Dear Sir/Madam:

On August 4, 1995, the Reader published a front-page article written to extol the accomplishments of Dr. Robert Simon, the Chairman of the Department of Emergency Medicine at Cook County Hospital. The article also supported his contention that the use of emergency-room observation centers would reduce health-care expenditures nationally in a significant way. The article made some convincing arguments on both of these topics. Nonetheless, for reasons known only to Dr. Simon he used the Reader’s entree to the public to gratuitously disparage a substantial segment of the population, that is, the homeless. Dr. Simon, without any supporting data and in the face of well-known data regarding the composition of the homeless population, unfortunately chose to spotlight for all to see his personal prejudices and tendency to snap judgments without adequate understanding.

Dr. Simon is quoted as stating, among other statements, “Most of the homeless really don’t care about themselves or are psychiatrically impaired. You can give them any opportunity in the world, and they would not take advantage of it. They could do things for themselves, but they won’t. So who the hell cares about them? To me, society wastes enormous energy, money, and resources on them.”

By making these remarks, Dr. Simon has violated several of the cardinal precepts of his profession. In the healing arts and sciences, we are taught to obtain as much objective data as possible before making decisions. We are also taught that, in our profession, we must control our prejudices and respond to our patients in a constructive, nonjudgmental way.

It is particularly destructive for the leader of a training program for young physicians at a public hospital supported by public funds to publicly espouse these views. The mission of a public hospital like Cook County Hospital is to serve all regardless of race, gender, socioeconomic status, etc. For a department chair, who is after all a role model, to suggest to his trainees that it is acceptable and appropriate for a physician to stereotype patients and make judgments with regard to which ones have earned the privilege to receive his or the hospital’s services is an embarrassment to the health providers and to the public who pays his salary. It does a disservice to the hundreds of trainees who come to Cook County Hospital, not only to learn technical skills, but hopefully also to inculcate values of tolerance, acceptance, empathy, and the potential they have for assisting patients in improving the quality of their lives.

We are angry about homelessness and the cruel conditions in which millions in this country live. As health providers and as citizens in a democracy our obligation is not to take the easy and intellectually lazy way and blame the victims but to learn about the causes of these social problems and confront those in power who have created these realities. We are very concerned that some of our patients who use us as their sole source of care will feel they are not welcome at Cook County Hospital because of Dr. Simon’s remarks and, as a result, will stay away when they truly need our services.

To all patients who come to Cook County Hospital, we believe that we speak for the vast majority of the staff when we say that patients are welcome at any time under any circumstances and that we deeply regret the hostility that Dr. Simon vented towards them. He knows not whereof he speaks. We will work very hard to educate him.

Ronald Shansky, MD

Cynthia Watson, MD

Sami Al-Skaf, MD

Richard Henry, MD

Physicians at Cook County Hospital