24000 BC – 3000 BC Primitive TimesIllness and diseases were a punishment from the GodsTribal witch doctors treated illness with ceremoniesHerbs and plants used as medicines (morphine and digitalis)Trepanation or trephining (surgically removing a piece of bone from the skull)Average life span was 20 years
3Early Beginning Medicines Medicines of early times still used todayDigitalis (foxglove plant) used to slow & strengthen heartQuinine (bark of cinchona tree) used for fever, muscle spasms, malariaMorphine (opium poppy) used to relieve severe pain; is addicting
43000 BC – 300 BC Ancient Egyptians Physicians were priestsBloodletting or leeches used as medical treatmentAverage life span was yearsEgyptians kept accurate health recordsDeveloped the art of splinting fractures,
51700 BC – AD 220 Ancient ChineseBelieved in the need to treat the whole body by curing the spirit and nourishing the bodyRecorded a pharmacopoeia of medications based mainly on the use of herbsUsed therapies such as acupunctureBegan to search for medical reasons for illnessAverage life span was years
61200 BC –200 BC Ancient GreeksFirst to observe the human body and the effects of disease – led to modern medical sciences.Chinese monitored the pulse/blood pressure to determine condition of the body; believed in treating the whole body; used acupuncture.Believed illness is a result of natural causesStressed diet and exercise as ways to prevent diseaseAverage life span was years
7753 BC – AD 410 Ancient RomansFirst to organize medical care by providing care for injured soldiersLater hospitals were religious and charitable institutions in monasteries and conventsFirst public health and sanitation systems by building sewers and aqueductsDoctors kept the sick in their home. They wore a death mask.Life span was years
8AD 400 – AD 800 Dark AgesEmphasis on saving the soul and study of medicine was prohibitedPrayer and divine intervention were used to treat illness & diseaseMonks and priests provided custodial care for ill peopleMedications were mainly herbal mixturesAverage life span was years
9AD 800 – AD Middle AgesBubonic Plague killed 75% of population in Europe and Asia. The “Black Death” or killed 60 million peopleMajor diseases included smallpox, diptheria, tuberculosis, typhoid, the plaque, and malariaArabs began requiring physicians pass examinations and obtain licensesAverage life span was years
10AD 1350 – AD RenaissanceDissection of body led to increased understanding of anatomy and physiologyInvention of printing press allowed medical knowledge to be sharedFirst anatomy book was published by Andreas Vesalius ( )Michelangelo and Leonardo da Vinci used dissection to draw more realistic pictures of the human bodyAverage life span was years
1116th and 17th CenturiesCause of disease still not known – many people died from infectionsInvention of the microscope allowed physicians to see disease-causing organisms.Apothecaries (early pharmicists) made, prescribed, and sold medicationsAmbroise Pare ( ), a French surgeon, known as the Father of Modern Surgery established use of ligatures to stop bleedingAverage life span years
1216th-17th Centuries Scientists William Harvey- heart is a pump which pumps blood through out the bodyGabrielle Fallopius- identifies and names fallopian tubes and vagina and tympanic membraneBartolomeo Eustachio identified and named the tube leading from ear to the throat
1318th CenturyGabriel Fahrenheit ( ) created the first mercury thermometerJohn Hunter ( ), established scientific surgical procedures and introduced tube feedingJoseph Priestly discovered the element oxygenBenjamin Franklin invented bifocalsAverage life span years
1419th CenturyRapid advancements due to discoveries of microorganisms, anesthesia, and vaccinationsInfection control developed once microorganisms were associated with diseasePaul Ehrlich discovered a treatment for syphilis on his 606th experimentFormal training for nurses beganWomen became active participants in health careLillian Wald started the public health nursing and visited homes to give care in New York City in 1893Average life span years
1520th Century Increased knowledge about the role of blood in the body ABO blood groups discoveredFound out how white blood cells protect against diseaseNew medications were developedInsulin discovered and used to treat diabetesAntibiotics developed to fight infectionsVaccines were developedNew machines developedKidney Dialysis MachineHeart Lung MachineSurgical and diagnostic techniques developed to cure once fatal conditions
1620th Century (continued) Organ TransplantsTest tube babiesImplanted first artificial heartHealth Care Plans developed to help pay the cost of careMedicare and Medicaid marked the entry of the federal government into the health care arenaHMOs provided an alternative to private insuranceHospice organizedWalter Reed found that mosquitoes carried yellow fever in His vaccine helped the building of the Panama Canal
1721st CenturyThe first totally implantable artificial heart was placed in a patient in Louisville, Ky. In 2001The threat of bioterrorism lead to smallpox vaccination of the military and first responders in 2002The Netherlands became the first country in the world to legalize euthanasia in 2002The Human Genome Project to identify all of the approximately 20,000 to 25,000 genes in the human
1821st CenturyStem cells were used in the treatments of disease early in the 2000’s and lead to increased research in the treatment of cancer and other diseasesPresident George W. Bush approved federal funding for research using only existing lines of embryonic stem cells in 2001Advanced Cell Technology announced it cloned a human embryo in 2001 but the embryo did not surviveThe U.S. FDA approved the use of the abortion pill RU-486 IN 200
1921st CenturyThe standards for Privacy of Individually Identifiable Health Information, required under the Health Insurance Portability and Accountability Act (HIPPA) of 1996, went into effect in 2003The Medicare Prescription Drug Improvement and Modernization Act was passed in 2003Vaccinations for cervical cancer and herpes zoster (shingles) in 2006
20Potential for 21st Century Cures for AIDS, cancer, and heart diseaseGenetic manipulation to prevent inherited diseaseNerves in the brain and spinal cord are regenerated to prevent paralysisAntibiotics are developed that do not allow pathogens to develop resistanceAverage life span years
21Individual Contributions What Georgian surgeon was believed to be the first person to use anesthesia but never given credit for it?
22Hippocrates (460 – 377 BC)Greek physician known as the “Father of MedicineAuthored code of conduct for doctors known as the “Hippocratic Oath” that is the basis of medical practice todayBelieved illness was not causedby evil spirits and stressedimportance of good diet, freshair, cleanliness, and exercise
23Anton van Leeuwenhoek (1632-1723) Invented the microscope lens that allowed visualization of organismsScraped his teethand observed thebacteria thatcauses toothdecay
24Benjamin Franklin ( )Invented bifocalsFound that colds couldbe passed from personto person
25Edward Jenner ( )Developed a vaccination for smallpox in 1796
26Rene Laennec ( )Invented the stethoscope in 1819First stethoscope was made of wood
27Elizabeth Blackwell (1821-1910) First female physician in the United States in 1849
28F lorence Nightingale (1820-1910) Known as the “Founder of Modern Nursing”Established efficient and sanitary nursing units during the Crimean War in 1854Invented the call bell system and use of dumbwaiters to deliver mealsBegin the professional education of nurses
29Louis Pasteur (1822-1895) Known as the “Father of Microbiology” His germ theory proved that microorganisms cause diseaseProved that heat can be usedto destroy germs through aprocess called pasteurizationCreated a vaccine for rabies in1885Founded the basic rules forsterilization
30Joseph Lister (1827-1912) Used carbolic acid on wounds to kill germs First doctor to use an antiseptic during surgery
31Clara Barton ( )Volunteer nurse for wounded soldiers during the Civil WarAfter Civil War, established a bureau of records to search for missing menCampaigned for the USA to signthe Treaty of Geneva, whichprovided relief for sick andwounded soldiersFormed American Red Crossin 1881 and served as its firstpresident
32Robert Koch ( )Developed the culture plate method to identify pathogensIsolated the bacteriumthat causes tuberculosis
33Wilhelm Roentgen ( )Discovered X-rays in 1895Let doctors see inside the bodyX-rayed wife’s hand
34Sigmund Freud ( )Discovered the conscious and unconscious part of the mindHis studies were the basis for psychology and psychiatry
35Sir Alexander Fleming (1881-1955) Discovered penicillin in 1928 which is considered one of the mostimportantdiscoveries ofthe twentiethcentury
36Jonas Salk (1914-1995) Albert Sabin (1906 – 1993) Discovered polio vaccineSaved many people fromthis virus that paralyzedthousands of adults andchildren each year.
37Francis Crick (1916 – 2004) James Watson (1928 - ) Described the structure of DNA and how it carries genetic information in 1953Built a three-dimensionalmodel of the moleculesof DNAShared the Noble Prizein 1962
38Christian Barnard (1922 – 2001)Performed first successful heart transplant in 1968
39Robert Jarvik Creator of the first artificial heart On December 2, 1982, it was implanted into Barney Clark, who lived for the next 112 daysThe second patient, William Schroeder, lived for 620 days
40Ben Carson ( )Famous for his surgeries to separate Siamese twinsCurrently Director ofPediatric Neurosurgeryat John HopkinsHe has refinedhemispherectomy, asurgery on the brainto stop seizures
41How much money does Healthcare bring in a day??????? Health Care SystemsHow much money does Healthcare bring in a day???????
42Private Health Care Facilities Hospitals: an institution that provides medical/surgical care and treatment for the sick and injured.Vary in size and types of service provided.General, burn centers, heart, oncology, children…etcCan be private, religious, nonprofit or government owned.Long-term care Facilities: mainly provide assistance and care for the elderly. Usually all in one.Nursing/Geriatric Homes: provides help with ADL’s, promote social interactions and provide safety and security.Extended care facilities: long term rehabilitative careIndependent Living: Rent apartments but are provided with services
43Private Health Care Facilities cont… Omnibus Budget Reconciliation Act (OBRA)Regulations regarding long term care and home health care.Requires state to establish training and competence evaluations for nursing and geriatric assistants.CEU’s, evaluations, registrations and certifications
44Private Health Care Facilities cont… Medical Offices: can be privately owned by one doctor or employ many doctorsServices: diagnostic, evaluations, treatment, examinations, minor surgeries, and testingSpecialties: pediatrics, cardiology, obstetricsDental Offices: can provide general or specialized careOrthodontist, periodontics, prosthodontics, etc
45Private Health Care Facilities cont… Clinics: health care facilities found in many types of health care.Some offer free servicesOptical Centers: provide vision careEmergency Care Services: provides special care for victims of accidents or sudden illnessesCan be both governmental or privateLaboratories: can perform diagnostic tests such as blood or urineHome Health Care: exactly what it says
46Private Health Care Facilities cont… Hospice: provide care for terminally ill persons with life expectancies of 6 months or less.Mental Health: facilities that treat patients with mental dis orders and diseases.Rehabilitation: provide care to help patients with physical or mental disabilities to obtain maximum self-care and functionHealth Maintenance Organizations: centers geared towards preventative healthcare.
47Government AgenciesWorld Health Organization: information about health issues around the worldU.S. Department of Health and Human Services: health issues in the U.S.National Institute of Health: disease researchCenter for Disease Control and Prevention: concerned with causes, spread and control of diseasesFood and Drug Administration regulating food and drugsAgency for Health Care Policy and Research: healthcare qualityOccupational Safety and Health Administration: protect workers from job related injuries and illnesses
48Voluntary/Nonprofit Agencies Supported by donations, membership fees, fundraisers and federal or state grants.Examples: American Cancer Society, The American Heart Association, the American Respiratory Disease Association, the American Diabetes Association, National Association of Mental Health, Nation Foundation of the March of Dimes, American Red Cross
49Health Insurance Plans What's the Purpose?To assist with the rising cost of health careHow does it work?The amount of payment and the type of services vary from plan to planDeductibles: set amounts that must be paid before the insurance will pay for anything.Co-Insurance: patient responsible for a certain percentage of the costCo-Payment: specific amount of money that must be paid before receiving services
50Health Insurance Plans cont… Health Maintenance Organization (HMO): provides a managed care plan for the delivery of healthcare servicesSet fee regardless of the amount of health care usedInsured can only use certain doctorsPreferred Provider Organization: contracts with certain doctors/dentist to provide health care at reduced ratesMore optionsUsually requires co-payments and deductibles
51Health Insurance Plans cont… Medicare: government program that provides healthcare for all individuals over the age of 65, disabled persons receiving SS and a few other exceptionsMedicaid: Government program but people covered varies from state to state.Individuals with low income, children who qualify, all disabled and blind people.Workers Compensation: insurance for workers injured on the jobTRICARE: Government military health insurance
52Organizational Structure All Health Care Facilities must have one.Hierarchy/Chain of Command
54Cost Containment Cost of health care began rising due to: Technological advancesAging populationHealth-related lawsuitsCost Containment measures include:Diagnostic related groups (DRG)Combination of servicesOutpatient servicesMass or bulk purchasingEarly intervention and preventive services
55Technological Advances Procedures such as heart, lung, liver or kidney transplantsComputers used for diagnostic examsPeople are living longer buuuuttt…….the result is …
56The Aging Population More pharmaceuticals Chronic diseases More frequent healthcare
57Health Related Lawsuits Expensive malpractice insuranceUnnecessary Diagnostic Tests
58Is there a firm answer to controlling health costs?
59Cost Containment Efforts Diagnostic Related GroupsMedicaid/Medicare:Set amounts for all servicesCan be a gain or a loss????Combination of Services:Clinics and laboratories shared by different agenciesDecreased cost for the provider means decreased cost for the patient.
60Cost Containment Efforts cont… Outpatient ServicesReducing the length of hospital stays… i.e. open heart surgery…Surgeries, diagnostic services, radiographsMass/Bulk purchasingBuying in larger quantities at reduced prices.Computerized inventoryEarly Intervention/PreventionPatient education, immunizations, physicals, incentives, easy access
61Cost Containment Efforts cont… Energy ConservationBetter building designsManaging heating/cooling servicesMaking repairs immediatelyInfrared FaucetsCould controlling costs turn into decreased quality of healthcare?Agency for Health Care Policy and Research(AHCRP)As a patient what can you do to help control costs?
62TelemedicineInvolves the use of video, audio and computer systems to provide medical/health care services.Decreases the need for trips to the “doctor”Great for rural areas? How?
63Wellness Emphasis on promoting wellness of the whole individual: Physical wellness: promoted by a well balanced diet, exercise, routine physicals.Emotional wellness: promoted by an understanding of ones own personal feelingsSocial wellness: promoted by showing fairness, concern, tolerance, etc…Mental and intellectual wellness: promoted by being creative, logical, curious, open minded individualsSpiritual Wellness: promoted by using values, morals, ethics, etcHolistic Health: promotes treating the whole person; all aspects of wellness
64Alternative and Complementary (CAM) Methods of Health Care Complementary Therapies: used in conjunction with conventional medical therapiesAlternative Therapies: used in place of biomedical therapiesIntegrative health care: uses both mainstream and CAM therapies to treat patiendts
65Alternative and Complementary Methods of Health Care Chinese medicine practitioners: holistic based healing practice based on the belief that a life energy (CHI) flows through every living personChiropractors: practice base on the belief that the brain sends vital energy to all body parts through nerves is the spinal cordHomeopaths: belief in the body’s abilities to heal itself using the immune system; no medicine, if so all naturalNaturopaths: only natural therapies
66Current Concerns National Health Care Plan Has become a leading topic of debate due to the increasing number of uninsured AmericansEducation and preparation for a potential pandemicA pandemic exists when the outbreak of a disease occurs over a wide geographic area and affects a high proportion of the populationDue to the high rate international travel, the possibility for a devastating pandemic has increased