This paper focuses on the study of the Conseil Général des Hospices Civils de Paris in the early nineteenth century, the biggest hospital institution in western Europe of the time, ruling all Parisian relief systems precisely when French medicine was experiencing the rise of the “Paris school of medicine” (E.H. Ackerknecht (1967), Medicine at the Paris Hospital, 1798-1848; M. Foucault (1963), Naissance de la clinique). Through it, it aims to show that the sorting out of hospital patients, and decisions about who was to benefit from various treatments, belong not only to physicians on medical grounds. The distinction between hospital and hospice, the creation of specialized hospitals for venereal and skin diseases or sick children, all crucial to the constitution of clinical medicine and its subsequent specialization had more compounded rationales. The outcome, highly propitious to physicians, can actually be seen as a mix of public health, economic and moral motives enforced by political authorities and administrators, as well as by physicians themselves. Supporting the same measures to sort out patients, but for diverging ends, doctors and administrators shaped hospital medicine.