Background on Medicine:
In England physicians were educated to be physicians at the Royal College of Physicians. They originated linking medicine to an education in the field. But with 1870's science, the treatment garnered only a 50% chance of being beneficial to the patient. Doctors simply developed over time, and as doctors stopped working those that took over were apprentices of them. In America, after the War of 1812, medical schools were developed as two year studies. Physicians worked for state licensing, but in the 1820's-30's Andrew Jackson forced states to eliminate licensing, as it was viewed as "elitism".
By the mid 1800's the average yearly income for physicians was $800. In 1847 the American Medical Association (AMA) was created. Political clout around this organization lasted for 50 years, when finally science became more predominate and gave the AMA power.
In the 1870's-80's physicians had success with creating licensure laws. This set up requirements for education and training, but even still, different schools had different on thoughts on what exactly to teach.
Medicine as A profession:
Originally, medicine as an occupation sought 'professional sovereignty (to have total control of their profession)" but over time lost it. Some examples of their professional sovereignty though include: the ability to prescribe legal drugs (pharmaceuticals), the authority over sub-professions (nurses, physicians assistants, EMS, etc.), the authority to allow citizens to work (physicals needed for many jobs), the ability to pronounce someone dead, and the authority over their patients.
When this search for professional sovereignty was still going, physicians forced mid-wives out of business, simply claiming that they needed to be performed by professionals (though even now you can still get a mid-wife to deliver your child). The physicians also claimed that the reason was because women were not intelligent enough to deliver a child because they were too emotional (obvious sexism I know lol).
Sidenote: Why to this day children are delivered in hospitals by physicans/doctors, as they claim the technology in medicine is the best, mid-wives are cheaper and more efficient (my professor explained that a "natural" delivery is not performed by laying on a hospital bed, that standing up is actually a natural birth).
Medicine, over time developed what we all know of today, the tension between doing what is right and making a living. Selling drugs at the doctors office for example creates a conflict of interest, as they may offer a drug they sell to make money, as opposed to a different brand of the same drug they would have to write a prescription for. Doctors also may try to process patients as fast as possible, for obvious benefits, the more patients the more money brought in. One of the biggest issues with this dilemma of doing the right thing or doing what profits more is that with insurance companies. If a doctor can suggest a drug that is covered by insurance, or partially covered, if a doctor or physician gets more money with a certain option does that skew their treatment?
There will be more to come, hopefully at least someone finds this interesting, I know it might seem boring, but at least all the TR members who live in America could probably find this knowledge useful (maybe not all of this ^ but other things about our health care system when I continue on with this).
As always, any questions, feel free to ask
