School of Historical and Philosophical Studies - Theses
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ItemDoctoring old age: a social history of geriatric medicine in Victoria.( 2003-02)The pattern of medical practice that emerged in Victoria, following the introduction of a national system of publicly subsidised voluntary hospital and medical insurance by the Liberal-Country Party Coalition government in the early 1950s, was dominated by the provision of individualised, curative medical services based upon a reductionist model of disease. Older adults, classified officially as aged according to age of eligibility for the Age Pension introduced in 1909 by the Commonwealth government, were prominent in this pattern of practice. The number of adults over the age of sixty-five increased over the early decades of the twentieth century, and the technical advances made in postwar medicine led to a growing clinical engagement with the degenerative diseases associated with old age. The growing medical involvement with old age , the basis of the specialist fields of medical practice that proliferated throughout the 1960s, was recognised as such only in relation to the work of general practitioners. Specialist practitioners defined their clinical engagement with old age in terms of pathologies of bodily organs or systems. In contrast, the special role of the GP in relation to elderly patients was defined in terms of that practitioners personal knowledge of patients as individuals. Formal designation of the general practitioner as specialist in caring for the sick aged was confined to the Pensioner Medical Service, a component of the national system of remuneration for medical services. Within this pattern of medical practice infirm old people, whose afflictions could not be readily resolved by curative medical services, occupied a residual category outside the field of active medical practice. When poverty compounded the difficulties experienced by these infirm old people they were categorised as a social problem to which the appropriate response was the provision of adequate infirmary beds through the charitable efforts of local communities. (For complete abstract open document)