Learning from the history of hospitals


Every year SHM’s Annual Conference Committee examines prior attendee surveys, reviews the content presented the preceding year, and asks itself what new areas of learning are needed by hospitalists, said Dustin Smith, MD, SFHM, associate professor of medicine at Emory University in Atlanta, and HM19 course director.

“The conference’s schedule-at-a-glance of content can be overwhelming, so we have tried to use distinct educational tracks to provide focus and clarity for conference attendees,” he said. “Every year there are a few areas where questions often come up about complex clinical situations in which established medical guidelines aren’t much help.”

As a result, for HM19 an educational mini-track called “Between the Guidelines” was developed to gather up several of these areas of clinical complexity where what’s available in established clinical practice guidelines doesn’t offer clear answers, Dr. Smith said. These include controversies around antithrombotic therapy in patients with major bleeds, and a debate on controversial aspects of guidelines to direct inpatient care.

A Wednesday session, “The History of Hospitals via Arts and Stories,” fits nicely into this mini-track.

“It’s a history lesson you can’t glean from medical guidelines, which maybe point us toward what to incorporate and what not to repeat from across the history of hospitals,” he said. “That could help us better appreciate the work hospitalists are doing today and into the future.”

Dr. Jordan Messler, a hospitalist at Morton Plant Hospitalist group in Clearwater, Fla.

Dr. Jordan Messler

Jordan Messler, MD, SFHM, a hospitalist with the Morton Plant Hospitalist group in Clearwater, Fla., will lead the session and thinks that modern physicians can learn a great deal from both the history of medicine and the evolution of hospitals, starting with the ancient Greek physician, Galen (129-200 AD), who directed the celebrated Asclepeion or hospital in Pergamon (present-day Bergama, Turkey). Dr. Messler said this ancient hospital’s treatment of disease also addressed the senses, the emotions, and the spirit – an early prototype for whole-person care – with an em-phasis on self-therapy through rest, relaxation, exercise, and the promotion of healthy lifestyles.

A different perspective on hospitals

“People used to travel to Pergamon for healing at the Asclepeion, next to the amphitheater, where plays and music were presented, and to be outdoors in the natural elements. Now we’re seeing hospitals being built with healing gardens, and a new emphasis on how artwork and music and environmental design can assist in healing,” Dr. Messler said.

Dr. Messler explained that his “History of Hospitals” presentation also will survey the advent of more recent hospitals in France in the 18th century, pioneering work done at Johns Hopkins Hospital in Baltimore and Bellevue Hospital in New York, and the influence of nursing pioneer Florence Nightingale (1820-1910) on the modern hospital. Dr. Messler said Ms. Nightingale helped improve hospitals in her day, which still influences their modern design, and fundamentally changed the role of nursing in hospitals, introducing professional training standards for nurses.

Santa Maria Nuova hospital, the oldest hospital still active today in Florence, Italy, was founded in 1288 by Folco Portinari.

Part of the goal for “Between the Guidelines” is to take a break from more clinically focused presentations and to think about the hospital from a different perspective, Dr. Messler said. His session will emphasize the power of stories and storytelling to inform and inspire medical practice.

“This is not something that can be applied clinically the next day, but lessons from the past can inform the design of hospitals and how we manage patients,” he said. “We need to ask ourselves, ‘How can we analyze hospital history to inform what we do today?’ ”

Origins Not Forgotten: The History of Hospitals via Arts and Stories
Wednesday, 12:30-1:10 p.m.
Woodrow Wilson A

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