University of Virginia Library

II. TYPES OF ORGANIZATION OF CLINICAL STAFFS IN TEACHING HOSPITALS

1. Part-time, in which members of the faculty carry on their private practices outside of and
entirely independent of the medical school and teaching hospital. They come to the hospital
when they have teaching assignments, have the privilege of admitting private patients, usually
are not engaged in research and receive little or no compensation from the medical school.
This plan has not proven most suitable for development of strong schools and is gradually
being discontinued.

2. Straight full-time, in which all income from private practice is turned in to the institution
and the staff is compensated on a straight salary basis. This plan is in operation completely
only at the University of Chicago and partially at several other schools. It is probably not
practical for a state institution where large salaries, regardless of the source of funds,
cannot appear on state budgets.

3. Geographical full-time, in which members of the clinical staff have offices within the
teaching hospital, engage in various amounts of instruction, research and private practice.
The school pays a basic salary and provides office space. The clinician reimburses
the institution from private practice income for approximately the cost of rent, equipment
and personnel, such a secretaries and office nurses, necessary for conducting practice efficiently.
This plan usually entails some restriction in the amount of income from private
practice.

This plan is considered the most desirable by medical schools throughout the United
States, all new schools are adopting it and many older schools are working toward it. It
provides a good balance between teaching and practice, good medical care for the patients
and adequate attention to the medical students. Although we recognize certain deficiencies
in our organization which interfere with its most efficient operation, the geographical
full-time plan at the University of Virginia should be preserved.