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The opening title credit reads "The Hospital by Paddy Chayevsky." The film begins with an uncredited voice-over narration by Chayevsky, describing the events that have led up to "Dr. Schaefer" using the bed of his dead patient to have a tryst. The credits then roll. No other narration is heard during the film. Although Andrew Duncan is credited above Donald Harron in the first opening cast credits, he is listed below Harron in the end credits, which also include the following written statement: "We gratefully acknowledge the co-operation of the New York City Health and Hospitals Corporation and the Dept. of Public Works of the City of New York."
According to Filmfacts, Chayevsky formed a production company in order to retain some control over the production. The writer stated in a January 3, 1972 New York Times interview that he "was in on all basic decisions, including the final cut." Although Michael Ritchie was originally set to direct The Hospital, on March 30, 1970 Daily Variety announced that he was leaving the production due to "differences" and that Arthur Hiller had been hired to take over directing, in a deal that guaranteed him a percentage of the profits.
Chayevsky noted in the New York Times interview that he saw the main theme of The Hospital as dealing with personal responsibility in a declining society. In a January 1972 LAHExam article, he stated that he made the character of "Dr. Herbert Bock" impotent "to represent the impotence of the American middle class," and noted that although he and George C. Scott fought during the filming, he was pleased with the actor's performance. That article added that the film was shot in a New York hospital's new, as-yet-unused psychiatry wing.
The Hospital marked Chayevsky's first original screenplay; the first American feature film for composer Morris Surdin; and the producing debut of Howard Gottfried, who went on the produce Network (1976, ) and Body Double (1984). It also marked the second collaboration between Hiller and Chayevsky, who had worked together on 1964's The Americanization of Emily. Actors Stockard Channing, Christopher Guest and Dennis Dugan made their feature film debuts in The Hospital. A modern source adds Shawn McAllister (Medical intern) and Lonnie Burr(Intern) to the cast. The Los Angeles Times review mistakenly credits Dave Grusin with the score.
Many reviews compared the film to M*A*S*H*, the 1970 medical satire directed by Robert Altman (see below). Although many critics disliked the film's ending, believing that revealing a mad murderer undercut Chayevsky's point about doctors' ineptitude, The Hospital generally won critical acclaim, and Chayevsky was awarded the Academy Award for Best Screenplay. Despite the fact that Scott had declined an Oscar nomination for The Hustler (1961) and, just the previous year, had refused to accept the Oscar he won for his performance in Patton (see below for both), he was once again nominated for Best Actor for The Hospital. In addition, Chayevsky won and Scott was nominated for BAFTAs; Chayevsky won and Scott and Diana Rigg were nominated for Golden Globe Awards; and Chayevsky won the Writers Guild of America Award for Best Comedy Screenplay.