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Medical Science: History and Practice Lesson 1: The History of Medicine Upon completion of this lesson, students should be able to … Discuss the contributions of early medicine to healthcare. Discuss medical contributors of the eighteenth, nineteenth, and twentieth centuries. Identify and discuss the role women played in the history of medicine. Discuss modern medicine and the future of medicine. Shamans Witch doctors Sorcerers Used by Babylonian physicians in 3000 BC Named after Hammurabi, an early king of Babylon Laws relate to the practice of medicine If laws were broken, severe penalties were sustained Egyptians: ◦ Lists of remedies ◦ Surgical treatments of wounds and injuries ◦ Records for sanitation Jewish Community: ◦ Personal hygiene practices ◦ Sanitation and other public health issues Greeks: ◦ Use of nonpoisonous snakes to treat wounds Indian: ◦ Herbal medical remedies as early as 800 BC Chinese: ◦ Writings about human blood pulses around 250 BC Japanese and Chinese: ◦ Practice of acupuncture 1. What medicinal remedies were developed in ancient civilizations and are still being used today? Opium derivates used in medication Nitroglycerin to treat heart patients Digitalis from the foxglove plant to regulate and strengthen the heartbeat Sulfur and cayenne pepper to stop bleeding Chamomile and licorice to aid digestion Cranberry to treat urinary tract infections Medieval period Time of little or no progress in medical practices Time of many epidemics Medical testing was mostly oral Surgeons only treated the wealthy; others were treated by the local barber 1. 2. Compare and contrast the Classical version and the Modern version of the Hippocratic Oath. Prepare to discuss and share Part of the writings of Hippocrates Serves as a widely used ethical guide for physicians Oath includes the physician’s pledge to: ◦ ◦ ◦ ◦ ◦ work for the good of the patient do the patient no harm prescribe no deadly drugs give no advice that could cause death keep confidential medical information regarding the patient 1. What advancements in medicine that impacted how patients were treated, occurred during the nineteenth century? Improved knowledge of the human body through accurate documentation Use of sophisticated microscopes Use of injection materials Use of instruments such as the ophthalmoscope Discovery of the cell Discovery that certain diseases and wound infections were caused by microorganisms 1. How has medicine advanced from the nineteenth century to the twentieth century? Death rates from diseases such as tuberculosis and diphtheria dropped dramatically Overall mortality rates decreased New emphasis placed on morbidity rates Chemotherapy and the specialty of oncology were developed Development of immunology Progress in endocrinology Advancements in nutrition The introduction of antibiotics First example of using chemicals to treat infections Discovered by Sir Alexander Fleming in 1928 Fleming and two other scientists won the Nobel Prize for their work with penicillin Occurred due to the advancements in the study of immunology Discovered in the 1950s Developed by: ◦ Dr. Jonas Salk (1914-1996) ◦ Dr. Albert Sabin (1906-1993) First vaccines included: ◦ Typhoid, tetanus, diphtheria, tuberculosis, yellow fever, influenza, and measles 1954 1960 1962 1967 1978 1984 1997 2001 2001 – – – – – – – – – First successful kidney transplant Invention of the heart pump Reattachment of limbs First heart transplant First test-tube baby Discovery of HIV as the cause of AIDS Cloning of first sheep Placement of an implantable heart Completion of human genome project Increased life expectancy rates Improved communication techniques affecting the way patients will be treated Robotics used in surgery Cure for AIDS Vaccine to prevent HIV Cloning organs to overcome shortage of donors Better treatment and outcomes for mental illness Cure for heart disease, cancer, and obesity Methods to slow aging Regeneration of brain and nerve cells to overcome paralysis Development of antibiotics that do not allow bacteria to develop a resistant strain Upon completion of this lesson, students should be able to … Describe the difference between an internship and a residency in the training of physicians. State which type of medical practice is addressed under the medical and surgical specialties. Discuss ten allied health fields and the educational requirements for each of them. Discuss the current trends in health care that are driving changes in medical practice. Designates a person who holds a doctoral degree Physicians are MDs or DOs Practicing medicine requires a minimum of 910 years of education and training ◦ Four-year college degree in premedical studies ◦ Four years of medical school ◦ 2-6 year internship depending on specialty area Indicates who must be licensed to perform certain procedures Establishes the requirements for licensure Denotes duties associated with the license Sets grounds on which a license can be revoked Designates reports that must be made to the government Specifies the penalties for practicing without a valid license Unprofessional conduct Commission of a crime Personal incapacity to perform one’s duties Largest industry Provides about 12.9 million jobs Costs increasing faster than cost of living About 14% of gross national product spent on health care Heath care costs per year equal to about 1.5 trillion dollars Costs of employer-sponsored health care continues to increase Only nation that does not provide some type of basic health care for all citizens Expensive technological advances Physician specialization Breakdown of physician-patient relationships leading to the increase of lawsuits Higher costs of medications Older population needing more services Longer life expectancy Informed consumers demanding more tests and options More uninsured rely on the emergency room for primary care Uninsured having less or no access to preventive care leading to the need for treating more advanced illnesses or ailments Social conditions such as: ◦ ◦ ◦ ◦ Homelessness Substance abuse Poverty Child abuse Allergy and immunology Anesthesiology Bariatrics Video on Bariatrics Cardiology Dermatology Endocrinology Emergency Medicine Family Practice Gastroenterology Geriatric Medicine Hematology Oncology Primary Medicine (Internal Medicine) Neurology Nephrology Obstetrician ◦ Provides pre-natal care up through the postpartum period Gynecologist ◦ Provides medical/surgical treatment of diseases/disorders of the female reproductive system Ophthalmology Orthopedics Otorhinolaryngology Terms: ◦ Otology – study of the ear ◦ Rhinology – study of the nose ◦ Laryngology – study of the throat Pathology Pediatrics Physical and/or rehabilitative medicine Sports medicine Psychiatry Pulmonology Radiology Rheumatology Urology Surgeons Hospitals Outpatient surgical centers Urgent care centers Nursing homes Long-term-care institutions Hospice Certification ◦ Shows that an individual has met the educational/experience standards in their profession Registration ◦ Indicates that an individual is registered with a specific organization that has determined the person is qualified to perform duties in their profession Licensure ◦ Provides proof that the individual has been authorized by a government agency to perform work in their profession 5. Professional: 4-year degree, advanced degree and clinical training, Bachelor (BA, BS), Master or Doctorate 4. Technologist: 4-year college program, Bachelor (BA, BS) 3. Technician: 2-year community college or vocational program, Associate’s degree (AS) 2. Assistant: Up to 1-year classroom and clinical preparation, diploma 1. Aide: On-the-job training, high school diploma Completed a training program and taken a state examination Assists nurses in nursing homes, hospitals, and other health care facilities Patient care includes bed baths, vital signs, feeding, and ambulation Also called a nurse’s aid or orderly PCT - patient care technician, may have a CNA or medical assisting background and can perform technical tasks (drawing blood, ECGs) Performs some of the same, but not all, clinical nursing tasks of a registered nurse (No IVP or IVPB meds) Must have graduated from a recognized one-year program (CTE or CC) Must be licensed by the State Board (requires NCLEX LPN) In some states, LPN is known as LVN (licensed vocational nurse) Provide hands-on patient care Employed in hospitals, physicians’ offices, industry, governmental agencies, ambulatory care units, emergency services, and schools Work ranges from direct patient care, to teaching and supervising others, performing research, and managing agencies Two-year or four-year program (ASN or BSN) Licensed after passing the National Council Licensure Examination (NCLEX) RN with additional training Provide basic care including diagnosing and prescribing medications and treatments Masters-degree, trained individual (Soon to change to Doctorate) Field emerged in 1970s Assists the physician in the primary care of patients (must work with a Doctor) Can prescribe medications in nearly all states Two-years education after a bachelor’s degree Work and/or internship experience Pass an accreditation examination Government agency Division of the Department of Health and Human Services (DHHS) Safeguard public health by preventing and controlling disease Acts as a resource http://www.cdc.gov/