The “Era of Public Health” by medical historians

1. Hippocrates advocated for a diagnostic protocol that include what three elements?
   -Testing patient’s urine
   -Listening to patient’s lungs
   -Observing skin color
2. Galen advocated for applying the Pythagorean theory to Hippocrates’ humoral theories. List the associations of Galen derived by combining these theories.

• Hot + moist = blood – Cold + moist = phlegm
• Hot + dry = yellow bile – Cold + dry = black bile

1. What time frame was considered the “Era of Public Health” by medical historians?
   19th Century
2. Although thermometry would not be used for another 100 years, this individual monitored temperatures of patients with typhoid and prescribed cold baths when necessary.
   James Currie
3. While the Mast cells hematopoietic lineage is still under debate, I am the individual who first discovered this cell!
   Paul Ehrlich
4. What year was the first Medical Technology certification issued by ASCP?
   1928
5. Who has been called the “Father of Nephrology”?
6. Otto Folin was a truly remarkable biochemist. List three analytical tests he developed for analytes in urine:
   Ammonia, urea, creatinine
7. At the beginning of the 20th century advances in physics contributed to the development of which diagnostic tools? (List two)
   Radioactive isotopes and electrophoresis
8. While the New York Hospital was chartered in 1717, it was not opened until 1737, making this hospital opened in 1734 the first in the US to service all classes of society.
   Daughters of Charity Medical Center in New Orleans
9. Under Medicare what were the roles of the “fiscal intermediaries” and the “carriers”?
   Provided reimbursements, consulting and auditing services.
10. What year were the Amendments enacted that require a Medical Technologist to have a bachelors degree?
    1978
11. What Committee joined together to improve patient safety and ultimately proposed guidelines for laboratory methods.
    National Committee for Clinical Laboratory Standards (NCCLS)
12. What government amendment established that all clinical laboratories be certified by the Department of Health and Human Services (HHS)? What was required to obtain certification?
    CLIA ’88. Certifications required only labs with adequate quality assurance and quality control and success pass proficiency tests.
13. What is a “Fee Schedule”? Why and when was it enacted?
14. What was the purpose of the Medicare-Medicaid Fraud and Abuse Amendments of 1977?

• Required disclosure of 5% or more in a facility such as independent lab in order to participate in Medicare/Medicaid
  -Illegal to pay or receive any remuneration (kickback, bribe, rebate) for referring patient/specimens from Medicare/Medicaid patients

1. List five indications that healthcare is heading towards integrated control.

• Change in ownership/control from nonprofit or government organizations to for-profits
• Horizontal integration of free-standing institutions into multi-institutional healthcare systems including shift of control of these facilities from community boards to regional and national healthcare corporations
  • Diversification and corporate restructuring that aggregated organizations operating in one
    Market into larger enterprises, often organized under holding companies, and sometimes
    Including nonprofit and for-profit subsidiaries in various healthcare companies
  • Vertical integration, or the combination of different types of healthcare facilities
  • Industry concentration of ownership and control in regional markets and within the nation

1. List and elaborate on the three phases that defined laboratory practices during the second half of the twentieth century.

• Academic phase (1950-1970) lab science became accepted as its own discipline within medicine and medical education
• Creation of professional groups (1970-1985)
• Business phase (1985-2000) laboratory is still an academic discipline but its connected to financial concerns
  • Molecular Information Phase (2000-present)

1. What was Rosalind Franklin’s contribution to the discovery of the construct of DNA? Why didn’t she receive the Noble Prize for her contribution?
2. What branch of medical research connects basic research to patient care with an emphasis on new technologies and personalized cure?