Alemany Emergency Hospital

This beautiful building was once the Alemany Emergency Hospital.

There were no other emergency rooms other than San Francisco General Hospital before 1966, therefore the County was responsible for all emergency care and all emergency ambulance transport. Emergency care was provided throughout San Francisco free of charge by the citywide system, which consisted of the primary emergency room—Mission Emergency—and four other “Emergency Hospitals” scattered throughout the City. These hospitals were Central, located adjacent to City Hall; Harbor, located on the downtown waterfront; Park, located on the eastern edge of Golden Gate Park; and this on, Alemany, that served the  the southwestern part of the city.

They were all staffed by surgeons—graduates of the County surgery residency program. At these hospitals, minor emergencies were treated and first aid administered. If a patient needed hospitalization and had private funds, a private physician was contacted and the patient was transferred by private ambulance to a private hospital. If the emergency was critical or the patient was indigent, the patient was transported by City ambulance to Mission Emergency, which was attached to but administratively separate from the City and County Hospital.

This information came from The History of the Surgical Service at San Francisco General Hospital, a wonderful read if you are interested in the history of the health care system in San Francisco.

This is from a 1962 San Francisco City Annual Report

Care is rendered at five Emergency Hospitals on a 24-hour basis with a minimum of one doctor, one registered nurse, one medical steward, and one ambulance driver on duty 24-hours daily throughout the year. Care is also provided at Ocean Beach Hospital from 9:00 a.m. to 5:00 p.m. every Saturday and Sunday by a doctor and a steward (no ambulance) ; additionally, by a doctor only on holidays and each week day during summer school vacation. Alemany and Park Emergency Hospitals have the minimum staff; Central has an additional nurse from 3:00 p.m. to 11:00 p.m., two additional part-time doctors on Friday and Saturday evenings and an extra “trouble-shooter” ambulance from 4:00 PM to midnight. Mission has 24-hour ambulance service, but has all the medical and nursing staff needed and provided by San Francisco General Hospital.

The San Francisco situation was not unique. The emergence of the modern emergency department (ED) is a surprisingly recent development. Prior to the 1960s, emergency rooms were often poorly equipped, understaffed, unsupervised, and largely ignored. In many hospitals, the emergency room was a single room staffed by nurses and physicians with little or no training in the treatment of injuries. It was also common to use foreign medical school graduates in this capacity. In teaching hospitals, the emergency areas were staffed by junior house officers, and faculty supervision was limited. One young medical student in the 1950s described emergency rooms as “dismal places, staffed by doctors who could not keep a job—alcoholics and drifters” (University of Michigan, 2003, p. 50).

  Photo Courtesy of the San Francisco Public Library – January 6, 1933