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Trends in Education, Practice, and Organization of Health Services

George T. Harrell, MD
JAMA. 1966;196(4):334-338. doi:10.1001/jama.1966.03100170076023.
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Concern with health has been a basic human reaction from the time of recorded history. The remarkable advances in knowledge of the sciences over the past 100 years have begun to affect the pattern of professional education. In recent years social pressures have been brought to bear for changes in the organization of health services and the patterns of practice.

Historical Trends 

Disease.—  In antiquity, disease was surrounded by mystery since it struck quickly without warning and often fatally. Death occurred predominantly in early childhood and during the most active and productive years of young adulthood. As a result, the average life span was short and most people died from acute infections.Disease had it primary effect on the individual, but members of the patient's family and the community were involved in epidemics. Observations on the natural history of disease by intelligent men, who originally were usually also priests, led


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