09 Sep Hopefully you have seen how advances in science and technology have shaped and generated careers in the healthcare field. For this assignment please think about the career you are planni

Rubric

1. Student indicates current career choice 1.0 pt. Indicated 0.0 pts Not indicated.

2. FIRST advancement and/or individual is clearly named and adequately described so that it is understood why it/he/she is relevant and important to this career.

3.0 pts Meets full expectations; an advancement is clearly identified and fully described for importance and relevancy 2.0 pts An advancement is named but is less than fully described for importance and/or relevancy 1.0 pts An advancement is identified but does not address importance or relevancy 0.0 pts No first advancement given.

3. Submission reflects collegiate-level academic writing. A clear effort has been made in terms of proper paragraph construction, sentence structure, grammar, spelling, and punctuation.

3.0 pts Adheres to writing expectations outlined; no glaring errors 2.0 pts A few, are minor writing mistakes; proofread better going forward 0.0 pts Does not adhere to writing expectations outlined.

4. SECOND advancement and/or individual is clearly named and adequately described so that it is understood why it/he/she is relevant and important to this career.

3.0 pts Meets full expectations; an advancement is clearly identified and fully described for importance and relevancy 2.0 pts An advancement is named but is less than fully described for importance and/or relevancy 1.0 pts An advancement is identified but does not address importance or relevancy 0.0 pts No second advancement given.

,

Chapter 1: The History of Healthcare

Chapter Description

Chapter 1 will begin with a look at the historical influences on healthcare and scientific advancements. These advancements laid the foundations for the careers we will discuss throughout this textbook. Finally, in this chapter, you will complete an exercise to examine the career you plan to pursue from a historical perspective and determine what advancements directly influenced its development.

LEARNING OUTCOMES

By the end of this module, the student will be able to:

Identify the origins of healthcare systems and innovations that have shaped healthcare and careers as we know them.

Discuss which innovations and historical figures have influenced the career fields you are interested in.

Historical Timeline: Ancient Times

Ancient Egypt

Beginning with the Egyptians, we see a spiritual/religious approach to medicine. Most of the healthcare providers were priests who used prayer and other spiritual methods to treat patients in contrast to the more scientific approach we often see today. Another important aspect of this period was the recognition of women in the role of priestesses and therefore "healthcare providers". ( https://www.ancient.eu/article/49/female-physicians-in-ancient-egypt/)

In the United States, women were not seen in the practice of medicine until the late 1800s. ( https://amazingwomeninhistory.com/elizabeth-blackwell-first-female-doctor/

The ancient Egyptians used very different techniques to treat disease. One example of a commonly used technique was called bloodletting which involved removing blood from a patient to attempt to cure or prevent disease/illness. The theory behind this method was the idea that the blood carried the substance which was the etiology for the disease and removal would cure or aid in the healing process. Another method to attempt to remove "bad blood" was the use of leeches. Leeches are parasitic worms that will attach to a host, in this case, the patient, and feed on their blood. However, these methods were only minimally effective in treating disease and often would worsen the illness if too much blood was taken, or the patient developed an infection following the procedure. ( https://www.bcmj.org/premise/history-bloodletting)

In this period, the average lifespan of a person was 20 to 30 years of age which is drastically different from the 78.6 years average lifespan of an adult in the United States today. ( https://www.cdc.gov/nchs/fastats/deaths.htm)

Ancient Greece

The medicinal practices of Ancient Greece are still relevant to modern medicine today. Hippocrates, who practiced in Ancient Greece, is known as "the father of modern medicine". In addition, some medical students still take a "modern version" of the Hippocratic Oath when they graduate from medical school. The central theme of this oath is to "do no harm". (nlm, Greek Medicine, retrieved from https://www.nlm.nih.gov/hmd/greek/greek_oath.html)

This society used a combination of spiritual and physical methods. one commonly heard belief was that the four humors needed to be in balance for a person to be well. The four humors referred to here are yellow bile, black bile, phlegm, and blood. While bloodletting was still used to achieve this balance, the Greeks also incorporated a healthy diet, exercise, and a psychological component to their treatments. They believed in a more holistic approach to treatment, an approach that is often used today. (Kleisiaris, C. F., Sfakianakis, C., & Papathanasiou, I. V. (2014). Health care practices in ancient Greece: The Hippocratic ideal. Journal of medical ethics and history of medicine, 7, 6.) When you think about the emphasis on nutrition regarding health you can see the development of some of the careers you may choose today, nutritionist or dietitian.

https://www.pbs.org/wgbh/nova/doctors/oath_modern.html to see a modern version of the Hippocratic Oath

Ancient China

One of the most influential societies in terms of advancing medicinal treatments for illnesses were the ancient Chinese. There was a spiritual aspect to their healthcare where they addressed balancing a person's chi. However, they were also scientists who studied disease states and were instrumental in the creation of medicines that used natural herbs, tree bark, and even some animals. Some of these methods and medications are still used today.

We can think about the careers that arose due to the practices in this civilization. This production of medication marked the beginning of apothecaries, or what we now more commonly call pharmacists. Think about it if you're going to start prescribing drugs, you need someone to do the research behind drug discovery and drug function, someone to make the drugs, someone to put them together and dole them out. We can see how many new career choices start to arise as new discoveries are made; pharmaceutical researcher and chemist, pharmaceutical sales, pharmacist, pharmacy technician and then there are all the other support and administrative positions that work with in the pharmaceutical industry today as it has evolved into "Big Pharma". This will be true throughout history so as you learn more and as new discoveries are made, even today, try to think about all the new careers that will be available because of it, one of them maybe in your future.

Another therapy used at this time that is still in use is acupuncture, which is the use of needles to align energies within the body. The average lifespan in this culture at this time was just 20-30 years. ( https://nccih.nih.gov/sites/nccam.nih.gov/files/Traditional_Chinese_Medicine_08-03-2015.pdf)

Rome

Healthcare in Rome was influenced by the mindset of this population as a whole at this particular time in history. The Romans were militaristic and very interested in expanding their empire. That was the focus of their culture at this point in history. If you look at a map of the Roman empire, you can see the extent to which they spread their territory. A major portion of Europe into Asia and all around the Mediterranean Sea, was essentially part of the Roman Empire. With their expansion, came the need for improved infrastructure and engineering projects such as transportation and sanitation projects. The Romans were the first civilization to build extensive roadways to transport their troops and supplies efficiently, thereby strengthening their reach and domination.

Additionally, Romans were very interested in the health of their troops. The health of their troops was directly related to their military gains. For this reason, the Romans were the first to organize medical care that was efficient, methodical, and planned. They developed care teams and mobile hospitals on the battlefield. However, battlefield wounds required advanced surgical care and therefore, the Romans developed advanced therapies and instruments to treat these injuries. Some instruments used in this time period including ones that we see in surgery today: scalpels, retractors, hooks, and forceps. Others included bleeding cups and warming salves.

Instruments found at Pompeii, dated circa 100BC-450AD.

Along with domination and the development of interconnected roadways and cities, came public health issues. The empire was increasing size and its' ability to transport troops, goods, food, and supplies was also increasing in scale. Unfortunately, diseases were now being transported quicker and further distances. To address this issue, the Romans developed sanitation systems. They had observed that if people were cleaner and less waste was around, illness would not spread as readily. One way to address sanitation was the development of public bathhouses. This is an early example of a public health initiative. Public Health initiatives are centered around promoting and protecting the health of the community, whether on the local, national, or global scale. (You can think of an "initiative" as a campaign or a program.) We will discuss the many careers in public health later in the course.

The Romans focused less than other societies on spiritual therapies and more on healthcare infrastructure development, scientific thought, and advancements. However, the lifespan of this population remains relatively similar at 25-35 years.

Middle Ages

After the fall of the Roman Empire, the period of history known as the "Dark Ages" began. The term "dark" may refer to the lack of knowledge and advancement during that period. This was a time of great political and social instability so there wasn't much research or development going on regarding healthcare.

During this period, in the mid 1300's, the bubonic plague inflicted Europe and Asia and killed an estimated 25 million people. ( https://www.nationalgeographic.com/science/health-and-human-body/human-diseases/the-plague/)

One may hypothesize that the relative lack of medical advancements that preceded the onset of the plague, or the black death as it was known, may have exacerbated the rapid spread of the disease. The massive toll the disease took on the population emphasized the need for focus on science and medicine.

The average lifespan at this time remained around 20-35 years.

The Modern Era

Renaissance

In the 15th century, known as the Renaissance period, there was a renewed interested in learning, not only in art, but also in science and knowledge. During this period, several advancements occurred which influenced healthcare as we know if today. One of the most important may not even seem like a health-related discovery. The printing press was invented in 1439, with the development of a tool that could reprint a text into many copies, scientific and medical advancements could be shared easily and across far distances. In addition, rather than sharing information by word of mouth everyone would have access to the same material presented the same way. This leads to great improvements in medical education, in fact not long after this the first anatomy text was published.

16th-17th Centuries

In the 16-17th centuries, infectious diseases remained among the most common causes of mortality. Societies during this time period were still uncertain to the etiology of these types of diseases and scientists and physicians began to study the causes. One scientist who advanced the field of microbiology was Antonie Van Leeuwenhoek. He is considered one of the "Fathers of Microbiology". He made vast improvements to the microscope which enabled other scientists to further expand the foundations of life science. As we discussed previously, as new "causes" or microorganisms were discovered so were drugs to combat them. The field of pharmacology grew rapidly and became well respected as a result. Advancements were made all over the world, a French surgeon, Ambroise Pare, developed procedures to utilize ligatures and surgical tools to stop bleeding during surgery. Careers grew around the surgical and medical technology industries. Advancements are also shared all over the world thanks to the printing press and the expansion of scientific journals and publications, and a whole new field of careers in scientific and medical writing and academics.

18th Century

If we look at what is happening in the very young United States at this time, the University of Pennsylvania established the first medical school in 1765 with Harvard and Columbia establishing programs soon after. This formalized training program was a huge step in medical education and even these were mainly apprenticeships when they first began. It wouldn't be long for a structured curriculum and faculty to take shape, giving rise to highly trained and even specialized physicians. However, if you lived in a rural area, it was still unlikely that you would be treated by one of these trained physicians. In fact, in those areas, barbers served as "physicians" which makes sense since bloodletting was still a common practice during this time. The first women would not be admitted to medical school until 1847.

Many tools were developed during the 18th century which helped physicians practice medicine for example the thermometer, feeding tubes, and bifocals. What careers can you think of that came from these discoveries?

19th Century

We see tremendous growth in science and medicine during this century and those to come. The microscope will be put to use as we are able to identify the composition of blood and other fluids. Scientists are getting closer to understanding what causes disease and how to prevent or kill the causative microorganisms. These advancements in the field of microbiology will lead to processes like pasteurization and improved infection control in medical settings resulting in a higher survival rate and longer life span overall. Another important advancement was the development of vaccines as preventatives. The first vaccine was developed by Edward Jenner in 1796 (18th century) against smallpox. He used smallpox material to create immunity, eventually, the vaccine would help eradicate the disease. A big step forward occurred in 1879 when Louis Pasteur created the first vaccine in a laboratory. You should already be thinking about the multitude of careers this will impact in the future! Pasteur also developed pasteurization, another discovery with a huge impact on health. A great resource to learn more about the interesting history of vaccines is this site: http://%20https://www.historyofvaccines.org/timeline/all

Along with Pasteur, Robert Koch is known as one of the founding fathers of Microbiology. His foundational research helped link bacteria to specific diseases as well as test medications on those bacteria for potential treatments. Obviously, this improved treatments, and outcomes and increased the average lifespan as well as created a multitude of career opportunities for scientists in drug research and development in the pharmaceutical industry and academics, pathologists, technicians, and laboratory personnel. We should also remember all the sales manufacturing and administrative positions that surround the industries created by these discoveries! All of these are health related careers.

Also, in the 19th century, we see women step to the forefront in healthcare, one of the pioneers in this regard was Florence Nightengale. During the Crimean war circa she saw a need for the support and care of soldiers wounded during battle. She had no specific training, but she began to aid physicians close to the battlefields and treat the wounds of patients, participating in their care. She is now known as the first nurse and to this day over 90% of nurses are female. As the century closed inventions like the Xray machine and areas of specialization like mental health (Psychology) brought the practice of healthcare to a new level and created even more opportunities.

More about Vaccines, Past & Present…

"How We'll Stop Polio for Good"

In this module, you learned about the history of healthcare and were asked to reflect on advances that shaped the healthcare professions. In our next modules, we will learn more about healthcare in the U.S. and around the world. To some degree, this TED talk ties these two modules together by discussing a very significant advancement in healthcare (the polio vaccine) but calls our attention to the fact that polio still exists within the world. Many of you in this class, and myself included, likely perceive polio as an "old" disease that no longer exists and may not personally know anyone affected by poliomyelitis. This common perception is illustrated by the clip of Comedy Central's Jon Stewart within this TED Talk. This talk is a nice reminder that even the most significant advances in healthcare are rarely complete and final solutions (there is always more work to do) and that what we see in America is not always what we find around the world.

"Aylward’s talk makes a moral, financial, and scientific case for ending polio forever. Watch at the end for a Q&A cameo by Bill Gates, who has also called for the eradication of the disease. In recalling terrible images of the polio epidemic, Aylward reminds us how we now take for granted the vaccine that changed the world. His earnest pleas to close the funding gap that will enable final treatment and eradication should be heeded by the global health funding community, and lessons learned from polio applied to the next horrific disease. In conjunction with the other talks on this list, he gets you dreaming about another TED talk, maybe thirty years from now, by some unknown scientist, about the final eradication of a disease that terrorizes us today." –Daron Sharps

More about http://www.who.int/dg/adg/aylward/en/

20th Century

As we move into the 20th century momentum builds on the discoveries of years past and science moves quickly into new technologies based on things that were inconceivable decades earlier. We go from not knowing what microorganisms were last century to elucidating the structure of DNA and realizing there is something in our cells that causes us to manifest certain characteristics (genes). Entire industries are now based on molecular treatments. This century sees rapid discovery and innovative technologies develop. We know more about blood and its components, and diseases like Diabetes are identified and treated with medications like insulin. The heart-lung machine, surgical devices, the artificial heart, test tube babies (invitro fertilization), and organ transplants revolutionized the practice of medicine, and you guessed it …. created whole new industries and careers!

Hospitals as we know them began to take shape during this time as well. The Hill-Burton Act of 1948 standardized and expanded care by providing financing to hospitals so they could develop into larger facilities with specialized services and enough beds for the populations they served. More specifically it legislated that 4.5 beds be available for every 1000 people in the community, this standardized what hospitals should look like and centralized care versus the house calls that were common before that. Administrators, nurses, specialized physicians, medical education personnel, technicians, physical therapists, mental health professionals and the support staff necessary to run a hospital were all positions that evolved or expanded as a result.

21st Century

There is no telling what careers will come from the healthcare innovations of the 21st century. This century, 2001 – 2100, has already seen CAT scans, MRI's, EKGs, and ultrasound become routine (again technicians run all those machines, and someone must make them!). When your grandmother was pregnant, she likely never had an ultrasound, now we can view a baby in utero in 4D, at your local strip mall for that matter, and mothers will often have several over the course of a pregnancy. The human genome project built on the elucidation of DNA from last century and sequenced the entire human genome, all 3 billion base pairs and around 30,000 genes. This information helps us identify abnormalities in the sequence associated with various diseases, such as breast cancer. It also allows us to target specific genes for drug development. How far we have come! As we progress through the 21st century we can expect to see the development of new careers with every innovation.

Learn more about the human genome project here: https://ghr.nlm.nih.gov/primer/hgp/description

Conclusion

Throughout the course, we will learn about many of the careers we discussed in this overview. It is important to understand how far we have come and how each new discovery shapes the career choices you have. As a student interested in health, I encourage all of you to keep up with the latest innovations and developments in healthcare, both scientific and political, so you can be prepared for the opportunities that are to come for your career.

Something to think about…

One important group of people, the Baby Boomer population is having and will have a great effect on the future history of healthcare. The boomers will greatly impact healthcare and the types of jobs therein that are most prevalent in the future. It will be very important for you to understand this group of people, born from 1946-1964, and how they will affect healthcare jobs. Read more about them here:

https://www.history.com/topics/world-war-ii/baby-boomers-video

https://www.monster.com/career-advice/article/baby-boomers-changing-industry