Proposed Collaborative Research Program Between the Medical Out-Patient Department of the Johns Hopkins Hospital, Baltimore,
and the U.S.P.H.S. Hospital, Baltimore
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McKusick, Victor A.
Original Repository: Alan Mason Chesney Medical Archives. Victor Almon McKusick Collection
Reproduced with permission of Anne B. McKusick.
From "Musical Murmurs" to Medical Genetics, 1945-1960
With the recent re-organization of the Out-Patient Clinics of the Johns Hopkins Hospital and Medicine I Clinic has been organized
as the out-patient investigative facility of the Medical Out-Patient Department. Medicine I is comprised of a number of specialized
sub-clinics with limited clientele for special therapy and long-term study. These subclinics include
1. Connective Tissue Clinic, under direction of Dr. Lawrence Shulman -- studying patients systemic lupus erythematosus.
2. Hypertension Clinic, under direction of Dr. David Grob -- treating selected patients with hypertension.
3. Growth Clinic, under direction of Drs. Albert H. Owens and Louis Lasagna. Program for chemotherapy of neoplastic diseases.
4. Genetics Clinic, under direction of Dr. Victor McKusick. Studying a group of families investigated 30 years ago by Dr.
Raymond Pearl; also other families referred to clinic.
5. Kidney Clinic, under the direction of Dr. W. Gordon Walker. Studying patients with chronic renal disease.
6. Venereology Clinic, under the direction of Dr. Richard Hahn. Studying late manifestations of syphilis and the identification
of the biologically false positive reactor.
7. Rehabilitation Clinic, under the direction of Dr. Douglas G. Carroll. Studying the rehabilitation of patients with chronic
neurologic defects and arthritis.
The social service, public health nurse, indexing and follow-up techniques developed in this clinic by Dr. J. E. Moore are
admirably suitable for clinical investigations in ambulatory patients. The program can, however, be strengthened greatly
by the availability of a certain number of research hospital beds for investigations which require in-patient observations.
1. That a limited number of "special study" patients be admitted to the U.S.P.H.S. Hospital for therapeutic and/or
diagnostic procedures which are part of the total investigative program of them Medicine I Clinic.
2. That one officer of the Public Health Service who has had sound clinical training and who preferably is at least an assistant
chief of the Medical Service of the U.S.P.H.S. Hospital be responsible for the in-patient investigation of the patients admitted
to the hospital. It would be desirable for him to work in the Medicine I Clinic a minimum of 1/2 day a week to maintain familiarity
with the research programs of the Clinic.
One can visualize the following advantages to the U.S.P.H.S. Hospital:
1. A diversified research program, usually found only to a much large university hospital.
2. Consultation-type teaching of resident staff by the directors of the several sub-clinics of Medicine I (listed above).
3. The opportunity to incorporate regular beneficiaries of the U.S.P.H.S. Hospital into one or another of the research programs
The following details come to mind as worthy of mention.
1. Although one might anticipate that the majority of the study patients would be admitted to the Medical Service and although
it would be obligatory for the U.S.P.H.S. officer in charge of the research program to have primary responsibility for the
care of all study patients, patients on other services than the Medical Service could be used in this program.
2. Admission of patients would be made through the mutual agreement of the Physician-in-charge of Medicine I and either the
Chief of the Medical Service or the Director of the research program in the U.S.P.H.S. Hospital.
3. When studies culminate in published reports, proper recognition of the participation of the U.S.P.H.S. staff will be made.
4. The program can be terminated at any time at the request of either party. It is entirely possible that the U.S.P.H.S.
Hospital staff may, after a time, wish to concentrate on a single area of clinical research, in collaboration with one of
the sub-clinics of Medicine I, or independently. Such a move would be encouraged.
5. It is likely that contingency funds for support of the research program at the U.S.P.H.S. Hospital would be necessary
in addition to the funds concerned with the ordinary bed rate and the part-salary of the research director. How large the
contingency funds should be would be dependent on the average census of special study and other research patients.
6. The number of "special study" patients would, of course, be the decision of the Medical Officer in Charge of the
U.S.P.H.S. Hospital and his staff. As far as the Medicine I Clinic is concerned, it is believed that no number of "special
study" beds offered would be so large as to exceed the capacity of the research program or no number too small as to fail
to be worth while to the program.