Page:Hospitals, medical science and public health.djvu/12

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HOSPITALS, MEDICAL SCIENCE,

touch with the medical he will continually make little mistakes and large blunders. Now do we, generally speaking, find such broad and continuous counsel between these partners in large hospitals? Do we not too often find on the contrary a lay board shutting itself up by itself, and week by week proceeding to business without continuous touch with the honorary staff; acting indeed sometimes as if the staff existed only to do what it is told; a custom surely discourteous and wasteful, as well as mischievous to the business the two partners have at heart. How, then, should concord, mutual understanding, and harmonious and efficient cooperation be maintained? At the Leeds General Infirmary every member of the honorary staff is, ex-officio, a member of the weekly board; thus at every board one or other of the staff is sure to be present, so that if any innocent-looking proposal arises which in so complex a machine might react prejudicially upon the welfare of the sick, a warning note is heard, and the proposal is deferred or modified. Larger issues are discussed, on due notice, by full boards of lay and medical members, with frank and equal interchange of opinion; but the staff vote is properly limited, in my day it was to eight, these votes being readily distributed among the staff at the discretion of the members present; votes being, of course, allotted first to the members of the departments especially concerned in the issue. The result during my experience was that no cool breezes chilled the cordial partnership between board and staff in that successful hospital; nor was there any loss of efficiency by want of touch, cross purposes, or conflicting opinions.

The next counsel I would offer is that a lively and effective sympathy be manifested with scientific aspiration and invention, even by lay managers who may be unable to see the bearings or object of particular researches. To speak personally, I shall never forget the almost comic astonishment of a certain weekly board to which, some 40 years ago, I appealed for a very modest outfit of electrical scientific apparatus, and at a later date for means of registering surface temperatures by electrical thermocouples, of recording continuous curves of bodily temperature by watchwork, and so forth. Bit by bit I did indeed get something of what I wanted, but with a delay and tediousness that crippled my endeavours. Now, I pray you to believe that no money is better expended