Medical Professionalisation Flashcards
1737
Edinburgh Medical Society formed
What does Jewson argue?
The C18th patronage system made medicine a commodity - increasing the power of patients
What does Waddington argue of the C18th?
Patronage and status mattered more than skill
Unificiation of training did not equal a unified profession, but began to create a professional idenitity
Pre-1815 division
Apothecaries Surgeons Physicians (though surgeon-apothecaries existed) However this apparent division did not reflect reality - most served as general practitioners
Who were the physicians ruled by pre-1815?
Royal College of Physicians founded 1518
When was a membership exam introduced for the Royal College of Physicians?
1860
had been founded in 1518
Who were surgeons ruled by pre-1815?
Barber-Surgeons Company 1745
became Royal College of Surgeons of London in 1800
How did the Royal College of Surgeons of London assess membership?
Had to have completed an apprenticeship
Had to have attended at least one anatomy and one surgery lecture session
How were apothecaries assessed pre-1815?
Society of Apocatheries in London established 1617
Oral examination and apprenticeships required
How did King James distinguish apothecaries from grocers
Grocers were “unskilful” - unlike apothecaries
What did the end of the Napoleonic Wars in 1815 cause?
Return of military surgeons - more competition
What were the disadvantages of apprenticeships?
Variable training standards and length, not standardized curriculum
What did Thomas Percival publish in the C18th
‘Medical Ethics’ - meant to negotiate interprofessional disputes
Apothecaries Act 1815
Examinations introduced (though inefficient)
6 months hospital experience required
5 year apprenticeship made standard
Need to provide reference for moral character as well as education
License of the Society of Apothecaries needed to dispense
Compulsory attendance @ at least one lecture series
Aimed to privilege them over druggists?
What was medical training generally by the mid-1840s?
Medical course generally 4 years
Apothecary course generally 3 years
What did Justice Park argue in 1828?
That the Apothecaries Act was intended to keep the separation between the functions of surgeons, physicians, and apothecaries
When was the British Medical Association founded?
1856
When was the British Medical Act?
1858
What did the 1858 Medical Act (Britain) do?
Established Register (publically available) Arranged to publish Pharmacopeia (in Latin though - inaccessible except for educated) Qualification regulation (NOT unification) Disciplinary code established (problematic; restrictions undefined) Sought to abolish geographic restrictions on practice (influence of geographic mobility?) General Medical Council established
What did the 1858 Medical Act (Britain) NOT do?
Make unqualified practice illegal - free market
Unify or standardize qualifications
Amalgamate/standardize universities and qualifications
Professional self-regulation remained
What effects did the 1858 Act ahve?
Minimal growth in number of registered medical practitioners relative to population growth
Increased earnings and status of medical practitioners
Foucault: exemplified evolution of knowledge into power?
How does Foucault’s theory of power relations apply to the standardization of medical practice?
Exemplifies the evolution of knowledge into a source of power
What does Parry argue about the 1858 Medical Act?
Meant to create status and upward mobility for doctors, not protect patients or unify profession
When did the Lancet argue that medics were not wealthy?
1830
What did the rise of hospital medicine mean?
Charitable basis - reduction in free will and choice of the patient (especially by NHS)
By C19th, hospital training generally standard for medical men
Status of and trust in doctors rose (Waddington)
What is an effect of increasing state liscensing?
Reducing professional competition
What did Voltaire publish?
C18th satire against doctors
What did new developments in the 1950s cause, according to Ivan Waddington?
Increased medical prestige
What showed the 1960s/70s distrust of medicine?
Shows such as MAS*H, movies such as One Flew Over the Cuckoo’s Nest
