Combined Jewish Philanthropies, Boston, Massachusetts

              Mr. Axelrod, Ladies and Gentlemen:    I am pleased to be asked to
return to talk to you about what promises to be my first and last medical
consultation in the fie^tf of hospital planning*
I am somwhat hesitant to do so, because as I look around, and even
though I see a good deal of warmth in your faces,  I realize that    there
are many of you who have listened to this talk twice before.    I can
tnink of no other way of describing this talk than to use what the
motion picture directors 3peak of as a "re-release", particularly when
I hear the ftmsic from the other room.
Now, this is a collection of thoughts which has been prepared
essentially for the lay mind.    I see the faces of some of my colleagues
hereabouts,  and I hope and pray that they will bear with me while I
enter into some rather primitive medical discussions
You have before you my rather limited report and recommendations,
and you have also had the opportunity,  I hope, of reading Dr. George
Baehr's Foreword to that report.
Let me say that my recommendations are based upon the following
assumptions; if those assumptions are incorrect, the recommendations
are obviously off-balance and askew.
The first assumption is that the Associated Jewish Philanthropies
are already committeed to certain responsibilities in the  care of the
patient during acute and long-term illness.    That cannot be avoided,
and th&re can be no retreat from those responsibilities.    Furthermore,
under this assumption recognition is made of the fact that no longer
can any well-ordered community look after only a small segnent of a
patient<s illness.    The total  care of the patient now comes to be a
community responsibility^ and this responsibility can no longer be
divided into  unrelated,   capricious,  and uncoordinated units.
Most successful shopkeepers look over their shelves and see how
many cans of Pet Milk and Quaker Oats are on hand.    So those of us in
hospital or community life must also look over our assets from time to
time.    The Associated Jewish Philanthropies are thus re-evaluating
their assets.    The Association recognizes that the only state compatible
with a lack of growth is death.    No one can stand still.   One moment
after I have said this last word,  all of us have changed.     So do our
hospitals,  our communities,  and our community responsibilities.
The second assumption is that the long-term patient - a better
phrase than chronic I think - and the healthy or infirmed aged,  should
be treated with the same dignity and quality of medical care which is
now provided the acutely ill.    I believe that this represents the
considered point of view of the Associated Jewish Philanthropies.