In 1857, the Chicago City Dispensary, a charitable outpatient service, was opened. The dispensary became affiliated with the newly established medical college known as the Medical Department of Lind University in 1859.
More than 8,000 patients were treated in the dispensary from 1862 to 1863. Professor Andrews gave a ‘Surgical Clinic’ in the lecture room every Wednesday, with selected patients from the dispensary. Professor Byford gave a ‘Clinic’ on diseases of women and children each Saturday.
In 1872, the name was formally changed to the Davis Free Dispensary. Its primary purpose was to provide free medical services to the poor. Prior to this date, the dispensary was not used for teaching purposes; only selected cases were presented to medical students by the attending faculty.
The dispensary was added as part of the regular curriculum in 1873 and divided into six departments: medical, surgical, diseases of the chest, gynecological, ophthalmic, and skin diseases, with daily instruction for upper classmen. A group of six or eight students were present at operations and examinations, and witnessed treatment in each department. Each group remained about a week in each department. All the students had the opportunity for learning the practical application of the instruments used in the dispensary departments. One or more of the advanced students were also employed in each department as assistants.
In 1874, the number of patients that visited the dispensary was nearly 7,800. The faithful attention given by the medical staff and the absence of other dispensaries on the south side contributed to the success of the Davis Dispensary from its very foundation. The expenses were relatively great, but through a board of trustees, gifts from Drs. N. S. Davis and W. H. Byford, and the Chicago Relief and Aid Society, an endowment was created. In 1875 the faculty of the college agreed to annually appropriate funds (not to exceed $500) for dispensary maintenance.
On Sept. 16, 1875, the name of the facility was changed to the South Side Dispensary.
In 1882, Dr. Davis met with trustees and advised placement of each department of the dispensary under immediate charge of the Chicago Medical College faculty, who would be responsible for the service in each department.
In July 1892, the trustees resolved that the reorganization and future management of the South Side Dispensary be entrusted to the executive committee of the faculty of Northwestern University Medical School. This would be on condition that the dispensary should afford the greatest amount of medical and surgical aid to the actual poor, and also provide the most efficient clinical instruction to the students. The dispensary became an integral and indispensable part of the school.
In the summer of 1893, Davis Hall was erected, fulfilling the trustees’ pledge of a new building for the dispensary. Constructed specifically as an outpatient hospital, it contained the most modern accommodations of any institution of its kind in the country. Between 24,000 and 25,000 patients were treated annually. There were nine departments: medicine, surgery, neurology, orthopedics, gynecology, laryngology & rhinology, dermatology & syphilology, ophthalmology & otology, and pediatrics. Each department occupied a separate room, or suite of rooms, and had a clinical instructor.
The dispensary provided students their first practical work in medicine: meeting the patient, developing a history of the patient’s illness, making careful physical examination, deliberation as to diagnosis and in a discussion with the physician in charge, differentiations from similar conditions that might lead to error and learning to eliminate the nonessential from the important. The training in the dispensary continued daily for two years, developing the qualities that make the good diagnostician: an abundance of material, a large experience, much observation, exercise of tact, deliberate judgment, and a growing confidence in the student’s ability, with a true appreciation of the student’s limitations.
In 1903, a diet kitchen was installed in which students learned the practical dietetics of infant feeding, a first in Chicago. X-ray service was added in 1917. Social service was instituted in 1920 and a prenatal clinic in 1922.
New Outpatient Clinics
In 1923 and 1926, Elizabeth J. Ward gave a total of $8 million for the erection and endowment of a Medical Center as a memorial to her husband, the late A. Montgomery Ward, founder of the world’s first great mail-order retail company. Specified in Mrs. Ward’s gift was a directive regarding civic duty, specifically “to render community health service.” In response, an outpatient clinic department was constructed in the new building. The facility was named the Montgomery Ward Medical Clinic and comprised a three-story “addition” on the west end of the Ward Memorial.
The Oct. 24, 1927, medical school announcement noted the “[a]dequate accommodations … [providing] care of somewhat excess of 300 patients per day. The outpatient departments furnish clinical teaching material of the utmost value. Adequate equipment has been provided in all departments including X-ray, electro-cardiograph, metabolism and physiotherapy. More than 80,000 patients were cared for during the year 1926-27.”
By 1934, there was an excess of 500 patients per day, with an annual total of more than 157,000 patients.
In 1940, a wholly redesigned and equipped X-ray department was given through the generosity of Colonel Robert R. McCormick as a memorial to his late wife, Amy Irwin McCormick.
In 1943, the Louis E. Schmidt Clinic for treatment of venereal disease was added, and the clinics were renamed the Northwestern University Medical Clinics.
By 1950, the X-ray clinic had been enlarged with additional equipment “to provide diagnostic and therapy facilities for the Clinics, Student Health and Research. Photoroentgen equipment is available for chest survey of all new admissions to the Clinic and the students of the various Chicago Campus schools,” as noted in the 1951 annual announcement.
With the addition of the Morton Building in 1955, more space was added to the Clinic. Outpatient teaching was conducted in the clinics of Children’s Memorial Hospital, Evanston Hospital, Rehabilitation Institute and in several community-sponsored clinics.
Senior students spent one full quarter in the outpatient clinics conducting their own office practice under the supervision of instructors. Comprehensive medical care was stressed.
By 1975, the long history of a dispensary service came to an end, as other units of the Medical Center provided aid on a private patient basis. Through the supervision of the Department of Community Health and Preventive Medicine, alternative clinics were made available to students on a volunteer basis, such as the Erie Clinic. Emphasis was placed on the importance of long-term ambulatory patient care, with students assigned for a longer term on an individual basis, conducting management as would a personal physician. Outpatient service was also made as an elective for senior students.
While another chapter in the history of the University came to an end, the next chapter began as students furthered their education through community-based healthcare facilities in cooperation with the members of the McGaw Medical Center.