By Melissa Dombrowski, Bicentennial Intern, Class of 2018, History
Part 1: Riley Hospital vs. The General Practitioners
As a teaching hospital of the Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health is recognized as one of the leading hospitals for children in the United States for patient care, research, and education. In 2018, Riley Hospital, the only nationally ranked children’s hospital in the state of Indiana admits approximately 250 young patients a day for treatment.[1] However, the road leading to the prestigious world-class children’s hospital of today was a rocky one.
In the late teens and early 1920s, Indiana, like most of the rest of the world, was still reeling from the 1918 flu pandemic. Indiana already had extensive waiting lists at hospitals for admission of people of all ages for various other life-threatening diseases in need of treatment. However, some members of Indiana University leadership along with many physicians saw the medical accommodation of children as the greatest need.[2] To help curb the child health crisis, the Indiana State Legislature passed a 1921 act which allowed for the establishment of Riley Hospital for Children.
While the demand for such a hospital was evident, not all Indiana doctors were on board with the idea. The source of alarm sounding from these doctors mainly resulted from newspaper articles touting the idea that Riley Hospital, while being a state-funded hospital, would be free to all children in the state of Indiana.
For instance, a November 1921 article in the Richmond Item described a meeting of the Richmond Rotary Club, where Dr. Samuel E. Smith (an Indiana University trustee member of the Joint Executive Committee charged with the construction of Riley Hospital and later the first provost of Indiana University’s Indianapolis campus) reportedly stated that “The hospital is a ‘free state institution to which any child residing in the Indiana may be admitted for medical or surgical attention. ” He went on to add, “the hospital is endowed by the state with an annual appropriation for operation.’”[3]
Additionally, an April 1922 article in Munster, Indiana’s newspaper The Times reported that, “Children whose relatives are able to pay for their care at the hospital may do so, but this is not compulsory.”[4] Therefore, not only indigent children had the opportunity for free healthcare, but so did any child in the state of Indiana.
Reports like those in the Richmond Item and Munster’s The Times prompted criticism among the private practitioners of Indiana, as well as members of the Indiana Medical Association. Fearing for the wellbeing of their careers, these medical professionals decried this plan for the new children’s hospital as socialistic and communistic.
One editorial in the Journal of the Indiana Medical Association (JIMA) declared, “Certainly it is time for every red-blooded medical man to take off his coat and work for the high ideals he represents, to say nothing of aiding in his own self-preservation,” adding that hospitals of this kind had no “moral right to enter into competition with the private institutions of the state.”[5]
This particular editorial seemed most concerned with the idea of treatment of non-indigent patients at a state-run hospital whether or not payment or contributions were made from the patient or other sources.
In other words, this author believed that Riley Hospital should accept indigent patients only with no exceptions, and to do otherwise would be to the detriment of the entire industry of private practitioners. Other JIMA articles took a slightly different perspective, however. One editorial from March 1922 stated that the openness of Riley Hospital to all children of the state was perfectly acceptable, as long as those who were able to pay actually paid.[6]
Additional JIMA articles throughout the early 1920s prior to the building of Riley Hospital also accused “newly enfranchised women” who took up jobs as social workers as undermining the work of general practitioners and cast doubt on the ability of the “faculties of medical colleges” to provide the same quality care as the general practitioners.[7]
Over the early months of 1922, Dr. Albert E. Bulson Jr. (JIMA Editor and Manager) also corresponded with Indiana University School of Medicine’s dean, Dr. Charles P. Emerson, fervently urging him to heed the outcry of the general practitioners and assure that the new Riley Hospital open its doors only to indigent patients if it was operated through state funding.
This correspondence was initiated by Bulson’s alarm from a letter he received from a man inquiring about a rumor inferring that the Robert W. Long Hospital, the School of Medicine’s teaching hospital, accepted patient referrals for free treatment.
In one letter, Bulson listed complaints about how Long Hospital charged different patients based on social class and expressed a concern that the situation at Riley Hospital may end up worse. He also emphasized what he referred to as the “overwhelming sentiment in the medical profession as opposed to [Riley Hospital]” and that local doctors worried that building up the medical school would create too much competition.
While the JIMA editor also clarified that personally he was not opposed to the construction of the hospital completely, he also indicated that there could be more freedom in the way Riley Hospital could operate based on how it was funded. Bulson stipulated that there would be a difference in operation depending on whether the hospital was funded by the state or maintained through donations.[8]
These letters from Bulson to Emerson foreshadowed the importance that bequests and donations would play in the midst of backlash from the medical community’s local practitioners. Throughout its history, charitable organizations have contributed to the growth of Riley Hospital for Children.
Key to this growth has been the Riley Memorial Association (today, the Riley Children’s Foundation) in the founding and the maintenance of the hospital. Many other charitable organizations such as Kiwanis, Rotary, the Junior League, Tri Kappa, Psi Iota XI, and the Riley Cheer Guild have also played important roles throughout the hospital’s history. Families of patients receiving treatment at Riley Hospital can even stay free of charge at the Ronald McDonald House on the IUPUI campus as well as at the hospital.
In the early 1920s, however, the backlash from the medical community illustrated the need for public support. As a result, the joint executive committee[9] began looking for new and on-going ways to increase public awareness for these needs and to generate funding.
To learn more about the early history of Riley Hospital, please visit:
Read part two here: https://blogs.iu.edu/bicentennialblogs/2018/09/05/the-rocky-road-to-the-creation-of-the-riley-hospital-for-children-part-2/
Notes
[1] “Riley Hospital for Children at IU Health Nationally Ranked in 8 Children’s Specialties,” US News and World Report, accessed July 1, 2018, https://health.usnews.com/best-hospitals/area/in/riley-hospital-for-children-at-iu-health-PA6420020#children-rankings
[2] Letter from Unnamed Dean to Indiana University President William Lowe Bryan, 30 September 1919, Box UA 73 #1, Folder 32, Office of the Dean Records, Ruth Lilly Special Collections and Archives, IUPUI University Library.
[3] “1700 Probably Will be Spent by Rotarians for Boys and Riley Hospital,” The Richmond Item (Richmond, IN), 16 November 1921, p. 1
[4] Fred Millis, “Great Philanthropic Project Aided by Legislature,” Times (Munster, IN), 13 April 1922, p. 9
[5] “A letter to the State Board of Health…,”Journal of the Indiana Medical Association, ed. Albert E. Bulson, February 1923, p. 64, accessed 22 June 2018, https://archive.org/stream/journalofindiana1611indi#page/64/
[6] “A campaign is on to raise funds for the Riley Memorial Hospital…,” Journal of the Indiana Medical Association, ed. Albert E. Bulson, March 1922, p. 101 – 102, accessed 22 June 2018, https://archive.org/stream/journalofindiana15unse_0#page/n122/
[7] Frederick E. Jackson, “A Medical Sermon,” Journal of the Indiana State Medical Association, ed. Albert E. Bulson, May 1922, p. 163 – 168, accessed 18 June 2018, https://archive.org/stream/journalofindiana15unse_0#page/n196/search/Riley
[8] Letter from Albert E. Bulson to Charles P. Emerson, 20 December 1922, Box UA-073 #1, Office of the Dean Records, Ruth Lilly Special Collections and Archives, IUPUI University Library.
[9] The Joint Executive Committee, consisting of members equally representing the Indiana University Board of Trustees and the James Whitcomb Riley Memorial Association, was in charge of the building and operation of the James Whitcomb Riley Memorial Hospital