Hoffman Chapters 1-5

Before the Great Depression hit the United States in the 1930s, many people had never experienced being in a public hospital in their entire lives. However, as unemployment rates across the country rose dramatically, more and more people were forced to go to public hospitals, free clinics, or even charities to get medical attention since they could not afford to pay a private physician anymore. This huge influx of new people to these hospitals caused many of them to quickly spend all their resources, with no way of being able to treat the massive amounts of people that came looking for treatment. Doctors were also resentful about the many new "unable to pay" patients that frequently began to come, to the point that some clinics and hospitals began to see patients based on their ability to pay. Government subsidies created some relief, but these did not last long as the President Roosevelt frequently began to focus more on unemployment rates rather than medical care. The issue of medical care for the majority of people lasted throughout the Great Depression, and was a constant problem that arose across the country. Many people at this time believed that medical care was a basic human right that everyone should have, and demanded that the government help the unemployed pay for their hospital bills. This was, of course, debated by the medical profession as not an option, since the doctors would not make as much money as they would if the patients were paying for their own treatments. This led to a national debate, one that helped create prepaid hospital insurance called Blue Cross, which only paid for hospital fees, and later, Blue Shield, which payed for the doctor's services. These services spread quickly across the nation, until most major employers used one or both of these plans for the benefit of their employees. This was just the beginning of national health insurance on a national scale.
When World War II broke out, there was an overwhelming rush by anyone that could, including doctors and nurses, to the army to help the cause. This rush devastated the civilian doctors who did not go, causing a massive shortage in doctors in areas that needed them from population shifts that occurred throughout the war. There was also the issue of men leaving their pregnant wives behind to pay for their medical bills on the meager pay that they earned. This was solved through the EMIC, which helped pay for millions of child-births across the country during the war. After the war, the Hill-Burton Act was the main bill passed for hospital reform. It sent millions of dollars to hospitals, and also sent millions of dollars to help build countless more. This bill was an important first step towards a national health care system.

Howell Chapters 6-8

When the blood count first started to become an important part of diagnosing and treating different types of diseases, it was met with skepticism and also greeted warmly. Many people felt that it was quicker and could lead to a more accurate diagnosis, thus potentially increasing the likelihood that the patient could survive. The rise of blood counts helped many patients with life-threatening illnesses survive and recover due to the quick and efficient diagnosis that they received. Though it took many years for a blood count to become a routine part of the original medical screening, it eventually caught on and became as important and possibly more than anything else that was done to the patient. Blood counts at first were done by the naked eye, and then later put onto hemocytometers and done with the microscope. The microscope provided a more efficient way to count the blood, and could help in efficiency and time when those were the most important factors that could save the patient's life. The rise of the Widal reaction also increased those two factors, and helped the blood count rise to be one of the most important ways to diagnose and determine treatment for a sick patient. These two tests saved countless lives, especially from the diseases that were common in the United States at that time, including typhoid, appendicitis, and pneumonia. All of these diseases were widespread, and caused many deaths throughout the nation before the blood count test was created. The blood count test saved many people, and should be considered one of the most important medical discoveries of the 20th century.

Howell Chapters 3-5

The urine test was an important part of 20th century hospital stays. But it increasingly became more important as doctors began to realize the potential diagnosis that could be determined by the test. When doctors realized this in the early years of the 20th century, they immediately began taking more notice of the urine tests than ever before. Urine tests had been known for a long time as a way to determine what the person was being affected by so the best possible treatment could be used. In 1900, the average patient admitted to the hospital had a urine test done right when they were admitted and not again. However, in 1925, it was not unusual for multiple urine tests to be conducted on a patient every other day for as long as they stayed at the hospital. This was mainly because doctors figured out that it was an important part of the diagnosis and treatment that they could use on the patient. Instead of the results being noted and barely looked at, doctors increasingly studied the results to find out something about the treatment the patient would need or to figure out what was wrong with them. Even when the patient was stricken with something that did not require the doctors to take a urine test, like a broken leg, urine tests were still taken from these patients in 1925.
The x-ray was another important technological advance that saw an increase in use between the years 1900 and 1925. It was especially important in looking at fractures, which was a major problem in those times, and determining patient history when they would or could not tell doctors themselves. Doctors also increasingly found that it was much simpler and easier to look at the fractures than just by feeling the patient or asking them directly. As doctors began to realize its importance, they began using it more and more, and by 1925 taking an x-ray was a regular occurrence during a hospital visit. World War I also helped the increase in use, as doctors had to maintain hospitals that saw an increased amount of men coming in, especially after a large battle. That, along with the many different injuries these soldiers suffered from, added to the idea that the x-ray was the quickest and easiest way to diagnose all the different assortments of injuries the doctors were seeing.

Howell Chapters 1-2

Technology in the hospital changed very quickly over a relatively short period of time between 1900 and 1925. In 1900, hospital care was not as efficient as it could have been. Tests were taken, but whenever possible, doctors relied on sight or their own knowledge to diagnose the symptoms and give out treatment. The tests that were taken were hardly even looked at, and long hospital stays might only take up one page of the record books of the hospitals. By 1925, however, things had changed. X-rays were used to take images of the body, and then used to confirm diagnoses. Doctors took much better records, and prided themselves in keeping a clean, tidy, well-furnished hospital setting. Blood tests were also an important part of the diagnoses, and doctors frequently referred back to them during treatment. Some people might say the hospital, by 1925, had become more scientific. Machines were relied on more heavily, and doctors and patients alike wanted to know and understand more about what kinds of illnesses they were suffering from and what caused them. The new technology both doctors and patients were experiencing in the hospital is a very important part of the upward use of technology at that time, which helped lead to more discoveries and made hospitals more about science than ever before. In other words, hospitals started to become a central part in medical education. This new technology often bewildered a patient who had never experienced these things before, and they must have been uncomfortable at first when their blood was taken for tests for the first time. As the technology became increasingly more advanced and people began to realize that it was alright to go to a hospital, the hospitals were faced with a management crisis. They fixed this by changing every part of their organization from the bottom up, thereby making it a lot more efficient in providing health care. Technology was the main cause of the rise of the hospital in the average American's life, and it continues to be an important aspect of the modern-day hospital as well.