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JAMA. 1987 Dec 4;258(21):3155-6.

Unconscious on a corner.



A physician working in inner-city Washington, D.C., uses the case of Mr. W., a homeless demented patient, as the starting point for his essay on medicine's abandonment of the poor. Having stabilized Mr. W. and treated his acute condition, the hospital physicians were prepared to discharge him to the unsupervised environment of a city shelter. Hilfiker acknowledges that the needs of the poorest, most broken members of society seem overwhelming. Physicians, not knowing what to do, do nothing, and the public sector does little enough. Hilfiker identifies the "monetarization" of private medical care, the inadequacy of the public system, and the stresses and frustrations of caring for the poor as the reasons for their abandonment by the medical bureaucracy. He urges his colleagues to bring the poor into their practices, and to return to their roots as members of a "servant profession."

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