Modern Medicine
Criticism on Modern Medicine:1. The Absence of the Democratic Ideal. 2. The Danger behind Professional Sector. 3. The Economic Hazard. 4. The Dominance Authority on the Patient's Life. 5. The Narrow Point of View. 6. The “Inverse Care Law”.Medical Profession: Medical profession is one of the main characteristics of the modern medicine, and can be defined as: "a profession as being based on a body of specialized knowledge (the content) not easily acquired and that, in the hands of qualified practitioners, meets the need of clients". Medical profession is also culturally and socially oriented
Characteristics of Doctors in Modern Medicine: 1. Group of healers whose positions are upheld by law. 2. They enjoy higher social status in the community. 3. They have greater income. 4. They have more clearly defined rights and obligations. 5. They have the authority over their patients. 6. They can also "label" their patient.
A specialist is defined as: "one who learn more and more about less and less“.The danger here, “if he might know less and less about more and more”.
Hospital Sociology: - Hospitals are among the most complex organizations in modern society. - Hospitals are dynamic organization, change according to need. - In the past (before100 years ago), hospitals were a place of refuge for the sick and homeless rather than a place for effective medical treatment.
Roles and Functions of Hospitals in the Community: 1. A cure house. 2. A factory. 3. A business. 4. A temple. 5. A university. 6. A prison:. 7. A city. 8. An employment agency.
The hospital is like a federal system with several departments each having a special system of its management. The great challenge is one of coordination between different parts of the hospital. It requires an administrative machinery to run the hospital smoothly and to avoid conflicts. Each hospital has a "personality" of its own.
Problems of Modern Medicine: 1. The success paradox. 2. The tax of advance. 3. The side effects of modern medicine. 4. The weakness of the modern medicine. 5. The stiffness of modern doctors. 6. The information overload.
Doctor- Nurse Relationship:Medicine and nursing have common goals→ preservation and restoration of health. Yet their roles in achieving that are different.Primary role of medicine → diagnosis and treatment (cure process).Primary role of nursing → caring, helping, comforting and guiding (care process).
The guidelines for good doctor- nurse relationships: 1. The doctor should regard the nurse as a member of medical team. 2. The doctor should maintain good communication skills with all medical and paramedical staff and patient. 3. The doctor should take the nurse's notes seriously. 4. The doctor should usually health educate the nurse.
Stages of medicine and humanity: 1. Stage of Hippocrates ideal: - Up to 19th century, - Humoral physiology - Very effective communication skills - Doctor at that time act as a servant or barber.
Stages of medicine and humanity: 2. Stage of medical advances: - Begins in early 19th century up to middle of 20th century. - Medical knowledge was not subjected to suggestions. - Patients became treated as cases or even as lab animal.
Stages of medicine and humanity: 3. Stage of human rights: - Begins from middle of 20th century till now. - The patient now can share in medical decision, even replace his physician if not believe in him. - In 1948, The Universal Declaration of Human Rights.
Consumer Protection Act: Over the centuries, the medical profession has been accorded respect by the society. Since last decade or so, increasing commercialization of the profession has eroded this faith. The patient can now claims the doctor or the health institution in the court for bad treatment.
COPRA Is a piece of comprehensive legislation and recognizes 6 rights of the consumer (patients), namely: 1. Right to safety. 2. Right to be informed. 3. Right to choose. 4. Right to be heard. 5. Right to seek redress. 6. Right to consumer education.
It is found that by new researches that 90 to 95% medical malpractice claims can be avoided only by good communication skills with patients, even when severe complications after medical treatment have been made. Most patients only need apology from doctors after medical errors
Autism: All children with autism demonstrate some degree of: 1- Qualitative impairment in reciprocal social interaction, 2- Qualitative impairment of communication, 3- And restricted, repetitive, and stereotypic patterns of behaviors, interests, and activities.
Range of the syndrome: Autistic disorder (AD) is currently listed as 1 of 5 pervasive developmental disorders (PDDs). The remaining 4 PDDs are: 1. pervasive developmental disorder-not otherwise specified (PDD-NOS), 2. Asperger syndrome, 3. Rett syndrome, 4. and childhood disintegrative disorder.
Although onset of symptoms for most children with autism occurs during late infancy, Most symptoms appear during the second year of life after a period of relatively typical development. Prevalence: The majority of studies showed the prevalence to be 1 in 1000 children and The prevalence of the broader ASD to be more than 1 in 500 children.
- Diagnosis and management of ASD presents the pediatrician with a challenging task. - Currently, there is no laboratory test specific for ASD. - ASD is a neurobehavioral phenotype that is now believed to have diverse etiologies.
Etiology: - Before the 1970s, it was incorrectly believed that autism resulted from a cold, unloving parenting style (the "refrigerator mother theory"). - Later, evidence for a genetic basis in isolated ASD was provided by twin studies. -In fact, autism has thus far been associated with an abnormality of every chromosome except 14 and 20. - Environmental factor (CRS, Thalidomide, even MMR).
Management: - Behavioral Management. - Parent Training. - Rehabilitative Therapies (Speech, Occupational, and Physical). - Medical Management (risperidone and flouxetine). - Community Support & Alternative Therapies. - Nutritional supplements (pyridoxine and Mg).