The latter part of the 19th century saw the emergence of many small hospitals throughout the United States, particularly in large cities like Philadelphia. These hospitals were often the work of special-interest groups. Examples include religious-based hospitals like Jewish and Catholic hospitals; race-based, like the Frederick Douglass Memorial Hospital, owned and operated by blacks; and gender-based, like the Woman’s Hospital of Philadelphia, established in 1861.
In the summer of 1889, a small group of social-minded women, led by Dr. Elizabeth Comly-Howell, determined that a hospital exclusively for women, run exclusively by women, was needed in the Belmont section of West Philadelphia. This area of the city was at least a half hour’s ride by public transportation from the already existing Woman’s Hospital of Philadelphia (WHP), a trip that women of limited means could ill afford. On Friday evening, June 7, 1889, the first meeting to discuss a new hospital for women and to organize a Board of Managers was held at the West Philadelphia home of Dr. Comly-Howell. There were serious misgivings about this venture, but Dr. Comly-Howell prevailed by the force of her character and the strength of her convictions.
In the Transactions of the 25th Annual Meeting of the Alumnae Association of the Woman’s Medical College of Pennsylvania of 1900, it is noted: “…..some were doubtful, afraid to take so great a responsibility without a penny for their treasury. Courage was soon gained, however, and this was largely due to the strong nature of Dr. Comly-Howell, who, in every objection urged or doubt expressed, maintained a serenity and confidence that was in itself an inspiration.”1
“Once the decision was made to establish a new hospital for women, the search for a suitable property began.”
Once the decision was made to establish a new hospital for women, the search for a suitable property began. Finding a large house to rent for use as a hospital was not an easy matter, as most homeowners regarded the use of their property for this purpose as an unappealing proposition. But eventually the managers found and leased what the Board of Managers called “an old-fashioned residence situated in a pleasant garden, with many attractions of sun and shade.”2 The parlor was capable of serving as a dispensary, and the house could accommodate a total of 10 inpatients. The first month’s rent of $50 was provided by a member of the Jeanes family, an immensely wealthy and philanthropic Quaker family that came to the rescue of the newly formed women’s hospital numerous times over the years.
In mid-July 1889, the West Philadelphia Hospital for Women (WPHW) opened its doors, a mere five weeks after its first organizational meeting. Dr. Elizabeth Peck offered her services for free as the first physician-in-charge, starting on July 15. The first inpatient appeared the following month. In September, Dr. Peck’s sister Anna began as the hospital’s matron and housekeeper, thus relieving her sister of a huge burden.3 According to the report of the resident physician, from the hospital’s opening on July 15, 1889, until September 1, 1889, there were 4 inpatients and 15 outpatients.4 The hospital was formally incorporated on January 18, 1890. A training school for nurses was established in July 1890. In general, there were four to six nursing students per class. By the end of the first full year of operation, in-house medical services were divided among three attending physicians, each serving four months, along with a resident physician and an assistant resident physician, both with a detailed job description.
The first formal report of the Board of Managers in January 1890 appears to have set the tone for future reports. Straightforward business was intermingled with a moderate amount of moralizing: “It is not possible in the present condition of the hospital to treat patients without charge, neither do the managers consider it a healthful plan morally. A nominal fee is asked for advice, treatment, and medicine, thereby stimulating that self-respect which should be an individual possession.”5
The following year’s annual report adds some religiosity to the mix: “We gratefully acknowledge all the interest already awakened, and believe its inspiration is from that Divine Spirit of Love which has manifestly led, guided and guarded us from the beginning.”6
By the start of 1891, the hospital’s managers realized that the facilities were inadequate. They decided to buy the homestead of former Judge William Kelly, located on the block south of the hospital, for $25,000. That property, 100 feet wide by 239 feet deep, was known as The Elms. It consisted of a house (insured for $10,000), a carriage house and a stable.7 The house initially accommodated 20 patients and was the central structure of the West Philadelphia Hospital for Women for the next 40 years (see Figure 1).
Initially, The Elms required considerable renovation to convert it to a hospital. The dining room and library of the mansion were converted to a lecture room, the carriage house to a laundry, and the stable to a nurses’ residence and store room. In 1894, an operating room was built, and in 1895, a diet kitchen and elevator were installed, and the attic transformed into spacious patient quarters.
As the hospital’s need for additional space increased, surrounding buildings and vacant properties were purchased. By 1903, a row of four houses along the northern border of its property had been added (see Figure 2). These were used as a dispensary, a nurses’ residence and an expanded maternity unit (17 beds).
In April 1917, the Elizabeth L. Peck Maternity Building (see Figure 3) opened, probably the single most important structural addition in the history of the hospital. This stately, colonnaded brick structure served to emphasize the hospital’s maternity function—an important aspect of the hospital’s mission and also a reliable source of income.
In December 1899, male physicians were given permission for the first time to admit and care for their female patients.8 This decision was purely an economic one, relating to the hospital’s tenuous financial status.
During World War I, wives of American soldiers were treated at the hospital at reduced rates, sometimes for free. In October 1918, at the height of the Great Influenza epidemic, the entire main building of the hospital was given over to the care of epidemic victims.9
In the 1920s, the hospital started receiving financial aid for the first time from the Welfare Federation of Philadelphia (funding from the state had started prior to 1920).
In September 1929, merger with the Woman’s Hospital of Philadelphia was consummated. (See Merger below for more details.)
“In 1950, the first male patient was admitted to the hospital.”
In 1950, the first male patient was admitted to the hospital.10 Similar to the granting of admitting privileges to male physicians in 1899, the decision to admit men was prompted by the hospital’s ongoing financial woes and specifically the desire to increase the number of paying patients.
Steady Increase in Medical Activity
The impact of the WPHW on the surrounding community might best be gauged by the steady growth in the numbers of patients treated per year. With the passage of time, the hospital experienced a steady growth in the number of patients treated per year. Table 1 illustrates this phenomenon for the hospital’s first 20 years. The increase in numbers was most prominent among outpatients, particularly in the clinics (dispensary). By 1909, two-thirds of the hospital’s maternal deliveries occurred in the Peck Maternity Unit.
Growth of Patient Population at the West Philadelphia Hospital for Women
|1889 (1st 6-month figures)||1899 (10 yrs)||1909 (20 yrs)|
|Pts treated as In-Pts||19||314||585|
|Pts treated in Dispensary||186||1,152||6,840|
|Pts treated at home||42||586||1,164|
From the day the WPHW opened its doors in 1889, it was always on thin ice financially. It relied very heavily on the largesse of the public, which donated clothing, food, useful items, services and money. Its Auxiliary Committee was kept constantly busy with fundraising events such as luncheons, dances, and even dog and pony shows. The hospital’s major benefactor was Anna Jeanes, the Quaker activist and heir to a huge family fortune. She intermittently infused the hospital with large monetary donations in times of greatest need.
In the late 1920s, the Welfare Federation of Philadelphia was funding the WPHW and the WHP, as well as every other Philadelphia hospital with indigent patients. The Federation had limited resources and was undoubtedly concerned about the need to fund two women’s hospitals in one city. The Federation appears to have exerted pressure, mostly behind the scenes, on the managers of both hospitals to bring about a merger.
At the June 5, 1928, meeting of the Board of Managers of the WPHW, a preliminary resolution to merge with the WHP appeared.11 The merger effort was solidified during the fall of 1928 and winter of 1929 in a city-wide survey of the condition of all Philadelphia hospitals, headed by Dr. Haven Emerson. Under the auspices of the Philadelphia Chamber of Commerce and the Welfare Federation of Philadelphia, this survey confidently pointed out that a merger of the two institutions was underway.12
“Eventually, the merger was consummated in September 1929 and the charter for the newly merged hospital was granted in February 1930.”
A seemingly endless series of meetings occurred through much of 1929, where merger details at all levels were hashed out. At first, representatives from the two hospitals as well as from the Woman’s Medical College of Pennsylvania (Woman’s Med) came to the table for a possible three-way amalgamation. The representative from Woman’s Med insisted on the college and the future new hospital being located at the falls of the Schuylkill River, where land had already been purchased for a new medical school and hospital. The WPHW and WHP wanted the West Philadelphia site on the grounds of the existing WPHW. Never the twain did meet.13 Woman’s Med withdrew from negotiations after several months, and further merger activities were carried out only by the two women’s hospitals. Eventually, the merger was consummated in September 1929 and the charter for the newly merged hospital was granted in February 1930.
Possibly in exchange for placing the newly formed hospital’s location at the site of the WPHW, the new hospital was named the Woman’s Hospital of Philadelphia. The joint committee overseeing the merger showed no overt evidence of dominance by either of the original institutions. The chair of the committee, Mrs. Thomas Shallcross, had been a member of the Board of Managers of the WPHW. There was an extreme even-handedness regarding representation on committees. Staff privileges were afforded to all staff members of both hospitals.
The Newly Formed Hospital
The original plan of the joint merger committee was for a hospital of 250 beds: 100 obstetrics/maternity, 50 medical, 50 surgical and 50 pediatric14 (see Figure 4). To finance this project, a vigorous building campaign was launched to raise $1,000,000. However, by the end of January 1931 only $517,000 had been subscribed, an outcome not unlike that of many hospital fundraising drives in the early days of the Great Depression. The managers had to scale back and build the new hospital unit by unit and limit the near-term hospital capacity to 160 beds (see Figure 5). The only structure that remained from the existing hospital was the Peck Maternity Unit. The old house that had served as the main building of the WPHW was torn down in the summer of 1930. Until the new hospital was completed in mid-January 1932, services were split between the two existing hospitals, with the WPHW doing maternity work and the WHP doing medical and surgical work.
The newly formed WHP functioned well but was never able to improve its tenuous financial status. The 1930s saw an increased demand for ward beds rather than private and semi-private rooms and a cut in funding from the Philadelphia Welfare Federation. A financial analysis performed in 1932 by the Charles Neergaard firm of New York City contained the less-than-encouraging phrase “a staggering burden of debt” (mortgages totaling $247,000 and current indebtedness otherwise of $114,000) and concluded that “the current debt would mean bankruptcy to a commercial organization.”15 However, things were not all bleak in the 1930s. On the bright side, the hospital still had an A rating with the American College of Surgeons and was on the approved list for interns at the American Medical Association and the Pennsylvania State Board of Medical Examiners. The emergence and growth of prepayment hospital plans like Blue Cross also provided reason for optimism.
World War II put a further strain on the hospital as the cost of goods increased and a country-wide shortage of stateside nurses occurred. Efforts to merge with other hospitals took place on a more regular basis in the 1950s, and by October 1963, meetings for a possible merger with the Kensington Hospital (formerly the Kensington Hospital for Women) were being carried out almost daily, but no merger resulted.
On January 7, 1964, the School of Nursing faculty issued a four-month suspension to a student nurse for failing to properly sign out of her quarters on New Year’s Eve. The nurse appealed to the President of the Board of Managers, Margaret Gordon, who lent a very sympathetic ear and rescinded the suspension on January 10. The nursing school faculty was irate and resigned en masse. Later that month, without presenting the matter to the Board for a formal vote, Ms. Gordon suspended nursing school operations completely, arguing that a qualified nursing school staff and nursing students had been extremely difficult to recruit in recent years. In fact, at the advice of the State Board of Nurse Examiners, no freshman nursing students had been accepted in September 1963.16 Some members of the Board of Managers were now irate, and in March 1964, three members, represented by former Philadelphia Mayor Richardson Dilworth, brought a formal lawsuit against the hospital and Ms. Gordon, charging her with gross mismanagement and requesting that the hospital be placed into receivership.17
“Robinson claimed to have reduced hospital expenditures by $200,000 during 1964, but the hospital’s debts continued to mount.”
The court sided with the plaintiffs and appointed Harry Robinson, an investment broker and philanthropist, as the hospital’s receiver. His task was not an easy one. The hospital was losing $10,000 to $12,000 per month; staff morale was extremely low; and doctors were deserting in droves. Robinson claimed to have reduced hospital expenditures by $200,000 during 1964, but the hospital’s debts continued to mount. He went to work behind closed doors with the administrators of the Hospital of the University of Pennsylvania and came up with a merger plan whereby the University assumed the assets and debts of the Woman’s Hospital. The merger was predicated on the establishment of a Woman’s Hospital of Philadelphia Division of the Hospital of the University of Pennsylvania.18 The courts granted approval of the merger plan, and on January 6, 1965, the Woman’s Hospital of Philadelphia closed its doors for the last time. Preliminary plans included conversion of the hospital into a nursing or convalescent home for elderly black people. It is now part of the Sarah Allen low-income housing project for senior citizens.
By 1964, the Woman’s Hospital of Philadelphia had lost its uniqueness as a hospital exclusively for women and by women, as men made up a sizable proportion of the medical staff and some of the patient population. In addition to its abysmal financial state, the hospital had no medical school affiliation, was located in a neighborhood that had deteriorated significantly and was being used by many of its remaining staff as an overflow hospital for patient admissions when other hospitals were full. The institution was clearly in need of rescuing, and its absorption by the University of Pennsylvania was probably its most viable alternative.