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Ethos of Caritas

A description of the ethos of caritas, by Alvan R. Feinstein...

"Patient care at the medical schools was taught mainly in large municipal hospitals, where the non-paying clientele, treated at in-patient wards and out-patient settings, were clinical material for the students, house staff, and teaching faculty. These non-paying patients also created the challenge, tradition, and ethos of caritas, a word that means both "charity" and "care".

In exchange for the experience of learning from the charity patients, the physicians-in-training and their supervising teachers were obliged to provide excellent care.The patients incurred no costs and paid no fees. The municipal hospitals were free, being supported by public taxes and private contributions.

The interns and residents who were called "house staff"” received minuscule stipends, and the attending physicians charged nothing, being either salaried by the school or sustained, in the old "Robin Hood" practice pattern, by fees from private patients.

The obligation to give excellent care to the charity patients was a crucial, ingrained part of the clinical ethos of caritas, both in teaching and in public perception.

The image of the compassionate caregiver was best shown in Luke Perspectives in Biology and Medicine Fildes’s famous painting (1891) of the physician at the bedside of an ailing child.

The Doctor by Fildes

The Doctor, 1891 by Luke Fildes ( Public Domain Art {{PD-Art}})

The caring medical-school environment was promulgated during the first part of the 20th century through the leadership of William Osler and in Francis Peabody’s oft-repeated aphorism that "The secret of caring for the patient is to care for the patient."

The clinical faculty who did the teaching were regarded as scholars.They had had extensive experience in caring for patients, and their knowledge of disease, therapy, and people, having been organized into various forms of clinical judgment, was transmitted to house staff and students "

...in The Metamorphosis of the American Medicine.

Clinicians working in the UK can access the rest of this paper using Athens credentials via the link above.

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Page Updated: 27 May, 2017

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