Module 5 lecture part 5 Flashcards
What can threaten the health of society at large?
Relying on rationing based on ability to pay and the lack of central planning
How has technology influenced the medical system?
Influencing medical education
Making it possible to deliver medical services in settings other than hospitals
Promoting corporatization of medicine
What are the four main eras of HC evolution in the US?
Pre-industrial, or consumer sovereignty
Post-industrial, or professional dominance
Corporatization or corporate dominance
HC reform, or gov’t dominance
Characteristics of the pre-Industrial Era: 1700s to 1800s
Medical practice in disarray
Primitive medical procedures
Missing institutional core
Unstable demand
Substandard medical education
Why was medical practice in disarray in the 1700s to 1800s?
It was a trade, not a profession
Give examples of primitive medical procedures in the 1700s to 1800s
Bleeding
Emetics
Purgatives
Describe the institutions of the 1700s and 1800s
Almshouses and pesthouses
Dispensaries
Mental asylums
What was the result of unstable demand in the 1700s and 1800s?
Self-reliance
Describe medical education in the 1700s and 1800s
Apprenticeship
College-based education lacked scientific training
Describe the characteristics of the post-industrial era: late 1800s-mid 1900s
Professional sovereignty of American physicians
Specialization in medicine
Development of PH
Birth of workers’ comp
Rise of private health insurance
Failure of national HC initiatives
Creation of Medicare and Medicaid
Development of managed care
What were the reasons medicine became a profession of power and authority?
Urbanization
Science and tech
Institutionalization
Pt dependency
Autonomy and organization
Licensing
Educational reform
Describe characteristics of specialization in medicine
It’s a hallmark in American medicine
58:42 specialist to generalist ratio
Also specialized fields in allied health professions
What is a consequence of preoccupation with specialization?
Lack of a rational coordination of medical care
Describe the gatekeeping model of HMOs
Has been occurring since early 1900s
Initial contact with GP required for a referral to a specialist
What were three forces behind the health insurance movement in the early 1900s?
Technology: advanced txs became available, but they were expensive
Social: desirability of HC
Economic: unpredictability of medical needs and costs of tx