HIST 249 Lecture Notes - Lecture 17: Flexner Report, Separate Spheres, Elizabeth Garrett Anderson
Modern Medical Profession, Women in Medicine
• Reading:
•
Textbook:
Deborah Brunton: “The Emergence of a Modern Profession?”
•
Assignment #2 con'td:
o Use course readings in assignment #2 - should do this to answer question #1 & #2
• Use lecture & readings
o Do not use course readings on #3 & #4 - find other readings for this (book/article)
• Find professional literature based on historical expertise
• Need it to be scholarly
• Allowed to use online articles of high quality
• Can you trust this author?
• Creditability in history - PHD in history of medicine
• Has published other work in or around the topic…
• Write a sentence why this paper/book is suitable to help you with your
question - the author has published this & that, medical historian etc.
o Break up questions into structured paragraphs
o Essay is not necessary
o Keep by the order of the questions so marker can find answers they are looking for
to give you marks
• Last time: traditional surgery, organized as a craft, separate from medicine
o What the concepts were before modern surgery
o Obvious that in a medical system - understanding of disease is about balance &
tumours, surgery only has a limited role to play
o To open up the body
o Idea of localization - disease is local
o To cure the disease
o Associated with anatomic physiology?
o Associating structure & function in surgery - experimental physiology
o Best example --> organ transplants
o Moved on to look @ technology
o Development of modern surgery
o Surgery needs to be controlled - issue of bleeding
o Doctors had to come up with ways of stopping the bleeding
o Control pain, movement - anesthesia
o Control infection
o Control invasion of the unprotected body of microorganisms
o This problem became visible around the middle of the 19th century
• Today's lecture: The Making of a Modern Medical Profession
o Aspects of medical knowledge
o Between practitioners & patients
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2
o About medical schools, medical societies
o Central theme in the history of medicine
o To define who is a member of the profession & who is not
o Who is a doctor and who is not?
o Traditional professions:
• Theology
• Law
• Medicine
• All based on university education
• Medieval universities: degrees in theology, law, medicine, and liberal arts
• All of this created a sense of professional identity
• Medicine was included in this
• Focus on the learned physician
o Traditional Medical Pluralism
• Learned physician
• Included healers
• Barber surgeons, midwives, specialists
• Medical services from multiple sources
• No dominance of just 1 'medical profession'
â–Ş Lots of different groups of health care services
• No monopoly of one occupational group
â–Ş Professionalization
o Process of professionalization:
• Late 18/19 century
• Fundamental changes in medical training & practice
• Apprenticeship --> university education for all medical practitioners for the
training of the medical profession
• Licensing: moved away from guilds --> to the state --> back into the hands of
medical profession
• Collective identity as a single occupation
• Differentiation towards irregular healers and unorthodox practitioners
• End of medical pluralism
o Characteristics of Modern Professions:
• Body of highly specialized knowledge
• Professional unity, ethos of public service
• Monopoly of practice
• Professional autonomy - only doctors can judge if other doctors are qualified or
not
• High social status - embodied in income & social respect
1. Highly specialized knowledge:
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