The contemporary hospital experience also boasts far more creature comforts. Rooms are climate controlled and smoke free. Patients need not eat whatever is
served to them, but can order from a full menu. Television and Internet access are available in each room. Hospitals now compete with one another in pampering their denizens,
offering such amenities as high-thread-count sheets, concierge services, gourmet chefs, and on-site spa facilities. Some even boast that their staffs have
been trained by the likes of the Disney Institute to deliver customer-pleasing service.
Nurse Florence French at Methodist Hospital, ca 1925 (Methodist Health Foundation)
Of course, such opportunities come at a price, and increasing price represents one of the major drawbacks of the progress over the past 70 years. Back
then, several types of accommodation were available, including a ward bed with a half-dozen or more other patients, a two- or three-bed room, a private
room, or even a deluxe room with a private bath. The daily price for even the latter option was only $25, a private room varied between $6 and $8.50, and a
ward bed cost just $3.50. These charges covered not just the room but also meals, nursing, house physician, and surgical dressings.
The dollar today not being what it was 70 years ago, of course these numbers need to be multiplied by at least 10 to put them into contemporary terms.
Nonetheless, hospital care was a bargain compared with today, when a day in the hospital, not counting the fees for physicians, medications, and
procedures, generally runs at least $2,000. And it deserves repeating that many of the services we now take for granted, including tests such as
mammography, drugs such as SSRIs and newer antidepressants, and procedures such as laparoscopic surgery, were not available then at any price.
Another big change concerns the people running the hospital. Back then, the administrator in charge of day-to-day operations was called the superintendent,
and he was a Methodist minister. The pamphlet bears a handwritten note from his desk, expressing the hospital's intention to provide the "very best care"
and urging patients in need to phone his office, whose primary purpose was to minister to the sick. Today the administrator typically bears a business
title such as CEO, and he or she is flanked by a CFO, a COO, and a legion of other staff whose degrees are far less likely to be in ministry than business.
The hospital also now employs large divisions of people in fields such as billing and coding, regulatory compliance, and marketing who barely existed 70
years ago. Whole new layers of management have been introduced, with the result that the hospital devotes a much smaller proportion of its much greater
revenues directly to patient care.
When the superintendent was a clergy person, the hospital tended to be more focused on its religiously inspired charitable mission. It had been founded by
people who saw service to the community not only as a duty but a privilege, and for whom business concerns were secondary. For example, the pamphlet states
that "an entrance deposit is kindly requested (not demanded)," and "it is not our policy to disturb the patient regarding bills unless absolutely
necessary." Patients were explicitly requested not to tip the staff.