Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

History and Culture of Medicine 2014

AHS 1600 Fall 2014
by

Shailendra Prasad

on 14 October 2015

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of History and Culture of Medicine 2014

AHS 1600 Fall 2014
History and Culture of Medicine
Used as a nausea medicine in pregnancy in the 1950s

Deformed babies noted

“phocomelia”

Led to formation and increased power of the FDA
Thalidomide
What is the purpose of
Medicine/Healthcare?
“are we losing our soul”
Reductionistic
At least the writing is legible!
Consolidation of information
Electronic medical record

Use of Latin to use of common language

“Patients don’t read textbooks”

Advent of Electronic Medical Records
Language in Medicine
36 yo aa f ĉ ESRD 20 HTN, DM II, CAD, PVD on HD – MWF

SHx – EtoH, Tob, NonCompliance

Presents – CP, SOB x 3 days; N/V +; 4/10; mid chest, rad to neck
Language in Medicine
Costs $800 million to $ 2 billion /drug
Of 250 candidate drugs 10 get to phase I human trials
Phase I – safety trials in human volunteers
Phase II – small scale studies in target population
Phase III – large scale studies in target populations
New “designer” medications
Increased cost of care
Administration costs
Legal issues

Necessary evil
Downside of Organized Medicine
So why bother with all this?
Influenced by Indian, Greek, Roman and Byzantine medical systems
Systematic
Large and Complex Medical Literature
Islamic Medicine
Cause of illness: Why?

Healers: Who?

Tools to heal: What?

Language: Words
Considerations
Science (Thinking)
Careful measurements
Looking for norms, patterns
‘reductions’
Unemotional
Art (Feeling)
Coaxing information
Beauty
Merging
Art and Science of Medicine

Medicine is a science of uncertainty and an art of probability

-Sir William Osler
Voltaire, French philosopher
"The art of medicine consists of amusing the patient while nature cures the disease."
Some from careful observations
Lithium for depression
Idea that uric acid causes depression
Lithium given to form Lithium urate salt- that would be flushed from Kidney

Some from dumb luck
Penicillin

Some from too much hype/faith
Opium
Medications
vs. “Eminence” based medicine

Not enough evidence for many things

Evidence changes!
“Evidence Based Medicine”
Growth into institutions

Buildup of scientific knowledge

Protection of people within the fold

Regulatory
Control of charlatans
Organized Medicine

Minoans practiced trephination ~2500 BCE

Banishing evil spirits
Exorcism
Amulets and sacrifices
Ancient Medicine
Explain how we got here?

What is the current state?

Medicine: Science and an Art - what does that mean?
Objectives
Cognitive base
Experiential learning
Continuity
Role Modeling
Mentorship
REVITALIZING PROFESSIONALISM
Current strategy is inadequate
Production of highly skilled technicians but not necessarily true professionals
Must strike a balance between explicit teaching and experiential learning incorporating the values of professionalism
REVITALIZATION
Acquisition of a knowledge base
Acquisition of skills
Acquisition of an understanding of ethical standards, social roles and responsibilities
THE APPRENTICESHIP OF PROFESSIONALISM
THE CHANGING FACE OF MEDICINE
Specialization of medicine
Patient Centered Care
Team based care
Newer models of care
Training is intellectual and involves knowledge
Work pursued primarily for others
Success should be measured by more than financial return

Justice Louis Brandeis
A PROFESSION
-Inui
THE PROFESSION OF MEDICINE
Mistrust?
Oregon Faith Healer gets probation in son's death
abc news 9/20/2012
curiosity
passion
CQ +PQ >IQ
Thomas Friedman
Egyptians
-Supernatural

- Exam
- Diagnosis
- Treatment
- Prognosis
Babylonians
Diagnostic Handbook:
Through examination of patient and inspection of symptoms, it is possible to determine the disease, etiology and future course of an illness.

If that fails, go back to magic
INDIA
Ayurveda: "Complete Knowledge for Long Life"
8 branches of medicine
Areas of study: 7 years
China
Empirical observation grew from Taoist tradition
herbal treatments
acupuncture
massage (tui na)
exercise (qigong)
diet
GREEK
Practice of observing patients 700 BCE

Humoral Medicine System

Ethics

Hippocrates -
"Father of Western Medicine"

Galen -
cowboy surgeon,
rational systematic approach
Medieval Europe
Medicine in Western Roman Europe went into deep decline until Islamic influences in Spain in the 12th Century

Medical schools started in 1200s in Italy
3 yrs prelim training
5 years medical training
Renaissance
Translation of Islamic and Greek works into Latin

Increase in experimental investigation
Age of Enlightenment: 18th Century
Science held in high esteem

Physicians upgraded social status

Still, most of health field had no formal medical education and were self-taught

Hospitals became more common
Rise of Modern Medicine:
19th Century
Hospital docs more systematic/analytical
Anesthesia
Antiseptics
Public Health
Nutrition
Germ Theory
Statistical Methods
20th Century
Application of scientific method to medical research and EBM

Advanced pharmacology

WWI and WWII -> Surgical Advancements

Technology

WHO

21st Century
Remote Surgery

Gene Therapy

Big Data

Team-Based Care
Full transcript