This essay will discuss the shift in medical care from the “patient knows best” approach to the “doctor knows best” approach. Advances in dissection, laboratory medicine, germ theory, and medical instruments, combined with the contributions of many individuals, lead to this shift in healthcare from being the domain of the patient, to becoming the domain of the doctor. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay The “patient knows best” approach is a medical system in which the power dynamic works in patients' favor, meaning they have more control of their care than doctors, and is influenced by many factors. Most of the general public could not afford to see a university-trained doctor and therefore had to resort to visiting unlicensed professionals such as barbers, pharmacists, or quacks. Patients were looking for quick fixes and wanted to be in control of their medical care, a doctor's advice was expensive and often inconclusive, while a quack offered a remedy without much investigation at a relatively reasonable price. Most of the public had not developed a sense of skepticism about the extravagant claims of the quacks, furthermore these individuals were often extremely charming, charismatic and knew how to use advertising techniques to their advantage, so patients would take any pill, balm or substance. potion they were offering. This process supported the "patient knows best" system because it put all the power in the patient's hands, they chose the drug they thought was best for their condition and were not questioned about it, the quack took their money and ran with it. it was going. In the 18th and 19th centuries there were very few university-trained doctors practicing and their patients were mainly from the aristocratic upper class. This disparity in status and quantity contributed to a patient-dominated healthcare system because doctors had to compete for their limited number of patients, so pleasing the patient was paramount. In response to this, a symptom-based disease model was born. Clinicians found that treating the patient's individual symptoms, based on their specific needs and experiences through attention, was positively received by the patient, therefore it remained the dominant model of care throughout the period. This symptom-based model has been reinforced due to the ineffectiveness of available tests and treatments. Medical decisions had to be made based on the self-description of symptoms in the sick person's own words. The patient was the only source of information about his illness and recovery, so he had to be at the forefront of the approach to medical care. Dissection has remained a fundamental component of medical education for centuries. Although its most basic purpose, to learn about the structure and functions of the human body, has not changed, the attitudes of medical professionals, educators and the general public have changed and evolved as social opinions have changed. During the 3rd century BC the Greek physicians, Herophilus and Erasistratus performed dissections in the Greek School of Medicine in Alexandria, Egypt. However, by the 2nd century AD, the practice of dissection had become such a cultural taboo that it fell out of favor in both Greece and Rome, leading the physician Galen to resort to dissecting animals in an attempt to understand the human body. During this period it wasIt was widely accepted that the internal workings of monkeys and humans were extremely similar, so Galen practiced dissections on monkeys, particularly Berber and rhesus macaques. This led to many errors in Galen's findings, and since there was no way to disprove them, his hypotheses persisted as medical knowledge for over 1400 years. In the Middle Ages, the material world and the physical body were considered by theologians and philosophers to be irrelevant to eternity, so human anatomy was not the focus of exhaustive study. Furthermore, dissection was considered a desecration of the body and was therefore prohibited. However, by the 15th and 16th centuries, a scientific revolution had begun, and some French and Italian university professors began using cadavers to emphasize lessons from ancient Greek and Latin texts. A shift towards scientific research and observation led to the return of human dissection, which laid the foundation for modern medical practice in which attention is focused on doctors' extensive evidence-based knowledge. The Renaissance was a time of great change and brought about a transition from the theology-focused Middle Ages towards a scientific method based on experimentation, practical proof and experience, with a renewed interest in the human body. The dissection of human corpses continued to be prohibited in England until the 16th century, after which a very limited number of the corpses of hanged criminals were permitted to be used for dissection. However, by the 17th century, the demand for cadavers had increased significantly due to the availability of anatomy texts from Italy and France. Pressure from anatomists for more cadavers to be studied led to the passing of the Murder Act in 1752, which legalized the dissection of all executed murderers, providing medical schools with an adequate supply of cadavers and also acting as a deterrent to the crime of murder . The government also increased the number of crimes punishable by hanging, but this still proved insufficient due to the expansion of medical training and anatomical studies during the 18th century, and the practice of illegal exhumation of corpses arose to compensate from cemeteries. . The men who engaged in this practice became known as "resurrectionists" and sold the bodies to medical schools. It is likely that body snatchers supplied the majority of cadavers to medical schools in the 18th and early 19th centuries and as part of an attempt to control the corpse trade the Anatomy Act 1832 was introduced in Britain. At first the unclaimed bodies of the poor and sick were allowed to be taken to medical schools, then later family permission was required before a body could be taken. The law has been amended and refined as the need for cadavers in medical training and research has become widely recognized. Today, consent is a vital part of cadaveric dissection; obtaining permission from the patient or their family strengthens public trust in medical professionals. Dissection, and its clear benefit to scientific research, helped underpin the rise of a professional monopoly. Doctors had the tools to scientifically prove their theories and ideas and began to steadily gain more knowledge than their patients. This has caused a power shift between patient and doctor in favor of the doctor, leading to the “Doctor Knows Best” approach prevailing. Dissection is still practiced in medical schools around the world, however it is becoming increasingly common for computer models to be used as teaching tools for anatomy. Dissection occurs most often aspart of an autopsy or autopsy or as part of a forensic investigation. “Laboratory medicine works to diagnose disease, evaluate the effectiveness of treatment, and research the causes and cures of disease.” This is achieved through studying samples of tissue, blood, or other body fluids at a molecular level outside the body and through specialized imaging such as X-rays and MRIs. Some fields of laboratory medicine include microbiology, hematology, pathology, and immunology. Fields such as pathology could only develop with the development of science. Ancient Greek physicians performed dissections and autopsies on human cadavers for 30-40 years, however, when human dissection was banned, scientific progress was hindered, leading to widespread adherence to the humoral theory of medicine. During the Enlightenment of the 18th century, the four senses theory of humor was disproved with the development of medical education. The legalization of human dissection allowed the study of pathology to develop rapidly as autopsies were performed more frequently and physicians began to consider that pathology could inform diagnosis. However, the introduction of laboratory medicine into the diagnostic process was not simple. By the late 1800s, the use of laboratory medicine was limited, and most specimens pathologists received were byproducts of surgeries, such as limbs amputated, fluids drained, and tumors removed. In the case of a tumor, pathologists were expected to provide an account of the appearance, macroscopic and sometimes microscopic. Usually, the surgeon was satisfied with the evaluation of the tissue they had removed and expected the pathologist to elaborate on the diagnosis they had made. he had already decided. In this way, the pathologist served as a check on the clinical diagnosis, usually confirming it, but sometimes correcting the surgeon's conclusion. Disagreements about overdiagnosis lead to some strain on each doctor's authority, and while many surgeons were happy to defer to the pathologist, others were not. As more and more correct medical decisions and diagnoses were influenced by the use of laboratory medicine, such as pathology, it became clear that it was an invaluable tool in medicine. Furthermore, it provided clear evidence of scientific discoveries and widened the knowledge disparity between medical professionals and the general public. This shift in power directly influenced the shift from the “patient knows best” approach to medicine to the “doctor knows best” approach. Germ theory states that microorganisms or pathogens are known as "germs", they cause disease by invading a host and then growing and reproducing within them. This theory developed in the 1800s gradually gaining acceptance and eventually supplanting existing theories of miasma and spontaneous generation. This radically changed the practice of medicine and remains the guiding theory of medical science. The physical existence of germs was demonstrated in 1677, over two centuries before the development of germ theory, by Antoni van Leeuwenhoek through his simply constructed microscope. He called the tiny organisms he found in a drop of water "animalcules", however, he made no connection to the disease, instead assuming that they were an effect of the disease, which fit with the then-popular theory of spontaneous generation. Years of development and the research of Ignaz Semmelweis, Joseph Lister and John Snow would retrospectively contribute to the acceptance of the germ theory, however, it was the research of Louis Pasteur in the 1860s and then Robert Koch that provided the scientific evidence that solidified the theory . Louis Pasteur demonstrated the existence of germs througha highly publicized experiment: he developed a vaccine against anthrax by reducing the virulence of the bacterium by exposing it to air and vaccinating a group of farm animals while leaving another group unprotected. A month later all the animals were exposed to a lethal dose of anthrax. Two days later Pasteur and the waiting press found the vaccinated animal alive and well while the unprotected group was all dead. The publicity meant that the public and the scientific community could no longer deny the validity of the germ theory. The development of medical knowledge and approaches to healthcare to what we see today has been greatly influenced by the contributions of many individuals, as in the case of Pasteur's anthrax. experiment. One such individual is John Hunter, a surgeon, often credited as the founder of pathological anatomy in England. He was an early advocate of scientific research and experimentation, even self-experimentation. He led and encouraged his students to conduct studies and experiments on comparative aspects of biology, anatomy, physiology and patology. Not only did he make important scientific contributions to the field of surgery, but he also obtained the dignity of a scientific profession for surgery. This has been achieved by basing the practice of surgery on biological principles and a vast body of knowledge acquired through extensive scientific experimentation. As a teacher, Hunter inspired a generation of doctors to base their practice on scientific evidence, rather than belief in unproven but popular beliefs. theories. In his lectures, Hunter emphasized the relationship between structure and function in all types of living things. He believed that surgeons should understand how the body compensates and adapts to damage from injury, disease, or environmental changes. He encouraged students like Edward Jenner to carry out experimental research and apply the knowledge they gained to treating patients. Hunter's in-depth teaching of the scientific process leads Jenner to develop a vaccine for smallpox, an extremely contagious and deadly virus, one of the most important medical discoveries of all time. During Jenner's time as a practicing physician, smallpox epidemics raged throughout the world. To combat the disease, Jenner, like many others, practiced variolation, the process of exposing healthy patients to material from a smallpox victim in the hope that contracting a mild dose would lead to immunity. While this method was sometimes effective, it could result in full infection and even death. Folklore of the time suggested that milkmaids who contracted cowpox, a mild disease in humans, never contracted smallpox. After researching the matter, Jenner conducted an experiment to prove his theory that cowpox could produce immunity to smallpox. In 1796, he infected an eight-year-old boy named James Phipps by inserting pus from a cowpox pustule into an incision on the boy's arm. Six weeks later the boy was variolated with smallpox and suffered no ill effects, proving that Phipps was now immune to smallpox. It took many years before Jenner's findings were widely accepted and he conducted many more experiments, vaccinating many other children including his eleven-year-old. one month old son. Once the effectiveness of his vaccination was accepted and its obvious benefits were understood, Jenner was praised around the world and vaccination became commonplace. In 1979, after a widespread vaccination campaign, the World Health Organization declared smallpox the first infectious disease in history to be eradicated. . Without Jenner and his scientific contributions, this would not have been possible. There.