The physician as a moral force in American history

John Duffy

pp. 3-21

in: William B. Bondeson, Tristram Engelhardt, Stuart Spicker, Joseph M. White Jr (eds), New knowledge in the biomedical sciences, Berlin, Springer, 1982

Abstract

Before discussing the profession of medicine it may be well to point out that professionalization is itself a fairly recent development. While doctors, lawyers, professors, and other university-trained individuals have existed in Western society for many centuries, the concept of a highly organized group possessing specialized knowledge and backed by a legally sanctioned monopoly is relatively new. In the American colonial period, neither law nor medicine could properly be called organized professions. Entrance into both of these fields was open to anyone, regardless of qualifications. In the case of medicine the first few tentative efforts to establish licensure laws had only limited success, and opposition to such proposals intensified in the early 19th century with the rise of Jacksonian democracy. All measures by local and state medical societies to require minimum educational standards for entrance into medicine were looked upon askance by legislators convinced that physicians were simply seeking a legal monopoly to improve their financial position. Thus by the 1850's the few existing state licensure laws were completely swept away. Even the ministry, a profession long the prerogative of the educated class, felt the impact of the egalitarian spirit. Both the Great Awakening in the colonial period and the Revival Movement of the early 19th century emphasized emotionalism and revealed religion and led to a multiplication of religious sects. In so doing they opened the ranks of the ministry to all who felt inspired by the Holy Spirit.