Advances in the practice of medicine

Surgeon scrubbing hands prior to performing an operation

At the beginning of the century local doctors still visited the sick in their homes, usually carrying their sturdy Gladstone bag. Doctors could do little to cure disease, although they had learned some ways of preventing it, and some new techniques of caring for patients.

The modernisation of medicine changed the role of the doctor. Sixty per cent of new doctors are now women. Familiar illnesses, previously dangerous, can often be treated by a course of pills.

Many other diseases now call for the use of expensive technology so, by the end of the century, most medicine was delivered in hospitals (in America in 2002 only 2 per cent of doctor-patient contact took place in the home).

Public confidence in doctors

Towards the end of the century, confidence in doctors began to wane. A survey in America in 1974 found that 2.4 million unnecessary operations were performed every year, at a cost of $4billion a year. In Britain in the 2000s, a number of scandals (eg that of the GP Harold Shipman, who murdered his elderly patients) reduced confidence.

One in five Britons prefer alternative healthcare to conventional medicine, and many more are looking after their own health by visiting a gym or attending self-help health groups.

Even so, a National Health Service survey in 2002 found that 82 per cent of the population had visited a doctor at least once during the year, and that 90 per cent of those people were satisfied with their treatment.

Revision tip

To familiarise yourself with the achievements of 20th-century medicine:

1. Make a series of spidergrams showing the five key achievements for each of the key areas of 20th-century medicine (ie knowledge about the body and disease / surgery / methods, diagnosis and treatment / public health / doctors). This will give you a list of 25 achievements.
2. Look back at the ten characteristics of the western world in the 20th century in the 'civilisation' unit, and work out which of them are reflected in each of the achievements you have identified.
3. Taking an overview of the 25 key achievements, decide on five over arching aspects of 20th-century medicine.
4. Find five failures of 20th-century medicine.

Answer preparation

As part of your revision, think about the arguments and facts you would use to explain:

1. How 20th-century medicine reflected the ideas and practices of society of the time.
2. What caused people to be healthy or unhealthy.
3. What ideas people had about the causes and treatment of illness and injuries.
4. Who provided medical care.
5. How much medicine changed during the 20th century, and what the main turning points were.
6. Why some diagnoses and treatments changed, while others remained the same.
7. How (or whether) the process of change was influenced by:
   • individuals
   • the government
   • science and technology
   • war
   • attitudes and beliefs in society
   • trade
8. To what extent developments in medical understanding and practice in the 20th century affected people's lives.