Lege Artis Medicinae

[The Faith of Faithlessness ]

BÁNFALVI Attila

DECEMBER 15, 2017

Lege Artis Medicinae - 2017;27(10-12)

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[The article elaborates on the untold chapters of nursing history in Hungary, based on research in archives. The situation of nursing in Hungary in the first half of the 20th century is described, when nursing and nursing education became issues of outstanding importance and secular nursing appeared alongside faith based nursing. Several nursing organisations worked to address the unacceptable situation of nursing and strove to raise the status of nursing so as to allow this self-sacrificing vocation to take its rightful place in society. The tools to achieve this goal included providing professional education and training, creating professional literature and safeguarding nurses’ interests. The Hungarian National Association of Female and Male Nurses that came into being as a grass-root organisation in 1902, and its president, József Michalicza, an unreasonably forgotten figure in Hungarian secular nursing were instrumental in pursuing these goals. The article also mentions several dedicated figures in Hungarian nursing history, due to whose commitment Hungarian nurses were represented in the International Council of Nurses from 1933 until the interference of politics. ]

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[Up-to-date wound care is a kind of teamwork that requires modern bandage, a high degree of theoretical knowledge and a strong sense of vocation. The authors describe the complete healing of a patient’s diabetic foot ulcer with all these three factors present. Patients suffering from all the complications of diabetes can often have faith only in the dedicated medical staff. An old patient having almost lost his vision can be treated successfully for diabetic foot ulcer in the period of 11 months due to modern wound management and vascular surgery. With the presentation of this case the authors wish to emphasise the need for devoting more time to medical training concerning modern wound care, and to improve the psychological management of the affected patient. ]

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[Economic features of rewarding physicians – changing for fair incomes in Hungary ]

BALÁZS Péter

[Since ages, rewarding physicians was a crucial problem. Among true professionals (priests, legal experts, physicians and teachers) only medical doctors are necessarily working in physical terms, which generates permanent uncertainty about their remuneration. Old Age manual services (surgery, obstetrics) were paid by artisans’ standards while patients of faith-healing (by priest-doctors) presented religious offers according to their capacities. Hippocrates’ business ethics transformed this pattern as price elasticity for profane providers. During the Medieval Ages, governments issued also for physicians fee schedules or in some countries like Hungary they agreed free on remuneration with their patients. Thus, Hungary’s physicians experienced 1891 the implementation of the Bismarck type social health insurance as a real shock-wave generated by the depressed fee proposals. After the first hit, during the following 100 years Hungary committed all possible financial failures down to the fall of Communism in 1989. After the age (1949–1989) of socialism in the health care, general practitioners returned to the self-employed business however under heavy custody of a single payer public fi­nan­cing. Specialist in out and in-patient care (if they used this opportunity) were “li­cenced” for earning money on the quasi pri­vate market of the under-the-table informal business. Actually, only the private dentistry preserved its legal free market share and by the cross-border “dental-tourism” Hungary joined also the competitive international dental market. All other specialists demonstrate income discontent by requiring higher wages, working abroad or fuelling debates on accepting informal payments of “thankful” patients. Contrasted to dentistry, there are actually no economic standards to ponder physicians’ income expectations and compare them with purchasing power of public and private financing. This study shows first the historic evidence of the relevant golden standard and its continuity un-der the present circumstances however supressed for political reasons. It would be able to settle debates about the public employees’ wages of doctors caught out of the thin air. ]