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Interface of Private/Public Interface of Private/Public Entities in TB CareEntities in TB Care
Dr. Yossef AelonyDr. Yossef Aelony
TB: History of Contagion TB: History of Contagion Hypothesis 1/Public HealthHypothesis 1/Public Health
Ancient Brahmins: “Do not marry”Aristotle: person to person spread1609: scrofula pronounced
contagious1699: Republic of Lucca requires
Notice1751: Spain; Naples in 1782:
failure of doctor or family member to notify TB punished by Exile.
TB: History of Contagion TB: History of Contagion Hypothesis 2/Public HealthHypothesis 2/Public Health
1800: 20% of all deaths due to TB1800: introduction of private hospital
beds19th century: progressive recognition of
need to protect public; specialized TB hospitals & sanitariums; TB ‘resorts’ contain the most expert physicians in TB
Sanitariums supported by state or charity
Brompton in London; Saranac Lake NYLa Vina in Pasadena
TB: History of Contagion TB: History of Contagion Hypothesis 3/Public HealthHypothesis 3/Public HealthRobert Koch postulates1880 prove
AFB origin of TB, reducing resistance to protecting the public.
Public attitudes had retarded support for public protection until then.
Remember Verdi’s La Traviata (‘one who went astray’): Violetta
20th century saw widespread public institutions against TB. (1929 in Palestine)
Increase TB in NYC with HIV epidemic demonstrated relation of Pub Health $ to TB
Single BedsSingle Beds
Isolated SanatoriumIsolated Sanatorium
TB Fund Raising StampsTB Fund Raising Stamps
Fresh Air for TBFresh Air for TB
Brompton Hospital LondonBrompton Hospital London
Public/Private Cooperation Public/Private Cooperation 20102010
I surveyed 10 pulmonologists in LA, all of whom indicated they were pleased with our relationship, EXCEPT they often don’t get a follow up at the end of Rx.
We are in the process of trying to rectify this & would welcome any other suggestions from the audience