Background on Social Problem
The
Progressive Era of the early 1900’s was one of the most demanding times in the
history of medicine. It was known as a time of economic, political, social and
moral reformation to better society; however, just below the surface, major
problems began to form.
One of the major issues during the time was public health, which was caused by industrial accidents, pollution, contaminated produce, poor water supply as well as poor sanitation. Public health was at the worst at this time. Urban areas started to become overcrowded due to a large amount of immigrants, which allowed diseases to spread quicker. Hospitals were filled with patients with diseases. However, medicine preferred to look to the biological roots of disease rather than the patient’s experience with the illness (Dodds, 1993, p.418). This resulted in many repeated hospital or office visits for patients, often presenting with the same symptoms as previously reported. Medicine, for many of these patients had been relegated to symptomatic relief, or a placebo effect that often simply meant sending the patient home to die of the illness or disease.
For Dr. Richard Cabot, this became wholly unacceptable. His realization that hospitals and physicians, himself included, had systematically began to be blind to the patients they saw resulted in a change to his approach to medicine. In his book, Social Service And The Art of Healing, he states, “The shortsightedness of our hospitals in this respect is really marvelous. They will take in the wards a baby whose digestion is upset, give it free treatment, which costs the hospital twenty dollars, send it out again without any inquiry into the way the mother feeds it or the air it breathes or the clothes it wears. A month later the baby is back again, as sick as before, and from just the same causes… I followed up a case like this recently, and found that the mother was grossly ignorant of the first principles of feeding and caring for a baby, though perfectly capable of being taught… At the end of hundreds of hospital records one can read the words, ‘Discharged well”… But peer into the background a little, follow up these cases for a few months or years, and you will often find that the last state of that man was worse than the first" (Cabot, 1909, p. 20 & 21).
For Dr. Cabot, the problem was that physicians and hospitals were only partially treating the patients. He determined that understanding background issues such as family and home life, occupational hazards, financial stressors, moral and spiritual context, were equally as important to the patient recovery as treating presenting symptoms or curing their disease.
One of the major issues during the time was public health, which was caused by industrial accidents, pollution, contaminated produce, poor water supply as well as poor sanitation. Public health was at the worst at this time. Urban areas started to become overcrowded due to a large amount of immigrants, which allowed diseases to spread quicker. Hospitals were filled with patients with diseases. However, medicine preferred to look to the biological roots of disease rather than the patient’s experience with the illness (Dodds, 1993, p.418). This resulted in many repeated hospital or office visits for patients, often presenting with the same symptoms as previously reported. Medicine, for many of these patients had been relegated to symptomatic relief, or a placebo effect that often simply meant sending the patient home to die of the illness or disease.
For Dr. Richard Cabot, this became wholly unacceptable. His realization that hospitals and physicians, himself included, had systematically began to be blind to the patients they saw resulted in a change to his approach to medicine. In his book, Social Service And The Art of Healing, he states, “The shortsightedness of our hospitals in this respect is really marvelous. They will take in the wards a baby whose digestion is upset, give it free treatment, which costs the hospital twenty dollars, send it out again without any inquiry into the way the mother feeds it or the air it breathes or the clothes it wears. A month later the baby is back again, as sick as before, and from just the same causes… I followed up a case like this recently, and found that the mother was grossly ignorant of the first principles of feeding and caring for a baby, though perfectly capable of being taught… At the end of hundreds of hospital records one can read the words, ‘Discharged well”… But peer into the background a little, follow up these cases for a few months or years, and you will often find that the last state of that man was worse than the first" (Cabot, 1909, p. 20 & 21).
For Dr. Cabot, the problem was that physicians and hospitals were only partially treating the patients. He determined that understanding background issues such as family and home life, occupational hazards, financial stressors, moral and spiritual context, were equally as important to the patient recovery as treating presenting symptoms or curing their disease.