What a difference a few thousand years can make. Following is a look at some of the milestones in the history of medicine and healthcare. Events within a given year may not be chronological.
Circa 8000 B.C. -- Prehistoric people practice trephining -- drilling a hole in the skull to relieve pressure on the brain -- the first-known surgical treatment.
Circa 2,500 B.C. -- Egyptian physicians develop first systematic methods of treating disease.
Circa 460 B.C. -- Hippocrates born. Greek physician known as the Father of Medicine.
Circa 50 A.D. -- First pharmacology text written.
100s A.D. -- Greek physician Galen develops first medical theories based on scientific experimentation.
600s A.D. -- Founding of oldest hospital still in existence, Hotel Dieu in Paris.
1100s -- First medical schools established in Europe.
1300s -- Black Death, a form of bubonic plague, kills more than one-fourth of the European population.
1503 -- First hospital built in Western Hemisphere (Hispaniola). Its ruins still stand in Santo Domingo, Dominican Republic.
1543 -- Belgian physician Andreas Vesalius publishes first scientific study of the human anatomy, On the Fabric of the Human Body, helping mark the beginning of modern medicine.
1590 -- Principles of the compound microscope discovered by Dutch spectacle-maker Zacharias Janssen.
1628 -- Circulatory system discovered by British physician William Harvey.
1676 -- Bacteria first described by Anton van Leeuwenhoek, a Dutch amateur scientist.
1736 -- Founding of L'Hopital des Pauvres de la Charite, what's now Charity Hospital in New Orleans (French territory at the time).
1751 -- America's first hospital chartered, today's Pennsylvania Hospital in Philadelphia. Founded by Benjamin Franklin and Thomas Bond, M.D.
1765 -- College of Philadelphia opens the first American medical school.
1773 -- Eastern State Hospital, Williamsburg, Va., founded as North America's first public psych hospital.
1796 -- British physician Edward Jenner gives first officially recognized vaccination, against smallpox. Smallpox, which killed hundreds of millions worldwide and blinded and scarred millions more, was the first infectious disease conquered by humans -- through vaccinations.
1816 -- Stethoscope invented by French physician Rene Laennec.
1842 -- American surgeon Crawford Long first to use anesthesia -- ether -- to mask pain during dental surgery.
1847 -- American Medical Association founded in Philadelphia.
1853 -- Aspirin first synthesized by French chemist Charles Gerhardt, but its medicinal value isn't fully known until 1899.
1863 -- Red Cross founded in Switzerland.
1864 -- French scientist Louis Pasteur suggests that dangerous microbes could be killed through application of controlled heat. Leads to process of Pasteurization.
1866 -- Following the Civil War, Congress establishes the National Home for Disabled Volunteer Soldiers, the beginnings of the nation's veterans healthcare system.
1867 -- First report by British physician Joseph Lister on use of carbolic acid to fight micro-organisms. Year is now regarded as the birth date of antisepsis.
1881 -- American Association of the Red Cross founded through work of Clara Barton.
1891 -- First school of osteopathic medicine founded by Andrew Taylor Still, D.O.
1895 -- Discovery of X-rays by German physicist Wilhelm Roentgen.
1896 -- Victor Electric Co., Chicago, builds first diagnostic X-ray machine.
1898 -- Association of Hospital Superintendents formed in Cleveland, predecessor of the American Hospital Association.
1900 -- St. Rose's Free Home for Incurable Cancer is founded in New York, the first hospice in the U.S.
1906 -- Spanish histologist Santiago Ramon y Cajal shares Nobel Prize in physiology and medicine for his discovery that the nerve cell is the basis of the nervous system.
1909 -- German scientist Paul Ehrlich introduces chemotherapy, a method that uses chemicals/drugs to attack the causes of specific diseases.
1910 -- Abraham Flexner writes his scathing report Medical Education in the United States and Canada, criticizing the state of physician training. By the 1920s, medical education would be revolutionized, thanks to Flexner's work.
1910 -- Managed care begins as two physicians in Tacoma, Wash., contract with a lumber company to provide medical services for 50 cents per member per month.
1910 -- First group health insurance policy issued, covering employees of Montgomery Ward retail chain.
1913 -- William Coolidge develops the hot cathode, high-vacuum X-ray tube, which allows X-ray output to be precisely controlled.
1915 -- The Catholic Hospital Association, predecessor of the Catholic Health Association of the United States, is founded in Milwaukee.
1918-1919 -- Worldwide flu epidemic kills 20 million people, including 500,000 Americans.
1921 -- Federal Veterans' Bureau established. It would be become the Veterans Administration in 1930 and the Department of Veterans Affairs in 1989.
1922 -- Insulin discovered by Canadians Frederick Banting and Charles Best, and Scottish researcher John Macleod.
1927 -- Food, Drug and Insecticide Administration formed (Becomes Food and Drug Administration in 1930).
1928 -- Penicillin discovered by Scottish bacteriologist Alexander Fleming.
1929 -- Baylor University in Dallas agrees to provide hospital care for 1,250 teachers in exchange for prepaid premiums, forming first Blue Cross plan.
1929 -- Physicians Donald Ross and H. Clifford Loos start Ross-Loos clinic in Los Angeles, which offers prepaid healthcare for municipal employees.
1932 -- German chemist Gerhard Domagk discovers sulfa drugs.
1935 -- President Franklin D. Roosevelt signs Social Security Act into law.
1938 -- Federal Food, Drug and Cosmetics Act requires that new drugs receive premarket approval from the FDA.
1939 -- Federal Security Agency established. Included responsibility for public health issues.
1945 -- Kaiser Permanente HMO opened to public enrollment.
1945 -- President Truman calls for expansion of Social Security to include compulsory health insurance funded by a payroll tax. The proposal would die. After re-election, Truman resurrected the plan in 1949 but backed off following intense criticism.
1946 -- Centers for Disease Control established.
1946 -- American Association of Hospital Accountants formed, which would evolve into today's Healthcare Financial Management Association.
1947 -- Cleveland surgeon Claude Beck performs first heart defibrillation.
1951 -- Joint Commission on Accreditation of Hospitals is created, predecessor of the JCAHO.
1953 -- Federal Department of Health, Education and Welfare is established.
1953 -- Birth of genetic engineering with discovery of the DNA double helix.
1954 -- President Eisenhower proposes $100 million government fund that would allow private companies to purchase reinsurance. Proposal failed to pass.
1954 -- First successful kidney transplant is performed by surgeons Joseph Murray and John Hartwell
Harrison and nephrologist John Merrill.
1955 -- Birth-control pill developed.
1955 -- Jonas Salk, M.D., discovers oral polio vaccine.
1955 -- First patient treated by heart-lung machine.
1957 -- American physicist Gordon Gould develops first laser. The invention would become a versatile tool in healthcare.
1960 -- Eisenhower administration proposes "Medicare Program for the Aged." Bill fails, but the name sticks.
1960 -- First pacemaker successfully implanted by William Chardack, M.D., and Andrew Gage, M.D., with assistance from Wilson Greatbatch, an electrical engineer.
1961 -- Healthcare Information and Management Systems Society formed.
1962 -- President Kennedy calls for expanded medical coverage for the elderly.
1964 -- First successful coronary artery bypass by American surgeon Michael DeBakey.
1965 -- Medicare and Medicaid established through amendments to Social Security Act.
1967 -- First human whole-heart transplant, by South African surgeon Christiaan Barnard, M.D.
1968 -- Hospital Corporation of America, the first for-profit hospital management company, founded in Nashville by Thomas Frist Sr., M.D.
1969 -- First artificial heart implanted in a human by a team led by Denton Cooley, M.D.
1969 -- Four-computer experimental network formed by the Defense Department. It would evolve into the Internet.
1970 -- The Health Security Act, a national health insurance program, is introduced in Congress. It would fail.
1971 -- Nixon administration endorses HMOs as new national health strategy.
1972 -- Computed tomography scanner introduced by EMI Ltd. of England. Idea envisioned by Godfrey Hounsfield in 1967.
1973 -- President Nixon signs HMO Act of 1973, stimulating growth in the industry.
1974 -- Employee Retirement Income Security Act becomes law.
1977 -- First in-vitro fertilization results in birth of Louise Brown
1977 -- Health Care Financing Administration established.
1977 -- First off-the-shelf personal computers introduced.
1979 -- HEW renamed Department of Health and Human Services after most national education programs are transferred to the new Department of Education.
1979 -- President Carter calls for national health insurance. The bill introducing the plan would die.
1980 -- First commercial magnetic imaging scanner introduced.
1980 -- World Health Organization declares smallpox eradicated.
1981 -- First AIDS cases reported.
1982 -- Blue Cross and Blue Shield associations merge.
1982 -- First permanent artificial heart, the Jarvik-7 invented by Robert Jarvik, M.D., implanted in a human at University of Utah Medical Center by American surgeon William DeVries. Patient Barney Clark lives for 112 days.
1983 -- Medicare's prospective payment system implemented.
1983 -- FDA approves cyclosporine as immunosuppressant drug. It would greatly reduce rejection of transplanted organs.
1984 -- Human immunodeficiency virus identified by French researcher Luc Montagnier and American Robert Gallo.
1984 -- First implant of an animal heart into a human. Twelve-day-old Baby Fae lives for 21 days after receiving the heart of a 7-month-old baboon.
1988 -- First inductions into the Health Care Hall of Fame, housed at Pennsylvania Hospital in Philadelphia.
1988 -- President Reagan signs Medicare Catastrophic Coverage Act. Senior outrage over the plan's extra cost would lead to its repeal in 1989.
1990 -- First gene therapy treatment performed.
1990 -- Human Genome Project launched.
1991 -- National Committee for Quality Assurance begins accrediting managed-care plans.
1993 -- First lady Hillary Rodham Clinton appointed to head White House healthcare reform task force. The group's plan would take months to compose. The 1,300-page proposal, the Health Security Act, would die more than a year later, in late 1994, following a bitter debate.
1995 -- Operation Restore Trust kicks off major federal crackdown on healthcare fraud.
1997 -- British researchers report the first successful cloning of a mammal, a sheep named Dolly.
1997 -- Balanced Budget Act passed. The legislation's provisions would affect just about all sectors of the healthcare industry.
1998 -- Y2K "millennium bug" becomes an increasing concern in healthcare.
1998 -- First legal doctor-assisted suicide reported in Oregon.
1998 -- Viagra sold to treat impotence.
1999 -- First time that hospital executives are convicted of Medicare fraud under federal fraud-and-abuse statutes.
1999 -- Congress continues to grapple with managed-care patient-protection proposals.
Sources: Modern Healthcare; Abbott Laboratories; American Association of Health Plans; American Hospital Association; Associated Press; Blue Cross and Blue Shield Association; Catholic Health Association; Centers for Disease Control and Prevention; Encarta Encyclopedia; General Electric Co.; New England Journal of Medicine; National Kidney Foundation; U.S. Department of Veterans Affairs; World Almanac; World Book Encyclopedia