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.
• Academia, Medical Version The first hospital in America generated the first medical school, the first medical society, and many of the unique features of American medicine. In modern times, the gusher of federal research funds not only distorted academic medicine, but academia as a whole.
• 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.
• Clinton Health Plan of 1993 - Part One Mistaking Senate re-election of Harris Wofford to mean the country demanded reform of the medical system, newly-elected President Clinton announced he would create one. When stakeholders surmised he was making it up as he went along, they deserted him.
• Clinton Health Plan of 1993 - Part Two Fifteen years after the Clinton Plan, public dissatisfaction with the health financing system is no better, probably worse.
• 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.