while the physicians not 

 on the staff of the hospital are limited in their hospital 

 practice by the privileges granted them or denied them 

 by the gi'oup of men who are fortnnate enongh to be on 

 the hospital staff. Thus from the standpoint of the med- 

 ical man who is not on the hospital staff, though he live 

 under a democratic government, which licensed him to 

 practice medicine and snrgeiy, his professional life is 

 controlled, in so far as his patients require hospital care, 

 by an autocratic group of men, the Hospital Staff, whose 

 authority he resents to the extent that he will habitually 

 refuse hospitalization of his patients except in the most 

 extremely urgent cases, this to the detriment of the hos- 

 pital, himself and his patients. TVTien one considei*s that 

 if the application of the Minimum Standard be univer- 

 sally adopted by hospitals, not more than Ib^c of the 

 medical profession can hold hospital staff* positions, one 

 can foresee this, that S5^ of the medical profession will 

 be constantly advising against hospitalization rather 

 than for it. The more prosperous physicians without 

 staff positions will endeavor to establish private hos- 

 pitals for their patients which will, if they succeed, neces- 

 sarily be more expensive, less well equipped, consequent- 

 ly less efficient than the larger hosjDitals from which they 

 are barred and which are given public support. The 

 foregoing comparisons of hospital organizations are 

 graphically brought out in the following charts : 



