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These days, no one blinks twice when a stand-alone hospital links up with a regional heavy-hitter. But Pennsylvania Hospital isn't just another hospital. Founded by Benjamin Franklin, the downtown institution is a place where generations of Philadelphians have been born, been cared for, and died since 1751. It also happens to be America's first hospital.
"The reason the hospital has survived for 250 years is not because it's stayed the same, but because it appropriately changed with the times," says CEO John R. Ball, M.D., from his office in a building that predates the Revolutionary War. "I've often said that with Benjamin Franklin's name on the first page of the story of this place, I don't want mine on the last page. So there is a certain pressure...to continue the good tradition."
Given that tradition, last year's decision to merge with the University of Pennsylvania Health System was ironic and bittersweet in a city where the nation's Declaration of Independence was signed. The deal ended the hospital's solo days, yet stabilized the institution in a hotly competitive marketrecently characterized by Moody's Investors Service as one of the nation's most volatile. Like a living, breathing museum, Pennsylvania Hospital offers both a glimpse of the evolution of the nation's hospitals and a symbol of the changes and challenges at work today.
The hospital admitted its first patient on February 11, 1752. In opening its doors to a class then known as the "sick-poor and insane," Franklin and cofounder Thomas Bond, M.D., set a standard and provided a rare haven for people with nowhere else to go.
At the time, the wealthy were treated in their homes. Poorhouses, which functioned much like today's homeless shelters, were the only quasi-medical facilities available to the masses. Most of Pennsylvania Hospital's earliest patients were servants, slaves, paupers, and the insane relatives of upper-class families. The hospital treated a range of maladies-skin diseases, asthma, gunshot wounds, leprosy, bone fractures, putrid fever, ulcers, and rheumatism.
In the years following its founding, the hospital became a launch pad for many innovations and cornerstones of modern health care: the first outpatient clinic (1752), first hospital pharmacy (1755), first medical library (1762), first medical resident (1773), and first surgical amphitheater (1804).
History and traditions are...