Read the following case carefully and answer the questions that follow: Start begins with a look at the shift from domestic medicine in early America when the family wants the locus of care of the…

Read the following case carefully and answer the questions that follow: Start begins with a look at the shift from domestic medicine in early America when the family wants the locus of care of the sick to the shift towards the professionalization of medicine in the late 1700s. Not all were accepting, however, as lay healers in the early 1800s saw the medical profession as nothing but privilege and took a hostile stance to it. But then medical schools began to emerge and proliferate during the mid-1800s and medicine was quickly becoming a profession with licensures, codes of conduct, and professional fees. The use of hospitals and the introduction of telephones and better modes of transportation made physicians accessible and acceptable. Start also discusses the consolidation of professional authority and the changing social structure of physicians in the nineteenth century. For instance, before the 1900s, the role of the doctor did not have a clear class position, as there was a lot of inequality. Doctors did not earn much and a physician's status depended largely on their family's status. In 1864, however, the first meeting of the American Medical Association was held in which they raised and standardized requirements for medical degrees as well as enacted a code of ethics, giving the medical profession a higher social status. Reform of medical education began around 1870 and continued through the 1800s. Start also examines the transformation of American hospitals throughout history and how they have become central institutions in medical care. This happened in a series of three phases. First was the formation of voluntary hospitals that were operated by charitable lay boards and public hospitals that were operated by municipalities, counties, and the federal government. Then, beginning in the 1850s, a variety of more "particularistic" hospitals formed that were primarily religious or ethnic institutions that specialized in certain diseases or categories of patients. Third was the advent and spread of profit-making hospitals, which are operated by physicians and corporations. As the hospital system has evolved and changed, so has the role of the nurse, physician, surgeon, staff, and patient, which Start also examines. Finally, Start examines dispensaries and their evolvement over time, the three phases of public health and the rise of new specialty clinics, and the resistance to the corporatization of medicine by doctors. He concludes with a discussion of the five major structural changes in the distribution of power that played a major role in the social transformation of American medicine:

1. The emergence of an informal control system in medical practice resulting from the growth of specialization and hospitals.
2. Stronger collective organization and authority/the control of labor markets in medical care.
3. The profession secured a special dispensation from the burdens of hierarchy of the capitalist enterprise. No "commercialism" in medicine was tolerated and much of the capital investment required for medical practice was socialized.
4. The elimination of countervailing power in medical care.
5. The establishment of specific spheres of professional authority Questions: a. What made the medical profession a higher social status in America? b. 'The status of doctors was not good before the 1990s American society'. Explain its based on the case. c. What were the major factors for the social transformation of American medicine? d. How did American hospitals become the central institution in medical care?