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American Medical Schools and the Practice of MedicineA History$
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William G. Rothstein

Print publication date: 1987

Print ISBN-13: 9780195041866

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195041866.001.0001

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Hospitals Affiliated with Medical Schools

Hospitals Affiliated with Medical Schools

(p.270) 14 Hospitals Affiliated with Medical Schools
American Medical Schools and the Practice of Medicine

William G. Rothstein

Oxford University Press

After mid-century, university hospitals became more involved in research and the care of patients with very serious illnesses. This new orientation has created financial, teaching, and patient-care problems. In order to obtain access to more patients and patients with ordinary illnesses, medical schools affiliated with veterans’ and community hospitals. Many of these hospitals have become similar to university hospitals as a result. Medical schools experienced a serious shortage of facilities in their customary teaching hospitals after 1950. Many university hospitals had few beds or set aside many of their beds for the private patients of the faculty. Patients admitted for research purposes had serious or life-threatening diseases instead of the commonplace disorders needed for training medical students. The public hospitals affiliated with medical schools had heavy patient-care obligations that reduced their teaching and research activities. To obtain the use of more beds, medical schools affiliated with more community and public hospitals. The closeness of the affiliation has varied as a function of the ability of the medical school to appoint the hospital staff, the number of patients who could be used in teaching, and the type of students—residents and/or undergraduate medical students—who could be taught there. In 1962, 85 medical schools had 269 close or major affiliations and 180 limited affiliations with hospitals. Fifty-one of the hospitals with major affiliations were university hospitals and 100 others gave medical schools the exclusive right to appoint the hospital staffs. Dependence on university hospitals has continued to decline so that in 1975, only 60 of 107 medical schools owned 1 or more teaching hospitals, with an average of 600 total beds. All of the medical schools averaged 5.5 major affiliated hospitals, which provided an average of 2,800 beds per school. Public medical schools were more likely to own hospitals than private schools (39 of 62 public schools compared to 21 of 45 private schools), but they averaged fewer affiliated hospitals (5.1 compared to 6.0). In 1982, 419 hospitals were members of the Council of Teaching Hospitals (COTH), of which only 64 were university hospitals. Members of COTH included 84 state or municipal hospitals, 71 Veterans Administration and 3 other federal hospitals, and 261 voluntary or other nonpublic hospitals.

Keywords:   Council of Teaching Hospitals, Johns Hopkins University medical school

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