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Lecture Ten: Specialization and Compensation

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Lecture Ten for HIST 30626

American Medical Reform

  1. 1844-1846: AMA, allopaths only need apply
  2. Mid-century medical incomes: ~$600/year -- a skilled trade
  3. 1890: American Association of Medical Colleges
  4. 1901: AMA Reform, inclusion of homeopaths, eclectics, county, state medical societies
  5. 1888: Dent v. West Virginia
  6. 1893: Foundations
    • Johns Hopkins Medical School
    • Rockefeller General Education Board (GEB)  2/3 to 7 schools
    • Carnegie Flexner Report #4 of 1910

Results of Reform

  1. The new sects: Chiropractic, osteopathy, Christian Science
  2. Decline in medical supply
    • 1906: 161 medical schools
    • 1910: 131 medical schools
    • 1915: 95 medical schools
    • 1922: 81 medical schools

Specialization: "Practice Limited 100% to..."

  1. Old Specialities (c. 1800)
    • Physician
    • Surgeon
  2. Middle Specialities (c. 1850, from Germany)
    • Man midwife
    • ophthalmologist (1916)
    • ear and throat (1924)
    • dentist
    • mad doctor
    • neurologist
    • veneralogist
  3. New Specialities (c. 1900)
    • Technology-related: clinical pathologist, radiologist, anesthesiologist
    • Society-related: pediatrician, psychiatry, psychology
    • Science-related: varieties of surgery, urology, podiatry