Mythical and Modern Medicine (cntd) 4/2/2021 7:51:34 AM
This Rush to become like, or nearly physicians was and is not limited to nursing. Osteopathy started out as treatment with manipulation of bones and joints supplemented by medicine as they believed disease was caused by loss of structural integrity. Their medical schools were separate. Gradually the manipulation part receded and the teaching of medicine and surgery akin to allopathy (regular medical system) expanded to become no different then it. They are no different than M.D.s now and even regular medical schools have 'osteopaths' among them.
Podiatrists started out as taking care of nails and feet now do all kinds of surgery on the feet and have expanded to the ankle joint at places. Optometrists, who examined vision and prescribed glasses are pushing to treat eye conditions and some eye surgery. Chiropractors wield stethoscopes and prescribe medicine. Physiotherapists order imaging studies and prescribe and carry out treatments for orthopedic and other bone and joint diseases. The goal is to be physician-like if not a physician.
In the medical field the one's to lose domain most are the surgeons. Physicians in the medical fields realized that surgical procedures paid more and some procedures did not require intensive training. So gastroenterologists doing gastroscopies, colonoscopies gastrotomies and and biopsies and treatment of smaller lesions and liver biopsies- taking these over from the general or gastro=intestinal surgeon. Nephrologists started doing kidney biopsies. Radiologists starting "non-cutting' procedures of the heart, kidney, prostate, blood vessels and many other organs. This was a process similar to what had occurred earlier when physicians stopped doing 'scut work' mentioned earlier. They were now busy with 'big' procedures so did not much care of the gradual encroachment on their field. The biggest loss in all this was the general practitioner and the general surgeon. The specialist took more and more away. The G.P. who treated most diseases and did deliveries now does referral to specialists, follow-up on their treatments and no surgery except in some rural areas. A general surgeon does mostly abdominal surgery and some minor surgery.
To a certain extent it is understandable but it has resulted in fragmented disorganized, chaotic, confusing medicine. General practitioners used to admit patients to the hospital treated the patient and asked for specialist as needed and were in charge of their care. Now the patient is admitted to the specialist according to the complaint or illness, who asks other specialists to care for other aspects of care- so no one is in charge. G.P.s found it convenient after a while for they avoided off hours calls, going to the hospital to make rounds and dealing with the paper work. They could see more patients in the office and less calls about the patient from the hospital and less worry. But someone has to take care of the patient in the hospital. So another specialist was born- the Hospitalist. The hospitalist admitted the patient asked for appropriate consults and did the paper ( now computer) work.
So the patient deals with multiple doctors, all unfamiliar. To him/her no one seems in charge.
There is no denying that specialization is inevitable but does the care have to be that fragmented? There are so many people and things between the patient and physician. The bond which used to be there is gone. In the same specialty you might have one doctor operate on you and see someone else the next day as he might be off duty. Patients feel frustrated, as again, it seems no one is in charge. Calls regarding a problem go un-answered or answered by a voice telling you that the call is important to the recipient and to leave a message and some one will call them back and if it is an emergency to go to the emergency room; and then not hear back for what seems like ages, and then by someone to whom you have to explain the problem again as your physician is off. (cntd)
