Social History of Medicine Advance Access originally published online on February 20, 2006
Social History of Medicine 2006 19(1):107-125; doi:10.1093/shm/hkj007
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Medicine of Senescence or Managing a Hospital System: The Resistible Rise of Geriatric Medicine in the State of Victoria
* Centre for the Study of Health and Society, School of Population Health, University of Melbourne, Victoria 3010, Australia. E-mail: cehunter{at}unimelb.edu.au
This paper investigates the conditions in which geriatric medicine emerged in the state of Victoria between the late 1950s and the late 1970s. It shows how, in transforming a charity model of care into a medical model of service, nascent geriatricians were caught up in the shifting balance of responsibilities between state and Commonwealth governments in funding health services and care for the aged, and in the efforts of a small segment of the Australian medical profession to establish an organisational setting and professional context for social medicine. In Victoria, the potential for doctors to circumvent bureaucratic and professional limitations on their work lay in their relationship with their institutional committees of management whose members were drawn from the general community. The paper argues that pioneer geriatricians failed to establish a field of practice that met all the needs they discerned in their patient group because they could not change community ideas about appropriate responses to old age infirmity.
Keywords: geriatric medicine; care of the aged; elderly people; social medicine; long-term care; community; rehabilitation