AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. September 2000, Volume 2, Number 9.

Did You Know?

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Physicians' Duty to Care for the Poor

Little-known medical trivia.

  • On May 11, 1751, the Pennsylvania legislature granted a charter to establish a hospital to care for the sick-poor and the insane. Founded by Benjamin Franklin and Dr. Thomas Bond, the mission of Pennsylvania Hospital to provide care to people in need regardless of station or income is reflected in its official seal, which is based on the story of the Good Samaritan – "Take Care of Him and I will repay Thee."
  • The obligation to provide legal counsel to the poor dates back to the days of ancient Rome. This historical commitment of lawyers and attorneys to perform pro bono work is reflected in the early versions of the American Bar Association’s Canons of Professional Responsibility, which was adapted from the Alabama Bar Association’s 1887 Code of Ethics.
  • The AMA’s Ethical Opinion 9.065 states that caring for the poor should be a "regular part of the physician’s practice schedule." However, it does not specify the number of hours physicians should provide in charity care.
  • According to the Model Rules of Professional Conduct of the American Bar Association, lawyers should perform at least 50 hours of pro bono work each year.
  • The 1996-1997 Community Tracking Study found that more than three fourths of physician respondents provided an average of 10.3 hours per week of free medical care or at reduced fees. This is slightly higher than the 7.2 hours per week in 1994 and 6.5 hours per week in 1990 that physicians reportedly spent on charity care. With more than 44 million uninsured Americans, sustained efforts such as those of the Reach Out Program are necessary to support physicians in private practice and increase access to care for the uninsured and the underserved.
  • In 1999, a lawyer practicing in the 100 highest grossing US law firms spent on average 36 hours a year on pro bono cases. This amounts to about 8 minutes per day and is down from the 56 hours per year spent on uncompensated legal counsel in 1992. A variety of efforts including those of the Pro Bono Institute are working to encourge and support lawyers in fulfilling their ethical responsibility to provide legal counsel to those who cannot afford it.
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