1. History of Health Care

2. State Standard
1) Synthesize information found in news media, professional journals, and trade magazines to create a report and/or presentation on the historical evolution of healthcare in the United States. Use a timeline or other graphic to illustrate major developments beginning with the first medical school through today.

3. Objectives Students will:
Identify medical/health care milestones that have led to advances in health care.
Predict where and how factors such as cost, managed care, technology, and aging population, access to care, alternative therapies, and lifestyle behavior may affect various health delivery system models.

4. 4000 BC – 3000 BC Primitive Times
Illness and diseases were a punishment from the Gods
Tribal witch doctors treated illness with ceremonies
Herbs and plants used as medicines (morphine and digitalis)
Trepanation or trephining (surgically removig a piece of bone from the skull)
Average life span was 20 years

5. 3000 BC – 300 BC Ancient Egyptians
Physicians were priests
Bloodletting or leeches used as medical treatment
Average life span was years

6. 1700 BC – AD 220 Ancient Chinese
Believed in the need to treat the whole body by curing the spirit and nourishing the body
Recorded a pharmacopoeia of medications based mainly on the use of herbs
Used therapies such as acupuncture
Began to search for medical reasons for illness
Average life span was years

7. 1200 BC –200 BC Ancient Greeks
First to observe the human body and the effects of disease – led to modern medical sciences.
Believed illness is a result of natural causes
Used therapies such as massage, art therapy, and herbal treatment
Stressed diet and exercise as ways to prevent disease
Average life span was years

8. 753 BC – AD 410 Ancient Romans
First to organize medical care by providing care for injured soldiers
Later hospitals were religious and charitable institutions in monasteries and convents
First public health and sanitation systems by building sewers and aqueducts
Galen established belief that the body was regulated by four body humors; blood, phlegm, black bile, and yellow bile
Life span was years

9. AD 400 – AD 800 Dark Ages
Emphasis on saving the soul and study of medicine was prohibited
Prayer and divine intervention were used to treat illness & disease
Monks and priests provided custodial care for sill people
Medications were mainly herbal mixtures
Average life span was years

10. AD 800 – AD Middle Ages
Renewed interest in medical practices of Greek and Romans
Bubonic Plague killed 75% of population in Europe and Asia
Major diseases included smallpox, diptheria, tuberculosis, typhoid, the plaque, and malaria
Arabs began requiring physicians pass examinations and obtain licenses
Average life span was years

11. AD 1350 – AD Renaissance
Dissection of body led to increased understanding of anatomy and physiology
Invention of printing press allowed medical knowledge to be shared
First anatomy book was published by Andreas Vesalius ( )
Average life span was years

12. 16th and 17th Centuries
Cause of disease still not known – many people died from infections
Invention of the microscope allowed physicians to see disease-causing organisms.
Apothecaries (early pharmicists) made, prescribed, and sold medications
Ambroise Pare ( ), a French surgeon, known as the Father of Modern Surgery established use of ligatures to stop bleeding
Average life span years

13. 18th Century
Gabriel Fahrenheit ( ) created the first mercury thermometer
John Hunter ( ), established scientific surgical procedures and introduced tube feeding
Benjamin Franklin invented bifocals
Average life span years

14. 19th Century
Rapid advancements due to discoveries of microorganisms, anesthesia, and vaccinations
Infection control developed once microorganisms were associated with disease
Formal training for nurses began
Women became active participants in health care
Average life span years

15. 20th Century Increased knowledge about the role of blood in the body
ABO blood groups discovered
Found out how white blood cells protect against disease
New medications were developed
Insulin discovered and used to treat diabetes
Antibiotics developed to fight infections
Vaccines were developed
New machines developed
Kidney Dialysis Machine
Heart Lung Machine
Surgical and diagnostic techniques developed to cure once fatal conditions

16. 20th Century (continued)
Organ Transplants
Test tube babies
Implanted first artificial heart
Health Care Plans developed to help pay the cost of care
Medicare and Medicaid marked the entry of the federal government into the health care arena
HMOs provided an alternative to private insurance
Hospice organized

17. 21st Century
The first totally implantable artificial heart was placed in a patient in Louisville, Ky. In 2001
The threat of bioterrorism lead to smallpox vaccination of the military and first responders in 2002
The Netherlands became the first country in the world to legalize euthanasia in 2002
The Human Genome Project to identify all of the approximately 20,000 to 25,000 genes in the human

18. 21st Century
Stem 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 diseases
President George W. Bush approved federal funding for research using only existing lines of embryonic stem cells in 2001
Advanced Cell Technology announced it cloned a human embryo in 2001 but the embryo did not survive
The U.S. FDA approved the use of the abortion pill RU-486 IN 200

19. 21st Century
The standards for Privacy of Individually Identifiable Health Information, required under the Health Insurance Portability and Accountability Act (HIPPA) of 1996, went into effect in 2003
The Medicare Prescription Drug Improvement and Modernization Act was passed in 2003
Vaccinations for cervical cancer and herpes zoster (shingles) in 2006

20. Potential for 21st Century
Cures for AIDS, cancer, and heart disease
Genetic manipulation to prevent inherited disease
Nerves in the brain and spinal cord are regenerated to prevent paralysis
Antibiotics are developed that do not allow pathogens to develop resistance
Average life span years

21. Individual Contributions

22. Hippocrates (460 – 377 BC)
Greek physician known as the “Father of Medicine
Authored code of conduct for doctors known as the “Hippocratic Oath” that is the basis of medical practice today
Believed illness was not caused
by evil spirits and stressed
importance of good diet, fresh
air, cleanliness, and exercise

23. Anton van Leeuwenhoek (1632-1723)
Invented the microscope lens that allowed visualization of organisms
Scraped his teeth
and observed the
bacteria that
causes tooth
decay

24. Benjamin Franklin ( )
Invented bifocals
Found that colds could
be passed from person
to person

25. Ephraim McDowell ( )
Surgeon from Danville, Ky.
Performed the first ovariotomy -(surgical removal of the ovary) - to remove a 22 pound tumor

26. Edward Jenner ( )
Developed a vaccination for smallpox in 1796

27. Rene Laennec ( )
Invented the stethoscope in 1819
First stethoscope was made of wood

28. Elizabeth Blackwell (1821-1910)
First female physician in the United States in 1849

29. Florence Nightingale (1820-1910)
Known as the “Founder of Modern Nursing”
Established efficient and sanitary nursing units during the Crimean War in 1854
Invented the call bell system and use of dumbwaiters to deliver meals
Begin the professional education of nurses

30. Louis Pasteur (1822-1895) Known as the “Father of Microbiology”
His germ theory proved that microorganisms cause disease
Proved that heat can be used
to destroy germs through a
process called pasteurization
Created a vaccine for rabies in
1885
Founded the basic rules for
sterilization

31. Joseph Lister (1827-1912) Used carbolic acid on wounds to kill germs
First doctor to use an antiseptic during surgery

32. Clara Barton ( )
Volunteer nurse for wounded soldiers during the Civil War
After Civil War, established a bureau of records to search for missing men
Campaigned for the USA to sign
the Treaty of Geneva, which
provided relief for sick and
wounded soldiers
Formed American Red Cross
in 1881 and served as its first
president

33. Robert Koch ( )
Developed the culture plate method to identify pathogens
Isolated the bacterium
that causes tuberculosis

34. Wilhelm Roentgen ( )
Discovered roentgenograms (X-rays) in 1895
Let doctors see inside the body
X-rayed wife’s hand

35. Sigmund Freud ( )
Discovered the conscious and unconscious part of the mind
His studies were the basis for psychology and psychiatry

36. Sir Alexander Fleming (1881-1955)
Discovered penicillin in 1928 which is considered one of the most
important
discoveries of
the twentieth
century

37. Jonas Salk (1914-1995) Albert Sabin (1906 – 1993)
Discovered polio vaccine
Saved many people from
this virus that paralyzed
thousands of adults and
children each year.

38. Francis Crick (1916 – 2004) James Watson (1928 - )
Described the structure of DNA and how it carries genetic information in 1953
Built a three-dimensional
model of the molecules
of DNA
Shared the Noble Prize
in 1962

39. Christian Barnard (1922 – 2001)
Performed first successful heart transplant in 1968

40. Robert Jarvik Creator of the first artificial heart
On December 2, 1982, it was implanted into Barney Clark, who lived for the next 112 days
The second patient, William Schroeder, lived for 620 days

41. Ben Carson ( )
Famous for his surgeries to separate Siamese twins
Currently Director of
Pediatric Neurosurgery
at John Hopkins
He has refined
hemispherectomy, a
surgery on the brain
to stop seizures

42. Activity
Create time lines for the history of health care. Show the top 10 events/persons you believe are most important in the development of modern-day health care.
on a separate sheet of paper. write an summary explaining why you believe these events are most important

43. Current Trends in Health Care

44. State Standard
1) Synthesize information found in news media, professional journals, and trade magazines to create a report and/or presentation on the historical evolution of healthcare in the United States. Use a timeline or other graphic to illustrate major developments beginning with the first medical school through today.

45. Objectives Students will:
Identify medical/health care milestones that have led to advances in health care.
Predict where and how factors such as cost, managed care, technology, and aging population, access to care, alternative therapies, and lifestyle behavior may affect various health delivery system models.

46. Cost Containment Cost of health care began rising due to:
Technological advances
Aging population
Health-related lawsuits
Cost Containment measures include:
Diagnostic related groups (DRG)
Combination of services
Outpatient services
Mass or bulk purchasing
Early intervention and preventive services

47. Health care facilities specialized to include:
Home health care
Hospice care
Geriatric care
Types of facilities
Omnibus Budget Reconciliation Act (OBRA)
Telemedicine

48. Emphasis on promoting wellness of the whole individual:
Physical wellness
Emotional wellness
Social wellness
Mental and intellectual wellness
Spiritual Wellness
Holistic Health

49. Alternative and Complementary Methods of Health Care
Chinese medicine practitioners
Chiropractors
Homeopaths
Hypnotists
Naturopaths

50. National Health Care Plan
Has become a leading topic of debate due to the increasing number of uninsured Americans
Education and preparation for a potential pandemic
Due to the high rate international travel, the possibility for a devastating pandemic has increased

51. Bioengineering
Includes fields in which problems are solved by the design of technologies used in biology and medicine
for example:
genetic engineering
additive manufacturing used in health
stem cell research
organ and tissue
transplants

52. Genetic Engineering Is the use of technology to change DNA code
transfer of genetic material of living cells to make them capable of performing new functions
Uses are still being developed
many more studies must be done to discover its full potential and to verify and improve the safety of procedures
many individuals question the ethics and possible consequences of some uses

53. Genetic Engineering Has applications in health science including:
the use of genes to make drugs specific to a disorder
the use of genes to choose drugs and dosages which will be most effective for a specific patient
the use of specific genes to create more effective vaccines

54. Genetic Engineering Has applications in health science including:
the isolating of genes to study in the hope of curing hereditary diseases
known as gene therapy
the duplicating of genes to use them in a different part of the body or even in a different person’s body
known as cloning

55. Stem Cells Are undifferentiated cells
they can divide to become any number of different types of cells
skin cells, muscle cells, etc.
makes them good candidates for research in medicine
if they can be stimulated to become organ cells, they can be used to aid patients in need of transplant

56. Embryonic Stem Cells Are found in a developing human embryo
very early stage of development
Can become any type of tissue
Use is controversial
to obtain embryonic stem cells, fetal tissue must be destroyed, creating ethical concerns

57. Adult Stem Cells Are naturally found throughout the body
Are more limited in their potential than embryonic stem cells
for example, bone marrow can become any type of blood cell and brain stem cells can become neurons and other types of nerve cells

58. Cord Blood Stem Cells Are taken from the umbilical cord
structure attaching a fetus to the womb
Are hematopoietic stem cells
can differentiate into any blood cell type
similar to those in bone marrow
Can be stored right after birth for later use
Have been successfully used in treating many diseases
leukemia (cancer of white blood cells)
anemia (too few functioning blood cells)
eye tumors

59. Transplants
Are operations in which a healthy organ or tissue from another person is placed in the patient’s body
when medical conditions cause organ or tissue failure
organs and tissues include:
heart
small intestine
heart valves
liver
tendons
corneas
ligaments
kidneys
skin
bones
lungs
veins
pancreas
blood

60. Transplants May come from a deceased donor
in cases where the organ is necessary for survival
for example, the heart
May come from a live donor
in cases where a person has more than one of the organ and can survive after losing one
for example, the kidney
in cases where a portion of the organ can be taken and the organ has the ability to regenerate and regain full function
for example, the liver

61. Transplants
Require:
the donor and patient have compatible blood types and similar organ size
relatives are preferred living donors
the organ be placed in the patient quickly after having been removed from the donor
time allowances vary by organ
the patient take drugs to prevent the risk of transplant rejection
the immune system may view the new organ or tissue as a foreign threat and attack it

62. Transplant Technology
Continues to advance
doctors are developing new procedures to decrease the chances of transplant rejection
by preparing the patient’s immune system with specific drugs before transplant
by transplanting bone marrow along with the necessary organ
systems are being developed to:
allow organs to remain outside of the human body for extended periods
enhance the health of donated organs before transplant

63. Activity
Stem Cells: Where Do You Stand? Perform research on the topic of medical use of stem cells. As you do your research, answer the following questions:
 What are stem cells
 How have stem cells been used in the past
 When were they first used
 How are stem cells used currently
 What are some of the potential negative and positive results that might occur with the use of stem cells in a medical procedure
 Why is there controversy surrounding the use of stem cells
****You will be writing an essay over the information that you just researched and your thoughts about stem cells. Do you think this is a good idea, why or why not.