Defining Moments In Medicine

Fifty years of medical advances

MJA 2001; 174: 8

For this issue of the Journal commemorating the Centenary of Federation, we wanted to put on record the defining moments in Australian medicine over the past 50 years. We asked distinguished clinicians in the nine major fields of medicine to describe the defining moments in their specialty. They were requested to consult with, or enlist as coauthor, someone of a different generation to ensure that they covered the full breadth of the past 50 years.

Some had trouble with "defining moments" and have given us "defining movements" instead. Overall, at the end of the 20th century

• general practice is celebrating its recognition as a distinct discipline;

• internal medicine has a greater understanding of the role of lifestyle factors in illness;

• pathology has exploited technological advances to develop new diagnostic techniques;

• surgery has widened its horizons largely as a result of technological breakthroughs and improved supportive medications;

• obstetrics and gynaecology has contributed to one of the major social changes in the Western world by enabling women to control their own fertility;

• radiology has been revolutionised by new techniques of imaging and has assumed a role in interventional therapy;

• paediatrics has conquered most of the infectious diseases of early childhood and greatly improved the survival of premature babies;

• anaesthesia has emerged as a more precise science, and now encompasses intensive care and pain control; and

• psychiatry has balanced a greater understanding of the biological basis for mental illness and the value of the new medications with the traditional pluralistic model.

So, whither medicine in the 21st century? Le Fanu believes that "the readily do-able has been done, the chronic diseases of ageing have been ameliorated, and the bottom of the barrel of lucky drug discoveries has been scraped". If this is true, medical advances in the future have limited prospects, and are more likely to be refinements of existing treatments or techniques than major breakthroughs. We can only wait and see (while continuing to look for those magic bullets).

Bronwyn Gaut
Deputy Editor, MJA

©MJA 2001
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