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USMLE® Step 1 flashcards Sociology 101 flashcards
1
Q

Acute care Settings

A

Either:

Inpatient or Outpatient

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2
Q

4 phases of Development

A

1) hospitals are centers of religious practice (mostly western medicine)
2) Hospitals turned into poorhouses
3) Late 1600s( hospitals turned into death houses)
4) Hospitals began to develop antiseptics and sterilizing before and after.

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3
Q

What were the principles of Christianity as part of hospitals?

A

achieve salvation by serving others and therefore , they had the duty to serve the less fortunate

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4
Q

Where were the first hospitals formed?

A

Along the root of the Crusades from England into the MidEast and were founded to care for soldiers.

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5
Q

After the first hospitals where were they next formed?

A

Built by the wealthy and the nobility (especially in England)

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6
Q

What kind of care was given in the wealthy hospitals?

A

Religious , and the care was given by priests and nuns

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7
Q

What were the primary treatments in rich hospitals ?

A

Leeching and blood letting

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8
Q

What was the primary function of the newly found hospitals of the rich?

A

religion and charity

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9
Q

In the beginning what kind of approach was patient care considered?

A

service approach

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10
Q

When Hospitals turned into poorhouses

A
  • they moved away from religious practice and from service orientation.
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11
Q

Who did poorhouses offer contracts to??

A
  • any one willing to take care of the poor and sick and the orphans and widows.
  • And who would do it for the least amount of money
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12
Q

Who paid the person to take care of the poor and sick?

A

The community

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13
Q

What happened to the poorhouse facilities ?

A
  • They were neglected
  • mismanagement of funds
  • The sick were housed in with the poor , and other groups who weren’t being taken care of by families were housed there
  • Standards went down
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14
Q

By the late 1600s

A

hospitals became known as “death houses” (No Germ Theory)

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15
Q

Who dominated “death houses”?

A

physicians

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16
Q

What were nurses status’ in “death houses”?

A

just above prostitutes in terms of morality or status.

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17
Q

Who is “Florence Nightingale”?

A
  • Didn’t believe in the Germ Theory
  • BELIEVED In CLEANLINESS
  • trained her nurses to clean their patients and the hospital.
  • Trained nurses that were willing to work very hard and this was the beginning of people being able to survive hospitalization.
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18
Q

4th Phase

A
  • Hospitals began to develop antiseptics and sterilizing before and after.
  • Anesthesiology had been developed for putting people to sleep during surgery.
  • Blood transfusions for severe blood loss.
  • Hospitals are now known as “TECHNICAL CENTERS” because of all that we could do.
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19
Q

The structure of the Hospitals in the (4th stage)

A
  • Changed around the time of 1940s and 1950s
  • They were run by a board of Trustees and being a board member was considered to be an honor and they picked board people
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20
Q

What “board of trustees people” did hospitals usually pick?

A
  • Well known people in various fields like, Religious leader, academic leaders, politicians, people that were known for service … etc.
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21
Q

What kind of “orientation” were the hospitals in (4th stage of development considered)?

A
  • service orientation
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22
Q

what kind of hospitals were in the 4th stage?

A
  • community

- people made decisions based on patient care

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23
Q

Early 20th century and by 1950 in the US

A
  • physicians had a lot of status
  • economic orientation service (emphasis on paying)
  • physicians were seen as “gods”
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24
Q

How were nurses seen in the “early 20th century ad 1950s”?

A
  • seen as hand maidens to the doctors because doctors had absolute control.
25
Q

in the early 40s and 50s

A
  • Emergence of hospital administration as an occupation

- Sometimes the administer was the physician and sometimes he or she was not

26
Q

by 60s

A

-you had duel authority in hospital and this is still the structure of hospitals today

27
Q

Today what kind of structure does the hospital have?

A
  • hospital administrator

- medical people (chief of staff) (chief of doctors)

28
Q

What is the purpose of the “Chief of Doctors”?

A
  • Looks over doctors associated with the hospital and are in charge of physicians related to patients and patient care
29
Q

What happened between physicians and “chief of staff”?

A
  • power struggle between hospital administration
30
Q

What was the primary focus of physicians ?

A
  • Hospital administration was to keep it in the black instead of red so it can function
31
Q

what was the primary focus of “chief of staff”?

A
  • focuses on patient care
32
Q

What did nurses do in the hospitals when the power struggle was going on?

A
  • get caught in the power struggle
  • Hospital administration hires/fires them, promotes them, etc.
  • take orders from doctors and work directly with doctors.
33
Q

Post war prosperity of 50s and 60s

A
  • majority of people began to get health insurance.
  • Medicare Act of 1965 also played a big role.
  • 35% of elderly lived below the level of poverty.
34
Q

Patients in the hospital..

A
  • Argue that hospitals are similar to Goffman’s total institution
  • When you enter a total institution, theres a certain mortification of the self in which you are stripped of personal possessions.
  • sign you a number
  • refer to you by your diagnoses and room number
  • little privacy
35
Q

What is “Prognosis”?

A
  • is how well the doctor thinks you are going to do
36
Q

Why don’t doctors like to give you info?

A

1) they don’t think you’ll understand the technical info related to your condition
2) they don’t want to deal with the emotional response that you might have to diagnoses or prognoses
3) assume that people don’t wanna know their prognosis

37
Q

What are the doctor’s fears of patients ?

A
  • if they give the patient a pessimistic prognosis then it will become a self-fulfilling prophecy.
38
Q

What is expected by the doctor from the patient ?

A
  • objectify your body and pain
  • eating and going to bed when they say
  • restrict your mobility
39
Q

Who are the best people to conform to hospitals?

A
  • older people and the less educated
40
Q

After WW2

A
  • more people were covered by third party insurance tied to their employment
  • Hospitals started charging more money for hospitalization.
  • For- Profit corporations entering into the hospital business, buying up hospitals and building their own.
41
Q

What tried to limit hospital costs?

A

1) implementation of DRGs.
2) gov. tried to apply anti-trust laws to hospitals to keep for profits from monopolizing services
3) development of HMO’s

42
Q

In result of trying to limit hospital costs..

A

1) some hospitals shut down and said they just could not stay in business with all this paper work without charging more
2) hospitals were dumping their non-paying patients onto county facilities.
3) most hospitals have abandoned level 1 trauma care because of very expensive , intensive , and typically you do not get reimbursed for the amount of money spent on this care.
4) Creme-skimming: trying to attract patients with the best paying insurances ( advertising )
5) Use of technical criteria for patient care ( only keeping people there if it is medically necessary ( they will get rid of you as soon as they can.
6) tried corporate rationing or restructuring of hospitals to eliminate certain positions.
7) they’ve tried to reduce competition from other hospitals

43
Q

What is “Creme-skimming”?

A

Trying to attract patients with the best paying insurances (advertising)

44
Q

what do “Long Term Car settings” do?

A
  • aimed at dealing with people with chronic illness that are maintaining their chronic illness
  • ex.) Nursing Homes
45
Q

Nursing Homes

A
  • you can have different levels of care:

- skill nursing care , and intermediate.

46
Q

What is “skilled nursing care”?

A
  • a patient has to have some sort of conditions that requires treatment by an RN for 24hours. a day
  • Only type that Medicare will pay for and only for 100 days.
47
Q

What is the majority of care in nursing homes ?

A
  • intermediate
  • Most patients need custodial care
  • “Commodatation of Care”
48
Q

Diamond’s Findings

A
  • in nursing homes today most care is given by nursing assistants.
  • being a patient in a nursing home is just like being a patient in a “Total Institution”
49
Q

Home Health Care

A
  • offering more of this to keep people out of nursing homes and acute facilities.
  • most is skilled nursing care.
  • Medicare pays for this to a certain extent
50
Q

Hospice Care

A
  • care that is delivered to individuals who have been certified to have less than 6 months to live
  • Hospice is NOT a facility
  • Philosophy of it , is that the patient should be allowed to die with dignity and in as little pain as possible.
  • NO medical care that can expand your life span will be given.
51
Q

Settings of Hospice Care

A

1) you can die at home and the hospice care will come to you. but if you do this , there has to be one member of your family that will agree to be there with you 24/7 and be primary care giver.
2) you can receive it in the nursing home
3) facility that is only for hospice care and it is a building.

52
Q

Hospice care in terms of “Medicare”

A
  • Pays for hospice , changes have been made in regards to patients.
  • If you live longer than 6months then they dump you and you will be out of hospice care
53
Q

How do you achieve to be a physician?

A

-Medical school lasts 3-4 years

54
Q

Characteristics of Medical School profession?

A
  • legally recognized form of licensure
  • required education
  • socialization
  • 1 year internship
  • testing
55
Q

What are some professional associations that lobby in their behalf to influence legislation?

A
  • AMA
  • NASW
  • APA
  • ASA
  • AASECT
56
Q

in 1800s Medical Schools…

A
  • were uncommon
  • Many who practiced as doctors did not attend medical school
  • Apprenticed Under other Dr.’s instead
  • *anyone could be a doctor
57
Q

University of Philadelphia

A
  • Taught by Europeans
  • Columbia
  • Harvard
  • Dartmouth
58
Q

By the middle of the 1800s , to become a professional and maintain a professional income ..

A
  • Association was needed

Medical Sociology (1 decks)

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