THEHISTORY OF

HEALTH CARE

UNIT 1

HISTORY OF HEALTH CARE

Introduction Why is it important to

understand the history of health care?

HISTORY OF HEALTH CAREIntroduction You have an infected finger and

the doctor orders leeches to treat the infection.

HISTORY OF HEALTH CARE

Introduction Is this an ancient or modern

treatment? Does it work?

HISTORY OF HEALTH CARE

I. Health Care Through Time 4000 BC-3000 BC Primitive Times- Illness & disease caused by spirits

and demons- Average life span = 20 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 3000 BC-300 BC Ancient Egyptians- Believed body was system of

channels (ducts)- Bloodletting was used when

channels were “blocked”- Average life span = 20-30 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 1700 BC-AD 220 Ancient Chinese- Used acupuncture to relieve pain

and congestion

- Average life span = 20-30 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks- Hippocrates – Father of MedicineDeveloped organized method to

observe human bodyRecorded Signs & Symptoms

HISTORY OF HEALTH CARE

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks- Hippocrates – Father of MedicineCreated high standard

of ethics:“The Hippocratic Oath”used by physicians today.

HISTORY OF HEALTH CARE

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks- Aristotle – Dissected animals;

founder of what is known today as anatomy

- Avg. life span=25-35 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 753 BC-AD 410 Ancient Romans- First to provide medical care for

injured soldiers- Physicians cared for ill people in

their homes- Hospitals established in religious

institutions

HISTORY OF HEALTH CARE

I. Health Care Through Time 753 BC-AD 410 Ancient Romans- Began public health & sanitation

systemsAqueducts to carry clean water to

citiesSewers to carry waste away from cities

HISTORY OF HEALTH CARE

I. Health Care Through Time 753 BC-AD 410 Ancient Romans- Claudius Galen: physician; body is

controlled by a balance of fluids (humors), blood, phlegm and bile. Imbalance in fluids lead to illness.

- Average life span = 25-35 years

HISTORY OF HEALTH CARE

I. Health Care Through Time AD 400- AD 800 Dark Ages- Prayer & divine intervention used

to treat illness & disease- Study of medicine was prohibited- Average life span = 20-30 years

HISTORY OF HEALTH CARE

I. Health Care Through Time AD 800- AD 1400 Middle Ages- Medical universities were created- Pandemic killed ¾ of the population

of Europe & Asia- Arab physicians required to pass

exam before getting license to practice

- Average life span = 20-35 years

HISTORY OF HEALTH CARE

I. Health Care Through Time AD 1350- AD 1650 Renaissance- Body dissection was performed- Michelangelo & Leonardo da Vinci

drew human body - Printing press allowed for

distribution of information- First anatomy book published

HISTORY OF HEALTH CARE

I. Health Care Through Time AD 1350- AD 1650 Renaissance- Average life span = 30-40 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 16th & 17th Centuries- Cause of diseases still not known- Ambrose Pare: Father of modern

surgery- William Harvey: described

circulation to and from the heart

HISTORY OF HEALTH CARE

I. Health Care Through Time 16th & 17th Centuries- Anton van Leeuwenhoek: invented

microscope- Average life

span = 35-45 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 18th Century- Gabriel Fahrenheit:

invented first mercury thermometer

HISTORY OF HEALTH CARE

I. Health Care Through Time 18th Century- Benjamin Franklin: invented

bifocals

- Edward Jenner: developed vaccination for smallpox

HISTORY OF HEALTH CARE

I. Health Care Through Time 18th Century- Average life span = 40-50 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- French barbers:

acted as surgeonsby extracting teeth, using leeches for treatment and giving enemas

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- 1st Blood transfusion (1818)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Rene Laennec:

invented stethoscope(1819)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Elizabeth Blackwell:

first female physician in the U.S. (1849)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Florence Nightingale:

Founder of modern nursing;

- Began educationfor nurses (1850’s & 1860’s)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Joseph Lister:

began use of disinfectants and antiseptics in surgery to prevent infection (1865)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Louis Pasteur:

“pasteurized” milk to kill bacteria

- Created rabiesvaccine (1885)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Dimitri Ivanofski:

discovered viruses (1892)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century- Wilhelm Roentgen:

discoveredx-rays (1895)

HISTORY OF HEALTH CARE

I. Health Care Through Time 19th Century

- Average life span = 40-60 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Most rapid growth in modern

healthcare occurred during this time period

- Many diseases were specifically identified, treated and cured

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Standards of care were established- Technology is integrated into

healthcare and is used in every aspect of medical care today

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Carl Landsteiner:

Classified ABOblood groups (1901)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Sigmund Freud:

formed the basisfor psychology &psychiatry (early 1900’s)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Frederick Banting & Charles Best:

discovered &used insulinto treat diabetes(1922)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Sir Alexander Fleming:

discovered the antibioticpenicillin (1928)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- George Papanicolaou:

developed the “pap smear”to detect cervical cancerin females

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Jonas Salk:

developed the polio vaccineusing deadpolio virus(1952)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Francis Crick & James Watson:

discoveredthe structureof DNA, ourgenetic blue-print (1953)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Christian Barnard:

Performed 1st heart transplant(1968)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- CAT Scan:

developed (1975)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Louise Brown:

first “test-tube” baby,conceived ina laboratory(1978)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Acquired Immune Deficiency

Syndrome (AIDS):first identified as a disease(1981)HIV (1984)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Ben Carson:

First to separateconjoined twins;has pioneeredmany new procedures (1987)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century- Sheep Cloned:

“Dolly” thesheep was cloned byDr. Ian Wilmut(1997)

HISTORY OF HEALTH CARE

I. Health Care Through Time 20th Century

Average life span = 60-70 years

HISTORY OF HEALTH CARE

I. Health Care Through Time 21st Century- What impact will YOU have on the

history of health care?- What will YOU discover?- What will YOU cure?- Average life span = 100 yrs plus?

HISTORY OF HEALTH CARE

II. Trends In Health Care

Cost Containment

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Cost Containment: controlling the

rising cost of health care- Reasons high costs:1) Technological advances2) Aging population (Rx)3) Lawsuits (malpractice Ins.)

HISTORY OF HEALTH CARE

II. Trends In Health CareB. Diagnostic Related Groups: DRG’s

place a limit on the cost of health care. Example: (?) Surgery $5,000 LimitIf hospital costs are less than $5,000 then hospital makes $$, otherwise hospital loses $$

HISTORY OF HEALTH CARE

II. Trends In Health CareB. Diagnostic Related Groups:

1) Combination of Services: health care facilities shop for services (laboratory, x-ray, etc.) to save $$.

HISTORY OF HEALTH CARE

II. Trends In Health CareC. Outpatient Services: Patients

receive care and are discharged home without being admitted to the hospital. Examples: Surgical Centers, Physical Therapy, etc.

HISTORY OF HEALTH CARE

II. Trends In Health CareD. Energy Conservation: Energy is a

large expense for health care facilities.

- Energy Efficient Bulbs- Consolidating Work Areas- Recycling

HISTORY OF HEALTH CARE

II. Trends In Health CareE. Summary: The quality of health

care should not be lowered simply to control costs.- Provider responsibility: provide the best health care while being conscious of costs

HISTORY OF HEALTH CARE

II. Trends In Health CareE. Summary: The quality of health

care should not be lowered simply to control costs.- Personal responsibility: take preventative measures to avoid or limit injury, illness & disease

HISTORY OF HEALTH CARE

II. Trends In Health Care

Home Health Care

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Home Health Care: Created

mainly as a result of DRG’s. History shows that this is not a new concept.

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Home Health Care:

Services include:- Nursing care- Physical/occupational therapies- Respiratory therapy- Social services- Nutrition & food services

HISTORY OF HEALTH CARE

II. Trends In Health Care

Geriatric Care

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Geriatric Care: Care of the elderly.

People are living longer.

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Geriatric Care:

Omnibus Budget Reconciliation Act of 1987 (OBRA)Government Act which requires states to establish competency standards which nursing assistants must meet. (Exam)

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Geriatric Care:

Omnibus Budget Reconciliation Act of 1987 (OBRA)Requires long-term health care workers to attend continuing education courses

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Geriatric Care:

Omnibus Budget Reconciliation Act of 1987 (OBRA)Loss of license/certificate can occur if compliance is not maintained. Facility can also be fined and even shut down.

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Geriatric Care:

Types of Facilities:- Adult day care centers- Retirement communities- Assisted living care centers- Long-term care centers

HISTORY OF HEALTH CARE

II. Trends In Health Care

Telemedicine

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Telemedicine: Involves using

technology to provide careMethods:- Computerized (EKG’s)- Remote (robotics)- Video (surgery)- Phone/Fax (Reports)

HISTORY OF HEALTH CARE

II. Trends In Health Care

Wellness

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Wellness: A state of being in

optimum health as it relates to physical, mental and social health.Preventative measures: diet, exercise, rest, stress reduction, habit cessation

HISTORY OF HEALTH CARE

II. Trends In Health Care

Alternative & Complementary Methods

of Health Care

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Alternative Medicine: Involves

evaluating and treating illness and disease in ways which may differ from current, modern medical treatment; or enhance medical treatment being used.

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Alternative Medicine:

Practitioners:- Ayurvedic: harmonizing body and mind- Chinese: Acupressure Acupuncture; Life Energy (Chi)

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Alternative Medicine:

Practitioners:- Chiropractors: energy through nerves; spinal alignment- Homeopaths: body can heal itself with immune system

HISTORY OF HEALTH CARE

II. Trends In Health CareA. Alternative Medicine:

Practitioners:- Hypnotist: trance-like state; verbal suggestions; follow- Naturopaths: natural therapies only; fasting, diets, lifestyle changes

HISTORY OF HEALTH CARE

II. Trends In Health Care

National Health Care Plan

HISTORY OF HEALTH CARE

II. Trends In Health CareA. National Health Care Plan:

Nationalizing health care is being considered as a result of rising health costs.

HISTORY OF HEALTH CARE

II. Trends In Health CareA. National Health Care Plan:

- Government Health Care- taxes to help pay

- Health Care Co-op- grouping of health care

providers which provide care at lower costs

HISTORY OF HEALTH CARE

II. Trends In Health CareA. National Health Care Plan:

- Managed Care- employers provide ins. &

government helps pay for poor- State-run Health Care

- Each state develops plan

HISTORY OF HEALTH CARE

II. Trends In Health CareA. National Health Care Plan:

Goal: Health Care For AllPotential Drawbacks:- Insured paying for uninsured- Limited choices of providers- Limited care

HISTORY OF HEALTH CARE

End of Lecture