The practice of Medicine is distinctive in a number of cities. This volume concerns the distinctiveness of physicians, hospitals and medical practice in the American city where the first hospital was founded, the first medical school, the first medical organization, and for a while the largest collection of medical organizations in the country.

At the present time, the electronic ability to compare Medicare records by the zipcode of the medical event has produced evidence of what anyone would expect -- considerable variation. And almost anyone could predict that this will lead to a search for the secrets underlying whatever region happens to be least expensive. Since this search will inevitably fail to demonstrate variations related to physician characteristics which are not collected and coded in the database, it will then likely produce suggestions that cost variations are related to some characteristics which did in fact happen to be collected and coded in the database.

Perhaps this collection of several hundred essays on the distinctiveness of Philadelphia medical care can warn us against the folly of jumping to such conclusions.

• Philadelphia Medicine The first hospital, the first medical school, the first medical society, and abundant Civil War casualties, all combined to establish the most important medical center in the country. It's still the second largest industry in the city.
• Philadelphia Physicians Philadelphia dominated the medical profession so long that it's hard to distinguish between local traditions and national ones. The distinctive feature is that in Philadelphia you must be a real doctor before you become a mere specialist.
• Medical Economics Some Philadelphia physicians are contributors to current national debates on the financing of medical care.
• Health Insurance Clinton Health Plan and its replacements.
• Medical Malpractice The medical system is on the point of abandoning the city to escape abusive lawsuits. A series of observations about shared blame, ultimately assigns responsibility to the mistake of allowing this matter to be covered by insurance, thus creating a financial target.
• Nobel Prizes Some Philadelphians won Nobel Prizes for work done here, or elsewhere. Some prize winners would deny they are Philadelphians, but their work was nevertheless done here.
• Medical Club of Philadelphia The Medical Club of Philadelphia was founded in the Nineteenth century, as a social club of doctors devoted to non-medical interests. Lots of famous names, here.