Licensing American Physicians: 1870-1907
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In 1870, physicians in United States were not licensed by the state or federal governments, but by 1900 almost every state and territory passed some form of medical licensing. Regular physicians originally promoted licensing laws as way to marginalize competing Homeopathic and Eclectic physicians, but eventually, elite Regular physicians worked with organized, educated Homeopathic and Eclectic physicians to lobby for medical licensing laws. Physicians knew that medical licensing was not particularly appealing to state legislatures. Therefore, physicians successfully packaged licensing laws with broader public health reforms to convince state legislatures that they were necessary. By tying medical licensing laws with public health measures, physicians also provided a strong legal basis for courts to find these laws constitutional. While courts were somewhat skeptical of licensing, judges ultimately found that licensing laws were a constitutional use of state police powers. The quasi-governmental organizations created by licensing laws used their legal authority to expand the scope of the practice of medicine and slowly sought to force all medical specialists to obtain medical licenses. By expanding the scope of the practice of medicine, physicians successfully seized control of most aspects of healthcare. These organizations also sought to eliminate any unlicensed medical competition by requiring all medical specialists to attend medical schools approved by state licensing boards. Ultimately, licensing laws and a growing understanding of medical science gradually merged the three largest competing medical sects and unified the practice of medicine under physicians. This dissertation includes previously published material.