Changes in Doctor/Patient Relationship Post WWII
One of the biggest changes in the healthcare delivery system since the end of WWII has been the Doctor/Patient relationship. By the end of WWII, doctors still made house calls. However with the increasing population- courtesy of baby boomers- and the economics involved in providing services, the delivery system has changed. The changes in the delivery system were brought about primarily by the advancement in technology and the elimination of house calls.
House calls prior to WWII were not an uncommon practice. Patients would call their doctor, generally the family doctor, and have them visit their home for whatever health services the doctor could provide. The doctor would gather their tools, drive to the patients home, provide their services, and from there drive to visit another patient. In hindsight, house calls were an inefficient practice in terms of…
• Time- Doctors spent valuable time traveling to and from house calls. The time doctors spent traveling or gathering the proper equipment for the job became very time taxing.
• Money- There is no such thing as a free meal. That being said, regardless if the doctors were reimbursed, they still had travel expenses.
• Productiveness- As previously stated doctors spent valuable time traveling to and from and preparing for the patient. House calls meant that doctors could only see a small number of patients in a single day (compared to today’s delivery system). Less time spent getting to the patient meant that more patients could be seen in a day.
• Technology- Because the doctor had to travel they were not able to transport all their medical equipment. After the doctor had visited the patient in their home the doctor may not have b...
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...elth also reduces hospital readmissions by 14% and emergency room visits by 20% (pg42, para 5). This nurse has a family member with a pacemaker monitoring system. She can tell it helps make these patients feel more in touch with their providers and gives them a sense of safety also. She believes this is especially true when it comes to the elderly who don’t get out as much.
This nurse believes that if the appropriate monitoring of safety and security is implemented to protect confidentiality and quality of care that information technology (IT) in healthcare with continue to have a positive impact on patient care and outcomes. This nurse also believes that proper extensive training on these sophisticated systems is very important to patient safety and efficiency of care. With all the new advances in healthcare emerging it will be challenging but can only get better.
There has been a shortage of physicians, lack of inpatient beds, problems with ambulatory services, as well as not having proper methods of dealing with patient overflow, all in the past 10 years (Cummings & francescutti, 2006, p.101). The area of concern that have been worse...
However, to fully benefit from implementing the recommendations as outlined by the American Recovery and Reinvestment Act of 2009 (ARRA), one would need to consider some barriers that could impact the success of computerization in the health care setting. Acceptance by the senior nurses is one hurdle that the organization has to address. The resistance lies more in the lack of computer skills of the seasoned nurses. Thus, this drawback calls for providing adequate training to the nurses that would require more Information Technology (IT) staff, which consequently would impose additional cost to the hospitals. One other concern with the EHR would be maintaining the privacy and security of patient information. McGonigle and Mastrian (2015) aptly cited “Network accessibility and network availability are necessary evils that pose security risks. ... As the cloud expands, so do the concerns over security and privacy. In an ideal world, everyone would understand the potential threats to network security” (p.
While the concept of the profession began in the 17th century, our paper will focus more on the contemporary American history starting in the 1940s. Dr. Amos Johnson, a founder of the American Board of Family Practice, hired a hospital orderly named Henry Treadwell to assist in the daily activities of his office. Dr. Johnson’s practice in Garland, North Carolina, initiated the spread of the physician assistant model across the state. Dr. Eugene Stead and his general medicine residents at Duke University took interest in this idea. In 1942, due to the lack of adequate medical care during World War II, Dr. Stead created a three year medical doctorate fast-track program. This sparked the idea that perhaps one day he could implement a similar program to alleviate the physician shortage in the United States.
It has been said by many experts that there has been a surplus of physicians in the past, but that there will soon be a shortage of physicians. This shortage will have been instigated by many factors, and is predicted to have various effects on society, both immediate and long term. There have been proposed solutions to this shortage, but there is a fine balance to be found with these many solutions and factors. However, once this balance is found, the long-term mending of the physician shortage may begin.
After the war Finland increased its welfare to accommodate a network of regionally sponsored maternity and child-care centers and immunization programs which grew from the prolific availability of midwives and public nurses who were available on a much larger scale than trained physicians. The eventual eradication of tuberculosis and control of other infectious disease rendered the sanitaria less useful and they were absorbed into approximately twenty government hospital districts throughout the country that were soon found ill equipped to care for more serious diseases by the sixties. (Jutta, 2002) According to Teperi, life expectancy for 40-year-old Finnish males was the lowest in Europe in the late 1960s. (Teperi, 2009) Moreover, the relative sizes of the facilities and populations who sought care from these hospital districts dictated an imbalance in the per hospital expenditure level and quality of care.
Transcribed from a talk given by Karen S. Palmer (1999). A Brief History: Universal Health Care Efforts in the US. Retrieved from http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-in-the-us
On top of this, it is crucial to consider the impact of the social conditions within which these physicians operated. Economic conditions had deteriorated drastically in Germany in the early 1930s, and this affected physicians in many ways. By 1932 the incomes of 72% of doctors lay below the minimum amount needed for survival, and in this context, the Nazis looked quite appealing with their claims that they could bring order to the medical profession and restore jobs, money, and professional pride (Baumslag 48). Economic hardship impacted medical institutions as well, and that influenced doctors’ opinions on the necessity of extreme acts. For example, it was after the Depression struck that involuntary sterilization gained widespread support among doctors, as there were now huge
Infection was not only an issue due to a lack of sanitation. There was little knowledge about how the speed of the treatment of a patient could alter their survival rate. The discovery of patient prioritization during World War One greatly reduced the number of fatalities in the field hospitals. World War One saw the rise of two main concepts related to patient prioritization: Triage, and The Golden Hour. Both of these ideas have continued to be important concepts in modern medicine. The process of triage was introduced before the war, but only gained popularity during war. Triage became standard practice in WWI and “nurses became much more systematic in their approach” (“Nursing and Medicine During World War I” ceufast.com). The reason this
As many things do, nursing continues to evolve. In particular, nursing has gone from paper charting to electronic charting for various reasons. Our technology is not just limited to charting, but has also developed into performing more surgeries, bringing people back to life, and organ transplants among other things (Burkhardt & Nathaniel, 2014, p.260). I will be identifying two types of IT-related incidents. In addition, I will be discussing a case study. Lastly, I will be discussing how nursing leaders can establish a culture of safety related to IT. The purpose of this discussion is to discuss the culture of safety related to health information technology (IT).
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
Technology continues to progress. Today, every business, school and organization thrive mostly because of a well-developed website or an application that is easily downloaded into any mobile device. Healthcare, as well has been progressively adding ways to incorporate the use of electronic devices. The use of the patient’s portal and the electronic health record are only a few technological advances in healthcare today. A bedside nurse working in an acute care has the competence with numerous gadgets operated to ease the patient care process.
Urgent care centers first opened in the United States in the early 1980s (http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20N/PDF%20NoAppointmentNecessaryUrgentCareCenters.pdf no appointment needed). The inspiration behind establishing urgent care centers originated when entrepreneurial physicians identified a gap in the industry. As there was a shortage of primary care physicians who lacked flexibility and extended office hours patients were forced to turn to emergency rooms for non-emergency treatment. As a result, emergency rooms became crowded with low risk patients that did not need immediate care. Consequently, overcrowding resulted in long wait times, unsatisfied patients, misdiagnosis, and overworked emergency rooms physicians. Additionally, at least two domains of quality of care, safety and timeliness, are compromised by emergency room crowding (http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2008.00295.x/full). Ultimately, in order to remedy such overcrowding urgent care centers were established.
Society is constantly working towards perfection. Perfection is rarely if ever achieved, but that does not stop the hard working medical force that keeps the human race on their feet today. The integrated care team that works around the clock on a daily basis, helps provide newer and better services to patients in need. Who are these specialists though?. A visit to the hospital can seem very chaotic with many employees constantly on the move and juggling multiple tasks all at one time. There are many more employees than just a doctor. Doctors are very important to the success of a hospital, but no doctor can say they save lives at their hospital without the help of many other employees.
From state and federal levels, the healthcare industry has come a very long way, experiencing changes along the way. The development of advanced technology that has enhanced the quality of healthcare delivery systems will help all patients to be able to benefit. Doctors are able to access patient records at a faster rate and respond to their patients in a much more timely fashion. E-mail, electronic transfer of records and telemedicine will give all patients and physicians the tools needed to be more efficient, deliver quality care and deliver quality telecommunication at a faster pace than before.
It is not uncommon for a new mother to call the telenurse in regards to her child’s cough; in the case, we do not think twice. Surely, the infant cannot speak for himself and the mother is the caretaker, but what about the wife who calls in regards to her husband? One ethical dilemma a telenurse can experience is a conflict between the patient’s autonomy in the care of their health and the relative’s, as well as the nurses “ambition” to help the patient. (Stokowski, 2008). To avoid this, the telenurse must strive to always speak to the actual patient at all times; there is a thin line between help and respect.