Health Occupations
Chapter 1: History and Trends of Health Care
Section 1: History of Health Care:
Objectives:
1. Differentiate between early beliefs about the cause of disease and treatment and current beliefs
about disease and treatment.
2. Identify at least ten major events in the history of health care.
3. Name at least six historical individuals and explain how each one has helped to improve health care
today.
4. Create a time line showing what you believe are the twenty most important discoveries in health care
and explain why you believe they are important.
A. Introduction:
1. Why is it important to understand the history of health care?
2. Some of the treatment methods in use today were also used in ancient times.
a. Before drugstores, people used many herbs and plants as food and medicine.
b. Many of these herbs are still in use today.
c. Common example is a medication called morphine made from a poppy plant and used to
treat pain.
B. Ancient Times:
1. Belief that disease and illness caused by demons and evil spirits.
2. Treatment directed toward eliminating evil spirits.
3. As civilizations developed, changes occurred.
a. People began to study the human body.
b. Made observations about how body functions.
4. Religion played important role
a. Common belief: illness and disease was a punishment from the gods.
b. Religious rites and ceremonies frequently used to eliminate evil spirits and restore health.
c. Exploring the structure of the human body was limited.
d. Most religions did not allow dissection of humans
e. Animals were frequently dissected to learn about different body parts.
5. Ancient Egyptians
a. First people to record health records
b. Many people could not read and knowledge was limited to an educated few
c. Most records were recorded on stone and were created by the priests who acted as doctors
6. Ancient Chinese
a. Had a strong belief in the need to cure the spirit and nourish the entire body
b. Today holistic health methods stress treating the entire patient –mind, body, and soul.
7. Ancient Greeks
a. Hippocrates
i. Father of Medicine; one of the most important physicians in ancient Greece
ii. Records created by him & other physicians helped establish that disease is caused by natural
causes, not by supernatural spirits and demons.
b. Ancient Greeks were among the first to stress that a good diet and cleanliness would help prevent
disease.
8. Ancient Romans
a. Realized that some disease was connected to filth, contaminated water, and poor sanitation.
b. Began the development of sanitary systems
i. Built sewers to carry away waste and aqueducts (waterways) to deliver clean water.
ii. Drained swamps and marshes to reduce the incidence of malaria.
iii. Created laws to keep streets clean and to eliminate garbage.
c. Established the first hospitals when physicians began caring for injured soldiers or ill people in their
homes.
9. SUMMARY
a. Although many changes occurred in health care during ancient times, treatment was still limited
b. Average person had poor personal hygiene, drank contaminated water, and faced unsanitary living
conditions.
c. Diseases such as typhoid, cholera, malaria, dysentery, leprosy, and small pox infected and killed many
d. Average life span was 20-35 years.
C. Dark Ages and Middle Ages
1. Dark Ages
a. After the fall of the Roman empire, the study of medicine stopped.
b. Individuals again lived in filth with little or no personal hygiene.
c. Epidemics of smallpox, dysentery, typhus, and the plague were rampant
2. Middle Ages
a. Brought a renewed interest in the medical practices of the Romans and Greeks.
b. Monks obtained and translated the writing of the Greek and Roman physicians and recorded the
knowledge in handwritten books
c. Medical universities were created in the 9th century to train physicians how to use this knowledge to treat
illness.
d. Later, Arabs began requiring that physicians pass examinations and obtain licenses.
3. In the 1300’s, a major epidemic of bubonic plague killed almost 75% of the population of Europe and Asia.
a. Other diseases such as smallpox, diphtheria, tuberculosis, typhoid, and malaria killed many others.
b. Average life span of 20 to 35 years was often reduced even more by the presence of these diseases.
i. Many infants and children died shortly after birth.
ii. Today most of these diseases are almost nonexistent because they are prevented by vaccines or
treated by medications.
D. Renaissance (1350-1650 AD)
1. Often called the “rebirth of the science of medicine”
2. Major source of new information about the human body was a result of accepting and allowing human dissection
a. Doctors could now view body organs and see the connections between different systems in the body.
b. Artists such as Michelangelo and Leonardo da Vinci were able to draw the body accurately
3. Development of the printing press resulted in the publication of medical books that were used by students at
medical universities allowing physicians to be more educated and knowledge to spread more rapidly.
4. Life span increased to an average age of 30 to 40 years.
a. Common infections still claimed many lives.
b. Actual causes of disease were still a mystery.
E. 16th , 17th, and 18th Centuries
1. Physicians gained an increased knowledge of human body
a. Harvey described the circulation of blood
b. Fallopius described the tympanic membrane in the ear and fallopian tubes in a female
c. Eustachio identified the tube between the ear and throat
d. These discoveries allowed other physicians to see how the body functioned.
2. Microscope invented by Anton van Leeuwenhoek, was a major development.
~ Allowed physicians to see pathogenic organisms too small to be seen by the human eye.
3. Drugstores or pharmacies started
a. Apothecaries (early pharmacists) made, prescribed, and sold medications.
b. Many of the medications were made from plants and herbs similar to those used in ancient times.
4. At the end of the 18th century, Edward Jenner developed a vaccine to prevent smallpox.
5. Cause of many diseases was still unknown and medical care was still limited.
6. Average life span increased to 40 to 50 years.
F. 19th Century (Industrial Revolution)
1. Major progress in medical science occurred because of the development of machines and ready access to books
2. Rene’ Laennec invented the stethoscope
a. Allowed physicians to listen to internal body sounds, which increased their knowledge of human body.
b. Original stethoscope, a rolled piece of paper, quickly evolved into a wooden tube that was inserted into
the physician’s ear. (COOL!! )
3. Formal training of nurses began
a. After training at a program in Germany, Florence Nightingale (the founder of modern nursing)
established sanitary nursing care units for injured soldiers during the Crimean War.
4. Infection control another major development
a. Physicians began to associate the tiny microorganisms seen in the microscope with diseases.
b. Methods to stop the spread of these organisms were developed by Theodor Fliedner, Joseph Lister,
and Louis Pasteur.
5. Women became active participants in medical care.
a. Elizabeth Blackwell was the first female physician in the U.S.
b. Dorothea Dix was appointed Superintendent of Female Nurses of the Army.
c. Clara Barton founded the American Red Cross.
6. Average life span increased to 40 to 65 years.
a. Treatment for disease was more specific after the causes of disease were identified.
b. Many vaccines and medications were developed.
G. 20th Century
1. Showed the most rapid growth in health care.
2. Physicians were able to use new machines such as X-rays to view body.
3. Medicines, including insulin for diabetes, antibiotics to fight infections, and vaccines to prevent diseases were
developed.
4. Causes for many diseases were identified.
5. Physicians were now able to treat the cause of a disease to cure the patient.
6. A major development in understanding the human body occurred in the 1950’s.
a. James Watson and Francis Crick were credited with describing the structure of DNA and how it
carried genetic information.
b. Their studies began the search for gene therapy to cure inherited diseases which continues today.
7. Health care plans were created to help pay the costs of care
8. Standards were created in an attempt to make sure that every individual has access to quality health care.
9. First open-heart surgery in the 1950’s has progressed to the heart transplants that occur today.
10. Surgical techniques have provided cures for what were once fatal conditions.
11. Infection control has helped decrease surgical infections that use to kill many patients.
12. Computer technology one of the greatest contributions to medical science.
a. Helped medicine progress faster than ever before.
b. Today computers are used in almost every facet of health care and will increase even more in the future.
13. Average life span increased to 60 to 80 years.
a. Not uncommon to see people live to be 100.
b. With current pioneers such as Ben Carson (developed landmark surgeries to separate conjoined twins)
and many other medical scientists and physicians, there is no limit to what future health care will bring.
H. 21st Century
1. Potential for major advances in health care is unlimited
2. Completion of the human genome project occurred early in the century.
a. Done by the U.S. Department of Energy and the National Institutes of Health (NIH).
b. Provided the basis for much of the research on genetics that is occurring today.
c. Research with embryonic stem cells could lead to treatments that will cure many diseases.
3. Major threats to health care
a. Bioterrorism, the use of microorganisms or biologic agents as weapons to infect humans is a real and
present threat.
b. New viruses, such as the bird flu virus, could mutate and cause disease in humans.
c. Pandemics, or worldwide epidemics, could occur quickly in this global society because people can
travel easily from one country to another.
4. Positive Points
a. Scientists now have computers and rapid methods of communication to share new knowledge.
b. Organizations such as the World Health Organization (WHO), an international agency sponsored by
the United Nations, are constantly monitoring health problems throughout the world and taking steps to
prevent pandemics.
c. Health care has become a global concern, and countries are working together to promote good health in
all individuals.
I. SUMMARY
1. Health care has seen many changes over the centuries.
2. Future changes may be even more dramatic.
J. Discussion
1. When did most of the significant changes in health care occur?
2. Why were the greatest advances made in this time period?
3. What are some possibilities for the future of health care?
4. Identify pioneers in the health care field and state their major contribution.
5. Choose an era in history of health care and tell how health care technology has changed.
Health Occupations
Chapter 1: History and Trends of Health Care
Section 2: Trends in Health Care
Objective: Identify at least five current trends or changes in health care
A. Introduction:
1. Most of you have probably heard about AIDS. How has this disease changed or affected health care?
2. Many events lead to changes in health care and changes occur almost daily. As a health care worker, you must
be aware of these changes and trends.
B.
Cost Containment
1. Means trying to control the rising cost of health care and achieving the maximum benefit for every dollar
spent.
2. One reason for high health care costs is technological advances
a. Heart, lung, liver, kidney transplants
b. Artificial hearts
c. Computers to examine internal body parts
d. Advanced technology allows people to survive illnesses that used to be fatal, but these individuals
may require expensive and lifelong care.
3. Second reason for high costs is the aging population
a. Increased use of pharmaceutical products
b. More chronic diseases
c. Need for frequent health care services
4. Increase in health-related lawsuits also contributes to increased costs.
a. Expensive malpractice insurance.
b. Doctors order diagnostic tests even though the tests might not be necessary
c. Make every effort to avoid lawsuits by practicing defensive health care (run tests even though pat.
may not need it so patient can’t sue for not running the test).
5. Costs could rise to levels that prohibit providing services to all individuals even though everyone should
have equal access to care regardless of the ability to pay.
6. Methods used to contain costs
a. Diagnostic related groups (DRG’s)
i. Attempt by Congress to control costs for Medicare and Medicaid
ii. Payment based on diagnosis
iii. Certain amount paid for each disease condition
iv. Agencies providing care for less can keep extra money
v. Agencies accept loss if care costs more than payment allowed
b. Combination of services
i. Agencies combine services to avoid duplication. Share clinics, laboratories, and so on. (A
large medical laboratory with expensive computerized equipment performing thousands
of tests per day can provide quality service at a much lower price than a smaller lab with
less expensive equipment capable of performing only a limited number of tests per day.)
ii. HMO’s and PPO’s are examples of sharing services. (St. Tammany Physicians Network)
iii. Care can be provided to a larger number of people at a decrease in cost per person.
c. Outpatient services
i. Patients receive care without being admitted to hospitals or other care facilities.
ii. Hospital care is expensive
iii. Reducing the length of hospital stays or decreasing the need for hospital admissions
lowers the cost. Ex. Open-heart surgery patients who used to spend several weeks in
hospital now stay five to seven days.
iv. Less expensive home care or transfer to a skilled-care facility is used for individuals who
require additional assistance.
v. Examples of outpatient services are surgery, X-rays, diagnostic tests
d. Mass or bulk purchasing
i. Buying equipment and supplies in larger quantities at reduced prices.
ii. Combine purchases of different departments in an agency.
iii. Major health care system purchasing medical supplies for hundreds or thousands of
health care agencies can obtain much lower prices than individual agency.
iv. Computerized inventory can be used to determine when supplies are needed and to
prevent overstocks and waste.
e.
7.
Early intervention and preventive services
i. Providing care before acute or chronic disease occurs. Preventing illness is more cost
effective than treating illness.
ii. Methods used to prevent illness include patient education, immunizations, regular
physical examinations to detect problems early, incentives for individuals to participate in
preventive activities, and easy access for all individuals to preventive health care
services.
iii. Studies have shown that individuals with limited access to health services and restricted
finances use expensive emergency rooms and acute care facilities more frequently.
iv. Providing early intervention and care to those individuals is more cost efficient.
f. Energy conservation
i. Monitoring the use of energy to control costs and conserve resources
ii. Major expenses for every health care industry/agency are electricity, water, and/or gas.
iii. Methods used include designing and building new energy efficient facilities, constantly
monitoring and maintaining heating and cooling systems, using insulation and
thermopane windows to prevent hot/cool air loss, repairing plumbing fixtures
immediately to stop water loss, using energy efficient light bulbs, installing infrared
sensors to turn water on and off, using alternate forms of energy such as solar power.
iv. Recycling is also a form of energy conservation.
Important note that the quality of health care should not be lowered simply to control costs.
a. Agency for Health Care Policy and Research (AHCPR)
i. Federal agency established in 1990
ii. Purpose is to research the quality of health care delivery and identify the standards of
treatment that should be provided.
b. Every health care worker must make every effort to provide quality care while doing everything
possible to avoid waste and keep expenditures down.
c. Health care consumers must assume more responsibility for their own care, become better
informed of options for health care services, and follow preventive measures to avoid or limit
illness and disease.
C.
Home Health Care
1. Rapidly growing field
2. DRG’s result in shorter hospital stays so patients need care at home.
3. Also cost containment because less expensive to provide.
4. All aspects of health care involved.
a. Nursing care
b. Physical and Occupational therapy]
c. Respiratory therapy
d. Social Services
e. Nutritional and food services
f. Homemaking services
D.
Geriatric Care
1. Care for the elderly
2. Field of rapid growth because individuals experiencing longer life spans and baby boom generation now reaching
this age.
3. Projections from the U.S. Census Bureau
a. Rate of population growth during the next fifty years will be slower for all age groups
b. Number of people in older age groups will continue to grow more than twice as rapidly as total
population.
4. Will lead to growth of different facilities
a. Adult day care centers
b. Retirement communities
c. Assisted/independent living facilities
d. Long term care facilities.