This essay will discuss the movement in medical care from the "patient knows best" approach to the "doctor knows better.” Advances in dissection, laboratory medicine, germ theory, and medical instruments, combined with the contributions of many people, are leading to this shift in health care from the domain of the patient to the domain of the physician. Say no to plagiarism. Get a tailor-made essay on “Why violent video games should not be banned”? Get an original essay The “patient knows best” approach is a system of medicine where power dynamics work in favor of patients, meaning that they have more control. of their own care than doctors, and is influenced by many factors. The majority of the general public could not afford to see a university-trained physician and so had to resort to visiting unlicensed practitioners such as barber-surgeons, apothecaries, or quacks. Patients were looking for quick solutions and wanted to feel in control of their medical care, a doctor's consultation was expensive and often inconclusive, while a quack offered a cure without much investigation for a relatively reasonable price. Most of the public had not developed a sense of skepticism about the outlandish claims of charlatans. Additionally, these individuals were often extremely charming, charismatic, and knew how to use advertising techniques to their advantage, which is why patients would take whatever pill, balm, or potion they offered. This process supported the "patient knows best" system because it put all the power in the hands of the patient, they chose the medication they felt was best for their condition and were not questioned on this subject, the charlatan took his money and left. In the 18th and 19th centuries, there were very few university-trained doctors and their patients were mainly from the aristocratic upper class. This disparity in status and quantity contributed to a patient-dominated healthcare system, as doctors had to fight for their limited number of patients. Therefore, pleasing the patient was paramount. In response to this, a symptom-based model of disease emerged. Doctors found that treating the patient's individual symptoms, based on their specific needs and experiences by being attentive, was received positively by the patient and therefore 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 were to be made based on self-report 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 an essential part of medical education for centuries. Although its fundamental goal, to learn more about the structure and functions of the human body, has not changed, the attitudes of health professionals, educators, and the general public have changed and evolved as societal views have exchange. During the 3rd century BC, the Greek physicians Herophilus and Erasistratus performed dissections at the Greek Medical School in Alexandria, Egypt. However, by the 2nd century AD, the practice of dissection had become such a cultural taboo that it had fallen out of favor in Greece and Rome, leading the physician Galen to resort to dissection of animalsto try to understand the human body. During this period, it was widely accepted that the inner workings of monkeys and humans were extremely similar, so Galen performed dissections on monkeys, particularly Barbary and rhesus macaques. This led to many errors in Galen's discoveries, and because there was no way to disprove them, his hypotheses persisted as medical knowledge for over 1,400 years. In the Middle Ages, the material world and the physical body were considered by theologians and philosophers to be inconsequential compared to eternity, so human anatomy was not a subject 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 ancient Greek and Latin texts. The shift toward scientific research and observation led to the return of human dissection, which laid the foundation for the modern practice of medicine, where the emphasis is on the extensive, evidence-based knowledge of physicians . The Renaissance was a time of major change and brought about a transition from a theology-driven Middle Ages to a scientific method based on experimentation, practical testing and experience, with a renewed interest in the human body. The dissection of human corpses continues to be practiced. banned in England until the 16th century, after which a very limited number of 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 corpses to be studied led to the passage of the Murder Act in 1752, which legalized the dissection of all executed murderers, thus providing medical schools with an adequate supply of corpses and also acting as a deterrent for 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 throughout the 18th century, and to compensate for this figure, the practice to illegally exhume corpses from cemeteries has emerged. . The men who carried out this practice were known as "resurrectionists" and sold the bodies to medical schools. It is likely that body snatchers supplied the majority of corpses to medical schools in the 18th and early 19th centuries and that, in an attempt to control the corpse trade, the Body Anatomy Act 1832 was introduced to Britain. At first, unclaimed bodies of the poor and sick were allowed to be taken to medical schools, then later permission from the family was required before a body could be taken. The law was amended and refined as the necessity of cadavers in medical education and research became widely recognized. Today, consent is an essential element of cadaveric dissection. Obtaining authorization from the patient or family builds public trust in healthcare professionals. Dissection, and its obvious benefits for scientific research, helped reinforce the rise of a professional monopoly. Doctors had the tools to scientifically prove their theories and ideas and they began to consistently have more knowledge than theirpatients. This caused a power shift between patient and doctor in favor of the doctor, leading to the “doctor knows what does best” approach being dominant. Dissection is still practiced in medical schools around the world, however, it is increasingly common for computer models to be used as a teaching tool for anatomy. Dissection most often takes place as part of an autopsy or autopsy or as part of a forensic investigation. “Laboratory medicine works to diagnose diseases, evaluate the effectiveness of treatment, and research the causes and cures of disease. » the study of tissue, blood or other body fluid samples at the molecular level outside the body and by specialized imaging such as x-rays and MRI. Some areas of laboratory medicine include microbiology, hematology, pathology and immunology. Fields such as pathology could only develop as science developed. Ancient Greek physicians performed dissections and autopsies on human corpses for 30 to 40 years. However, when human dissection was banned, scientific progress was hindered, leading to widespread adherence to the humoral theory of medicine. During the 18th century Enlightenment, the theory of the four senses of humor was refuted as medical education developed. The legalization of human dissection allowed the study of pathology to develop rapidly, autopsies becoming more frequent and doctors then began to consider that pathology could inform diagnosis. Introducing laboratory medicine into the diagnostic process, however, has not been straightforward. By the late 1800s, the use of laboratory medicine was limited and the majority of samples received by pathologists were byproducts of surgery, such as amputated limbs, drained fluids, and excised tumors. In the case of a tumor, pathologists were expected to report the appearance, macroscopic and, sometimes, microscopic. Usually the surgeon was satisfied with his assessment of the tissue he had excised and expected the pathologist to elaborate on the diagnosis he had made. had already decided. In this way, the pathologist acted as a check on the clinical diagnosis, usually confirming it, but sometimes correcting the surgeon's conclusion. Disagreements over diagnosis led to some tension over each clinician's authority, and although many surgeons were happy to defer to the pathologist, others were not. As more and more medical decisions and correct diagnoses were influenced by the use of laboratory medicine, as pathology, it became clear that it was an invaluable tool in medicine. Furthermore, it provided clear evidence of scientific findings and widened the knowledge disparity between healthcare professionals and the general public. This shift in power directly influenced the shift from a “patient knows best” approach to medicine to a “doctor knows best” approach to medicine. Germ theory states that microorganisms or pathogens, known as "germs", cause disease by invading a host and then growing and reproducing within them. This theory developed in the 1800s, gradually gaining acceptance and eventually replacing existing theories of miasma and spontaneous generation. It radically changed the practice of medicine and remains the guiding theory of medical science. The physical existence of germs was proven in 1677,more than two centuries before the development of germ theory, by Antoni van Leeuwenhoek thanks to his simply constructed microscope. He called the tiny organisms he found in a drop of water "animalcules", but he made no connection with the disease, assuming instead that they were an effect of the disease, which fit the then popular theory of spontaneous generation. the research of Ignaz Semmelweis, Joseph Lister, and John Snow would retrospectively contribute to the acceptance of germ theory, however, it was the research of Louis Pasteur in the 1860s, and then Robert Koch, that provided the scientific proof that solidified the theory. Louis Pasteur demonstrated the existence of germs through a highly publicized experiment: he developed a vaccine against anthrax by reducing the virulence of the bacteria by exposing it to the 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 entirely dead. This publicity meant that the public and scientific community could no longer deny the validity of germ theory. The development of medical knowledge and approach to health care to what we see today has been greatly influenced by the contributions of many individuals, as in the case of Pasteur's anthrax. One such individual is John Hunter, a surgeon, often considered the founder of pathological anatomy in England. He was an early advocate of scientific research and experimentation, even self-experimentation. He directed and encouraged his students to carry out studies and experiments on comparative aspects of biology, anatomy, physiology and pathology. He not only made important scientific contributions to the field of surgery, but also gave surgery the dignity of a scientific profession. This was 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 physicians to base their practice on scientific evidence, rather than belief in unproven but popular principles. theories. In his lectures, Hunter emphasized the relationship between structure and function in all kinds of living creatures. He believed that surgeons needed to understand how the body compensated and adapted to damage from injury, disease, or environmental changes. He encouraged students like Edward Jenner to conduct experimental research and apply the knowledge gained to treating patients. Hunter's extensive teaching of the scientific process led Jenner to develop a vaccine against smallpox, an extremely contagious and deadly virus, one of the most important medical advances of all time. During Jenner's time as a practicing physician, smallpox epidemics raged across the world. In order to combat the disease, Jenner, like many others, practiced variolation, the process of exposing healthy patients to material from a smallpox victim in the hopes that contraction of a dose mild would lead to immunity. Although this method was sometimes effective, it could lead to total infection or even death. Folklore of the time suggested that milkmaids who contracted cowpox, a mild disease in humans, never contracted smallpox. After studying this question, Jenner.