Hospitals – A Historical Perspective

Caregiving is rooted in a desire to enhance the well-being of our fellow man. Whether it is through our own need to be cared for or a loved one’s need, at some point in each of our lives we can benefit from this practice. The art of caregiving began as a family effort and over time became institutionalized. Before hospitals took care of the sick, the infirm were watched over by their family in their own home or they were expelled from the city.

The earliest documented evidence of institutions specifically designed for the care of the sick was in the 4th Century B.C. by the Sri Lankans.1 The first teaching hospital was documented at the Academy of Gundishapur in the Persian Empire around A.D. 300-600.2 The expansion of the hospital system in Medieval Europe was driven in large part by Christianity. Before Christianity the Romans would care for each other as part of family-based obligations. The Greeks did the same. The First Council of Nicaea in 325 A.D. ordered the construction of a hospital in every cathedral town in the Roman Empire to care for the poor, sick, widows, and strangers. They were staffed by religious orders and volunteers and were funded by the same.3

Although the first hospital in the United States was constructed much later in Philadelphia, Christianity was still the motivating force. Philadelphia grew into the fastest populated city in the 13 colonies and became a melting pot for diseases because of its ports and a constant stream of immigrants. With the increasing number of poor suffering from physical illnesses as well as the number of people from all classes suffering from mental illness, Philadelphia became the perfect place for the nation’s first hospital.

The Pennsylvania Hospital was established in May 1751, the result of a collaborative effort of Benjamin Franklin and Dr. Thomas Bond, a hometown physician who studied medicine in England and France and became inspired by the thriving hospital system overseas. The charter was granted to establish the Pennsylvania Hospital to care for the sick poor and the insane, and the first patient was admitted in February of 1753. The hospitals seal, the image of the Good Samaritan, was inscribed on the plaque outside as well as the phrase, Take care of him and I will repay thee.4 Although the hospital was created to benefit the community, it was not readily accepted, nor was any subsequent hospital that was built. In fact, most people found them unfamiliar and even frightening.

People were used to caring for their sick relatives in their homes, and it wasn’t until the Spanish flu epidemic in 1918 that people began to realize the appeal that mass care hospitals provided. Further promotion for the cause of hospitals came in 1921 when the editor for a Chicago magazine proposed that hospitals open their doors to the public for one day so the community could come inside and see them. After becoming more familiar with the medical advances employed by hospitals, people accepted them, and on May 12, 1921, America celebrated its first National Hospital Day.5

The majority of hospitals serve only medical needs, having separated themselves from their Christian roots. Since the late 20th century, more and more hospitals have been funded by the state, health insurances, health organizations, and charities rather than religious orders. Today nearly 6,000 hospitals are in operation with over five million staff members across the United States. According to Hospital Statistics, these hospitals admit almost 37 million patients each year, treat another 117 million in emergency departments, and see another 545 million for other outpatient needs. On any given day, 658,000 patients fill U.S. hospital beds.6

The latest facts from the American Hospital Association reveal just over 6,100 hospitals are in operation in the United States, according to its 2020 publication.

1 Prof. Arjuna Aluvihare, “Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo” Vidhusara Science Magazine, Nov. 1993.
2 C. Elgood, A Medical History of Persia, (Cambridge Univ. Press), p. 173.
3 Roderick E. McGrew, Encyclopedia of Medical History (Macmillan 1985), p.135.
4 University of Pennsylvania Health System. Accessed 8/10/07 from
5 American Hospital Association. Accessed 8/10/07 from
6 National Center for Health Statistics, Health, United States, 2006 With Chartbook on Trends in the Health of Americans Hyattsville, MD: 2006, p.364


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