Author

Anne Merritt

Date of Award

8-6-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Bruno Strasser

Second Advisor

John Harley Warner

Abstract

THE RISE OF EMERGENCY MEDICINE IN THE SIXTIES: PAVING A NEW ENTRANCE TO THE HOUSE OF MEDICINE. Anne K. Merritt (Sponsored by John H. Warner). Section of the History of Medicine, Yale University, School of Medicine, New Haven, CT. This thesis investigates how emergency medicine evolved in the United States in the 1960s. Three case studies, Alexandria Hospital, Hartford Hospital, and Yale-New Haven Hospital, demonstrate the changes in emergency medicine at a small community hospital, a mid-sized teaching hospital, and an urban academic institution, respectively. The government, the media, the American public, and the medical community brought emergency medical care to the forefront of national attention in the sixties. In an era of population migration to suburbs, the rise of group practices, and medical specialization, patients relationships with their general practitioners dissolved. Emergency visits increased astronomically because patients started to use the emergency room for non-urgent health problems. Simultaneously, physicians and house staff resisted working in the emergency room. In response to rising patient loads, mounting criticism of emergency services, and staffing problems, hospital administrators devised strategies to improve the quality and efficiency of emergency care. The rise of emergency medicine in the sixties was a result of (1) advances in pre-hospital, trauma, and coronary care which distinguished a new clinical field and (2) the emergence of full-time emergency physicians at community hospitals. Urban teaching hospitals, which established triage systems and ambulatory care facilities in order to improve emergency services, resisted the idea of emergency medicine and ultimately delayed its development as a specialty.

Comments

This is an Open Access Thesis.

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