Overview
This lecture covers the historical development of medicine, types of healthcare facilities, key medical professionals, health insurance systems, legal concepts, and terminology relevant to healthcare and patient care.
History and Evolution of Medicine
- Bubonic plague killed half the population during the Renaissance.
- Trephination involved drilling skull holes to release evil spirits in prehistoric times.
- Avicenna's "Canon of Medicine" was pivotal in explaining disease causes.
- Andreas Vesalius advanced human anatomy through dissection and wrote the first anatomy book.
- The fall of the Roman Empire in medieval times stalled medical progress; care centered on monasteries.
- Herbal mixtures and custodial care dominated medieval medicine.
- The Renaissance revived medical interest and introduced the printing press.
- Ancient Egyptians recorded health data and used medicinal plants.
- Bloodletting used leeches to remove "bad" blood.
- Ancient Chinese used pulse monitoring and acupuncture.
- Hippocrates, known as the "father of medicine," stressed prognosis and wrote the Hippocratic Oath.
- Romans focused on preventive care and sanitation systems.
- Edward Jenner developed the smallpox vaccine; Louis Pasteur identified germs as a cause of disease.
- Joseph Lister pioneered antiseptic surgery; Rene Laennec invented the stethoscope; William Harvey described blood circulation.
- Robert Koch, "father of microbiology," found tuberculosis was airborne.
- Christian Bernard performed the first human heart transplant; Dolly the Sheep was the first cloned mammal.
Health Care Facilities & Care Types
- Acute care facilities treat serious, urgent conditions.
- Assisted living offers housing, meals, and care for the elderly.
- Custodial care helps chronically ill people with daily activities.
- Home health care is delivered at home by health departments or nurses.
- Hospice focuses on comfort for terminally ill patients.
- Rehabilitation centers provide physical or emotional rehab.
- Subacute facilities serve stable patients needing complex care.
- Area Agency on Aging coordinates community services for seniors.
Health Care Professions
- Patient care: MD/DOs, physician associates, nurses, EMTs.
- Laboratory/pharmacy: Lab techs, specialists, phlebotomists, pharmacy techs.
- Diagnostic/imaging: Sonographers, clinical lab technologists.
- Therapy/rehab: Occupational, physical, speech, massage therapists.
- Health info/admin: Record and coding specialists, transcriptionists.
Health Insurance and Payment Systems
- Private insurance is employer-based; direct payment is out-of-pocket.
- Government plans include Medicare (elderly), Medicaid (low-income/disabled), TRICARE (military), and CHIP (children).
- Managed care focuses on preventative services and cost control.
- PCPs coordinate care and referrals; in-network providers are contracted, out-of-network are not.
- Premium = monthly insurance payment; deductible = amount paid before benefits; co-insurance = shared costs (e.g., 80/20%).
- Co-pay is a flat fee per service.
- Types of plans: HMO (in-network, low cost), PPO (choices, higher cost), POS (hybrid), EPO (local, no out-of-network), Indemnity (fee-for-service).
- Medicare A (hospital), B (outpatient), C (combined), D (drugs).
- FSA (pre-tax, use-it-or-lose-it); HSA (high deductible, low premium).
- Prospective Payment System (PPS) pays a fixed Medicare amount; DRGs set payment based on patient specifics.
- Bundling combines multiple services into one payment.
- Cost containment reduces healthcare expenses.
Legal and Ethical Concepts
- Public law: government vs. citizens; civil law: private disputes.
- Civil/constitutional/human rights protect individual freedoms.
- Common law is judge-based; statutory law is government-enacted.
- Torts are wrongful acts; unintentional torts are accidental harms.
- Litigation is the legal process of resolving disputes in court.
- Joint Commission accredits healthcare organizations.
Key Terms & Definitions
- Trephination — drilling skull holes to release spirits.
- Bloodletting — removing blood to treat illness.
- Custodial Care — long-term daily assistance for chronic illness.
- ADLS — Activities of daily living.
- IADLS — Instrumental activities of daily living.
- Health Literacy — understanding health information.
- Complementary Therapies — alternative healing methods like nutrition, exercise or relaxation.
- Gatekeeper — PCP who manages care and referrals.
- Premium — monthly insurance cost.
- Deductible — initial expense before insurance pays.
- Co-insurance — shared healthcare costs.
- Co-pay — fixed fee per medical service.
- FSA — flexible spending account, pre-tax, forfeited if unused.
- HSA — health savings account with low premiums.
- PPS — fixed Medicare payment system.
- DRGs — diagnostic categories for payment.
- Litigation — court proceeding to resolve disputes.
- Tort — wrongful act causing injury/damage.
Action Items / Next Steps
- Study key historical figures and medical advancements.
- Review differences between health insurance types and payment systems.
- Memorize key legal and ethical healthcare terms.
- Complete assigned readings or flashcard reviews as directed by your instructor.