Healthcare is a highly Complex Industry. Even as a patient if one has a health problem, one wonders whom should I visit. I should go to the Emergency/Casualty/Urgent care or my General Physician or a specialist. Highly confusing and at times even Frustrating!!! But things don’t stop here, finding the right Physician is just the beginning. The fun part begins right after/during your visit, because this is when all other healthcare entities (Insurance Companies, Pharmaceuticals, Medical Devices and many others) become part of the movie scene.
In order, to decode the confusing Maze of Healthcare we need to first enter the same, and the only way to do so is to start with the Basics. You know when I was doing my MBA, we had a subject “Integrated Marketing” and we were discussing the Primary purpose of a Phone. If I go back to the 90’s when we did not have mobiles/cell phones the only reason why a phone existed was to communicate with others. In simple words make a phone call, everything else additional we get now are Add-On’s. On Similar lines if I ask the question what is the primary purpose/goal of Healthcare? The answer should be pretty straight forward – “To Provide Care”.
At one point or the other we have all visited a Doctor, and to a certain extend are aware how Care is provided nowadays. But do you know how care was provided earlier ???.
In India we know herbs were used to treat patients i.e. Ayurveda. If we look at history specifically in ancient times health of an individual was handled within the home of an individual – a.k.a. Home Remedies (the world is now going back and trying to focus more on Home Health). Treatment was done using herbs – flora and fauna during these times. People who were experts in herbs and medicines existed and were called as “physicians”. This knowledge was passed from one generation to another, but at that time people still did not understand the underlying reason why a specific sickness was happening. Many cultures started to then study this subject and people started to document medicine.
The earliest reference of documented medicine is from Mesopotamian (somewhere between current Iran and Kuwait). These documents were kind of Stone Tablets (search for Sumerian medical tablet). These Tablets were used around 1600 BC and quite a few of them have been preserved in the British Museum.
But this is not how currently Patients are treated are they now ?. Doctors use Tablets but they are electronic 😊 So when exactly did the world see a change in how we treat patients, Any Thoughts ?? Ok if you are scratching your head and thinking Darwin’s Theory, Maslow’s law then that’s not it 😊
In the 19th and 20th centuries quite a few technological advances happened in the world and the focus moved towards research on specific diseases (Therapeutic Revolution). Diseases were linked to microorganisms (Germ Theory) and vaccines started to get developed for the same. There was a growth seen in bio medicine and along with this came globalization of medicine. In this era we also saw many new devices such as X-rays, antiseptics and newer means of diagnosing a patient’s problem. If we look at the time frame, this was also the time Britain was colonizing the world and due to this we also saw a rise in Infectious diseases.
The 1920 Influenza virus infected over 500 million people around the world and killed around 100 million. Overall there was an increased focus on public health and investing in surveillance systems. There was also a focus on eradicating specific diseases such as small pox – this approach was called as Vertical health approach (Top Down). This Approach faced lot of criticism as using this method other diseases were not eradicated. It is at this juncture around 1970’s came a realization that improving medical care cannot be the only aspect used to improve health and social conditions. We need other entities/sectors also to get involved, this fueled the need for building basic Health Services (Bottom Up).
Hopefully the above 600 words / 3000 characters were interesting, we also spoke about quite a few entities which we need to understand as part of our basics. Let us quickly look at these entities.
- The key entity which is the Patient – the person who needs to be provided care.
- A Physician/Healer – The person who provides care to the Patient.
- Governments – primary responsibility was improving Public Health and creating the infrastructure for providing basic Health Services. Now were there more, oh yeah there were !!!
- Research Organizations – These are life science organizations (LS) focused on studying micro-organisms (remember Germ Therapy).
- Medical Devices – Organizations who are focusing on creating new devices for improved treatments of patients.
- Pharmaceuticals – We talked about creating vaccines, this is done by Pharma companies who focus on developing new medicines for treatment of diseases.
There are many more entities and we will find them as we move forward. You might be aware in Each industry there is always a First Mover Advantage, on similar lines do you know which was the 1st Hospital ?? I am aware that Wisselbank was one of the 1st Banks to be established in 1609, but I was not able to exactly find out the name of a specific Hospital which was established first. Though it is interesting to know that “Early 200 to 400 BC have documented the use of temples and institutions to treat patients in Greece, Rome and India”. That is correct ancient Greece had temples of Asclepius (The Greek God of Medicine & healing), which was later adopted by Romans. In India cities had built houses for dispensing charity and medicine. These are some of examples of earliest documentary evidence where institutes provided care to the sick.
By the way if you are able to find out which was the 1st Hospital which was established do let me know 😊
These articles are small pieces of the book I am planning to write – Healthcare Decoded.