History of Health Care

1. History of Health Care

2. Bell Work • Look at the backside of guided notes. • Read the excerpt concerning leeches and maggots!!! (eewww)!!

3. State Standard • 1) Synthesize information found in news media, professional journals, and trade magazines to create a report and/or presentation on the historical evolution of healthcare in the United States. Use a timeline or other graphic to illustrate major developments beginning with the first medical school through today. • 7) Investigate current innovations in healthcare. Develop pro and con arguments based on information found in news media, professional journals, and trade magazines on how innovations have influenced the healthcare system. Support arguments with evidence presented in oral, visual, or written format.

4. Objectives Students will: • Explore the evolution of healthcare from the ancient times to the 21st century. • Investigate current innovations or in healthcare by creating a timeline of the radiology modalities explaining the pros and cons of each.

5. 4000 BC – 3000 BC Primitive Times • Illness and diseases were a punishment from the Gods • Tribal witch doctors treated illness with ceremonies • Herbs and plants used as medicines (morphine for pain and digitalis for heart) • Trepanation (surgically removing a piece of bone from the skull) • Average life span was 20 years

6. 3000 BC – 300 BC Ancient Egyptians • Physicians were priests • Bloodletting or leeches used as medical treatment • Average life span was 20-30 years

7. 1700 BC – AD 220 Ancient Chinese • Believed in the need to treat the whole body by curing the spirit and nourishing the body • Recorded a pharmacopoeia of medications based mainly on the use of herbs • Used therapies such as acupuncture • Began to search for medical reasons for illness • Average life span was 20-30 years

8. 1200 BC –200 BC Ancient Greeks • First to observe the human body and the effects of disease – led to modern medical sciences. • Believed illness is a result of natural causes • Used therapies such as massage, art therapy, and herbal treatment • Stressed diet and exercise as ways to prevent disease • Average life span was 25-35 years

9. 753 BC – AD 410 Ancient Romans • First to organize medical care by providing care for injured soldiers • Later hospitals were religious and charitable institutions in monasteries and convents • First public health and sanitation systems by building sewers and aqueducts • Hippocrates established belief that the body was regulated by four body humors; blood, phlegm, black bile, and yellow bile • Life span was 25-35 years

10. AD 400 – AD 800 Dark Ages • Emphasis on saving the soul and study of medicine was prohibited • Prayer and divine intervention were used to treat illness & disease • Monks and priests provided custodial care for sick people • Medications were mainly herbal mixtures • Average life span was 20-30 years

11. AD 800 – AD 1400 Middle Ages • Renewed interest in medical practices of Greek and Romans • Bubonic Plague killed 75% of population in Europe and Asia • Major diseases included smallpox, diphtheria, tuberculosis, typhoid, the plague, and malaria • Arabs began requiring physicians pass examinations and obtain licenses • Average life span was 20-35 years

12. AD 1350 – AD 1650 Renaissance • Dissection of body led to increased understanding of anatomy and physiology • Invention of printing press allowed medical knowledge to be shared • First anatomy book was published by Andreas Vesalius (1514-1564) • Average life span was 30-40 years

13. Brain Break!! • When would you have liked to have lived? • Ancient times go to the back of the room • Middle Ages go to the front of the room • The Renaissance go to the kitchen side of the room

14. 16th and 17th Centuries • Cause of disease still not known – many people died from infections • Invention of the microscope allowed physicians to see disease-causing organisms. • Apothecaries (early pharmacists) made, prescribed, and sold medications • Ambroise Pare (1510-1590), a French surgeon, known as the Father of Modern Surgery established use of ligatures to stop bleeding • Average life span 35-45 years

15. 18th Century • Gabriel Fahrenheit (1686-1736) created the first mercury thermometer • John Hunter (1728-1793), established scientific surgical procedures and introduced tube feeding • Benjamin Franklin invented bifocals • Average life span 40-50 years

16. 19th Century • Rapidadvancements due to discoveries of microorganisms, anesthesia, and vaccinations • Infection control developed once microorganisms were associated with disease • Formal training for nurses began • Women became active participants in health care • Average life span 40-60 years

17. 20th Century • Increased knowledge about the role of blood in the body • ABO blood groups discovered • Found out how white blood cells protect against disease • New medications were developed • Insulin discovered and used to treat diabetes • Antibiotics developed to fight infections • Vaccines were developed • New machines developed • Kidney Dialysis Machine • Heart Lung Machine • Surgical and diagnostic techniques developed to cure once fatal conditions

18. 20th Century (continued) • Organ transplants • Test tube babies • Health Care Plans developed to help pay the cost of care • Medicare and Medicaid marked the entry of the federal government into the health care arena • HMOs provided an alternative to private insurance • Hospice organized

19. 21st Century • The first totally implantable artificial heart was placed in a patient in Louisville, Ky. In 2001 • The threat of bioterrorism lead to smallpox vaccination of the military and first responders in 2002 • The Netherlands became the first country in the world to legalize euthanasia in 2002 • The Human Genome Project to identify all of the approximately 20,000 to 25,000 genes in the human

20. 21st Century • Stem cells were used in the treatments of disease early in the 2000’s and lead to increased research in the treatment of cancer and other diseases • President George W. Bush approved federal funding for research using only existing lines of embryonic stem cells in 2001 • Advanced Cell Technology announced it cloned a human embryo in 2001 but the embryo did not survive • The U.S. FDA approved the use of the abortion pill RU-486 IN 200

21. 21st Century • The standards for Privacy of Individually Identifiable Health Information, required under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, went into effect in 2003 • The Medicare Prescription Drug Improvement and Modernization Act was passed in 2003 • Vaccinations for cervical cancer and herpes zoster (shingles) in 2006

22. Potential for 21st Century • Cures for AIDS, cancer, and heart disease • Genetic manipulation to prevent inherited disease • Nerves in the brain and spinal cord are regenerated to prevent paralysis • Antibiotics are developed that do not allow pathogens to develop resistance • Average life span 90-100 years

23. Activity • Create a timeline of the Radiology Modalities and provide a brief description of each. • Explain the pros and cons (risks and benefits) of these procedures. • Provide an argument for why we should or should not use these modalities. • Do you believe radiology has had a major impact on healthcare? Why? Diagnostic X-ray Magnetic Resonance Imaging (MRI) Cat Scan (CT) Ultrasound Nuclear Medicine Mammography Bone Density Vascular Intervention

24. Example: X-Ray • Wilhelm Roentgen discovered x-rays, a type of gamma radiation. • When electrons are shot across a tube they either stop and are absorbed or pass through certain materials. The differences between metals, tissue, and bone, will all be made evident on a film. • 1st x-rayed his wife’s hand. • Major benefit to health. Now we can verify things like breaks in the bone or pneumonia without disturbing the tissue or causing infection. • Concerns with overexposure to radiation relating to cancer. • Definitely necessary today. Risks highly outweigh the benefits. We have also learned how to control or attenuate the radiation beams unlike decades before. We monitor radiation doses today as well.