Medicine as Business, Evolution of

Perhaps more than any other area of contemporary life, medicine has been transformed from its earliest organized beginnings. From the spiritual and empirical approaches of Imhotep to the ethical admonitions of Hippocrates, and from Cartesian dualism to the scientific method, medicine has evolved in diverse and often unimaginable ways over the past 4,000-plus years. However, prior to the last century, one basic tenet remained constant—physicians were by and large self-employed contractors who negotiated their payments and fees with their patients and/or their patients' families. Prior to the Industrial Revolution in Western medicine and 1918 in Europe, physicians set fees, or bartered with patients/families for payments for services. As the practice of medicine evolved in the 20th century, the business of health care evolved even more ...