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Lecture 12

HMED 3075 Lecture 12: the patient in 20th century american medicine

by OneClass511306 , Fall 2016
3 Pages
Fall 2016

History of Medicine
Course Code
HMED 3075
Tobbell D

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HMED 3075 Lecture Notes 10/26 Technology and Patient Identity
Le cture : The Patient in 20th ce ntury America n Me dicine
Re a d in g : Shelley McKellar, “Limitations Exposed: Willem J. Kolff and his Contentious Pursuit of a
Mechanical Heart.
Th e p a tie n t in 19th Ce n tu ry America
Physicians expe cte d patients to be complia nt
The y re lie d on pa tie nts de scription of his /her s ymptoms
o Depended on the physician’s ability to listen to the patient
o The y could dia gnose a nd tre a t through the mail
o Ta ilored treatme nts individually to the pa tie nts
Middle cla ss a mericans with chronic illne s ses could be come very knowle dge able about their
o “Expert patient” would question the physician and consider changing caretaker if they
didn’t like the treatment
Th e p a tie n t a t the turn of th e 20th century
New diagnostic techs diminished importance of patient’s self-reported symptoms
Increasing gap between physician’s technical knowledge and patients knowledge
Physicians expe cte d greater de fe re nce and complia nce
o Patie nts continue d to ask que s tions a nd compla in.
o Sought a lte rna tive he ale rs ex. home opa ths , chiropra ctors , a nd midwive s .
Ch ildbirth in the e a rly 20th c e n tury ho s pita l
19th ce ntury childbirth
o Home birth with midwives. Woma n controlled.
o Pain, s uffe ring, a nd dangerous . Minimal role for physicia ns .
By e a rly 20th ce ntury, ne w technologie s and te chnique s
o Ane s the s ia , force ps , s te rile techniques, and surgica l intervention
o Provided by the mode rn hospital
Childbirth moves to the hos pital (by choice of mothe rs)
o Women sought relie f from pa in, suffe ring and da nge rs
o Phys icia n-controlle d; childbirth is medicalized
o Los s of pa tient autonomy
Th e American P a tient at Mid -Ce n tu ry
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HMED 3075 Lecture Notes 1026 Technology and Patient Identity Lecture: The Patient in 20 century American Medicine Reading: Shelley McKellar, Limitations Exposed: Willem J. Kolff and his Contentious Pursuit of a Mechanical Heart. th The patient in 19 Century America Physicians expected patients to be compliant They relied on patients description of hisher symptoms o Depended on the physicians ability to listen to the patient o They could diagnose and treat through the mail o Tailored treatments individually to the patients Middle class americans with chronic illnesses could become very knowledgeable about their condition o Expert patient would question the physician and consider changing caretaker if they didnt like the treatment th The patient at the turn of the 20 century New diagnostic techs diminished importance o
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