Read Online Monoculture: How One Story is Changing Everything by F.S. Michaels - Free Book Online Page B
Authors: F.S. Michaels
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result, in the 1800s, being a doctor was a hard way to make a living. Americans were wary of medical authority. Doctors didn’t have stores of medical knowledge or techniques to pull from, and most families, isolated in rural areas with low incomes, could only afford to call a doctor if the situation was desperate. Doctors charged for mileage on top of the fee for a medical visit, and five to ten miles of travel meant the travel fee could be four or five times as high as the visitation fee. They ended up working long hours and traveling long distances to see patients. The image we still have today of the dedicated, selfless doctor comes from that era of medicine. 3
During the Industrial Revolution, work that used to be done at home started moving into the factories, making it harder for family members to care for the sick at home. As steamboats and railways were built, cities began to develop. Better mobility meant that family members were more spread out than they had been, so they weren’t always available to care for the sick. As cities grew, property values also started to rise, and many families could only afford to live in apartments, which left less space at home to care for the sick. More people were also living alone in cities, which meant the need for hospitals was growing along with the demand for doctors. At one time, few people used hospitals voluntarily because of the risk of infection; hospitals were more about charity than medical expertise and most were run by religious orders where nuns, doctors and nurses volunteered their time to care for the sick. You went to the hospital to die, or when you didn’t have family or friends to care for you. If you were sick, you were simply safer at home. 4
At the same time, doctors were also becoming more mobile. The invention of the telephone meant patients could call the doctor instead of sending for him, and the invention of the car meant doctors could reach patients faster; doctors were among the first car buyers. As doctors began to travel farther and faster, they saw more patients, increasing from an average of five to seven patients a day in the mid-1800s, to 18 to 22 patients a day by the early 1940s. As travel costs went down, medical care became more affordable. Doctors became more accessible, and people became more dependent on their services. 5
Still, in 1900, medical practice was unsophisticated. New ideas were slow to be adopted. Most surgeons still used their bare hands when operating, and few pharmaceutical drugs existed. A medical education meant you’d sat through two years of mostly lectures at one of over 150 schools, many of which were for-profit and had low entrance standards.
Then medical knowledge started to grow. From the early 1900s to the early 1940s, x-rays, ECGs, and the four major blood groups were discovered, along with insulin, sulfa, penicillin and anaesthetics. Doctors became a symbol of healing. The growing demand for medical care meant that doctors could afford to give up lower-paying services and focus on higher-paying, more complex services that involved things like diagnostic labs, radiology, and surgical suites. Those complex services were often offered in hospitals now that medicine had advanced to the point where a doctor’s expertise no longer fit into a black bag, and where the services offered were too expensive to be maintained in every doctor’s office. 6
As urbanization shifted care of the sick from families and neighbors to doctors and hospitals, health care became a commodity, something that was bought and sold. At the same time, though, medicine wasn’t thought of as just another thing for sale. It was regulated because it dealt with serious issues like the relief of human suffering. Bad health care could have drastic consequences like disability or death, and most people who needed medical help weren’t in a position to evaluate the kind of help they were getting.
The buying and selling of health care was
During the Industrial Revolution, work that used to be done at home started moving into the factories, making it harder for family members to care for the sick at home. As steamboats and railways were built, cities began to develop. Better mobility meant that family members were more spread out than they had been, so they weren’t always available to care for the sick. As cities grew, property values also started to rise, and many families could only afford to live in apartments, which left less space at home to care for the sick. More people were also living alone in cities, which meant the need for hospitals was growing along with the demand for doctors. At one time, few people used hospitals voluntarily because of the risk of infection; hospitals were more about charity than medical expertise and most were run by religious orders where nuns, doctors and nurses volunteered their time to care for the sick. You went to the hospital to die, or when you didn’t have family or friends to care for you. If you were sick, you were simply safer at home. 4
At the same time, doctors were also becoming more mobile. The invention of the telephone meant patients could call the doctor instead of sending for him, and the invention of the car meant doctors could reach patients faster; doctors were among the first car buyers. As doctors began to travel farther and faster, they saw more patients, increasing from an average of five to seven patients a day in the mid-1800s, to 18 to 22 patients a day by the early 1940s. As travel costs went down, medical care became more affordable. Doctors became more accessible, and people became more dependent on their services. 5
Still, in 1900, medical practice was unsophisticated. New ideas were slow to be adopted. Most surgeons still used their bare hands when operating, and few pharmaceutical drugs existed. A medical education meant you’d sat through two years of mostly lectures at one of over 150 schools, many of which were for-profit and had low entrance standards.
Then medical knowledge started to grow. From the early 1900s to the early 1940s, x-rays, ECGs, and the four major blood groups were discovered, along with insulin, sulfa, penicillin and anaesthetics. Doctors became a symbol of healing. The growing demand for medical care meant that doctors could afford to give up lower-paying services and focus on higher-paying, more complex services that involved things like diagnostic labs, radiology, and surgical suites. Those complex services were often offered in hospitals now that medicine had advanced to the point where a doctor’s expertise no longer fit into a black bag, and where the services offered were too expensive to be maintained in every doctor’s office. 6
As urbanization shifted care of the sick from families and neighbors to doctors and hospitals, health care became a commodity, something that was bought and sold. At the same time, though, medicine wasn’t thought of as just another thing for sale. It was regulated because it dealt with serious issues like the relief of human suffering. Bad health care could have drastic consequences like disability or death, and most people who needed medical help weren’t in a position to evaluate the kind of help they were getting.
The buying and selling of health care was
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