I moved to Philadelphia in 1976, and the first thing on my agenda was to get a job. After making the rounds of several hospitals, I made my way to Philadelphia General Hospital (PGH) and applied for a faculty position in its school of nursing.
Philadelphia General Hospital, a tax supported municipal hospital—the oldest in the United States—was located at 34th Street and Civic Center Boulevard and delivered healthcare mainly to a mainly medically indigent population. The interview went quite well and I decided that PGH would be a good place in which to work. Advised that I must take the required civil service exam, I set out the next day to take the test. As I was walking down Market Street towards City Hall, there appeared some unusual activity around a newsstand. I stopped to take a look at the papers whose headlines screamed, “RIZZO TO CLOSE PGH.” With that breaking news, my career as a PGH nurse came to an abrupt end!
Mayor Frank Rizzo’s decision to close an institution that had served Philadelphians since 1732 held ramifications not just for my immediate career prospects but also for the legions of Philadelphians who depended on PGH for their health care. Originally established as an almshouse in the English poor law tradition, the institution reflected the idea that communities assume some responsibility for those unable to do so themselves. In its early years, the almshouse, located at 10th and Spruce Streets (this link, like others in italics in this post, takes you historical images, in this case a sketch of the almshouse circa 1921), carried out a number of functions including housing for the elderly and poor, maintenance of a house of correction, psychiatric care, the housing of foundlings, a workhouse, accommodations for indigent women about to give birth and the operation of a hospital. In 1835, the almshouse moved to the west side of the Schuylkill, renamed its hospital section the Philadelphia Hospital and delivered services typical of hospitals of the time. Nicknamed “Blockley,” after the township in which it was located, the hospital thrived as a center of medical education, distinguished by its rich source of “clinical materials,” also known as patients or inmates in the parlance of the time. In the early 1880s, reform minded members of the hospital’s governing Board of Guardians, determined to improve the nursing care (which had never been very good) by establishing a school of nursing. The Guardians arranged for an English nurse, Alice Fisher, a colleague of Florence Nightingale, to take on the task of setting up a professional school of nursing. An accomplished and competent administrator, Fisher used a combination of brains, political savvy and her charismatic personality to establish a school that operated for 92 years and became known as one of the best in the country.
By the early 20th century, the institution shed its almshouse functions, was renamed Philadelphia General Hospital, and became a full-fledged general hospital offering modern medical and nursing care. Its reputation depended not just on the excellence of the medical and nursing staff but also on its role as provider of health care to those unable to access other hospitals due to their race or ethnicity, low income, or lack of health insurance. Its doors were always open to all Philadelphians. In a pre-Medicare, pre-Medicaid, pre-Affordable Care Act era, PGH guaranteed that no Philadelphian would go without needed hospital care in a city that took as a given the community’s responsibility to citizens less fortunate.