History of Medicine in America, Ⅳ
Despite the diverse marketplace being considered an ideal environment for healing opportunities by the public at large, there will always be opposing views in America that will flourish.
This is without a doubt one of the many defining characteristics of America that makes it great!
Among dissenters of the free marketplace of medicine were many regular medicine doctors who despised the extreme competitive business forces at work.
The main perceived dilemma by these dissenting doctors was the over-saturation of medical practitioners in the marketplace which drove their prices down.
In truth, they didn’t like being subjected to the economic laws of supply and demand.
An over-saturation of doctors in the marketplace meant there was less demand on their specific services. As reported in the 1860’s US census, there was a ratio of 175 people to one (1) medical practitioner. In comparison, from 2010 to 2016, that ratio is 339 people to every one (1) medical practitioner.
This over-saturation was in part caused by over-zealous schools of medicine who were turning doctors out as fast as they could. The more students they accepted, the more they could graduate, the more money were able to earn.
There was no requirement to have a license to practice medicine. Many schools of healing were turning out practitioners of every discipline, and all in varying degrees of skill. Even if you took the “irregulars” out of the picture, many regular doctors still thought the quality of education of their cohorts as poor.
Establishing a more favorable marketplace for their profession was the main reason many regular doctors sought to organize themselves through various agencies like the American Medical Association.
Most states had professional associations established to help elevate their profession to higher standards.
They sought to adopt higher standards and ethics for their profession that they wanted to be enforceable, and this was their second most important goal.
For nearly a century, many “regulars” sought to change the free medical marketplace through various strategies. Early on in the early 1800’s, most of these strategies entailed self-imposed standards that organized medicine sought to be enforced throughout their own profession by themselves. Their main strategy in attaining their goals was through the establishment of professional associations that would then organize, assemble and align professionals to their goals.
Other attempts were made through legislation. Because of the previous attempts of the organized regular doctors who opposed the free market place, there were some minor laws in place since the beginning of the 19th century which had minor, inconsequential effects. For instance, the first licensing of physicians in America was really a voluntary registration that allowed doctor’s more power in the courts to settle disputes. Though, the powers granted were basically useless in their day.
Most, if not all, of these early strategies were ineffective. Attempts at meeting these goals through professional associations proved to be unsupported by the public and for that reason were unsuccessful.
Also, their lack of success can also be attributed to the extreme opposition that they received from the schools of medicine, who just did not comply. They had their own agenda, and that was to conduct their business as they saw fit.
This is America after all, where individual autonomy is greatly valued.
Very few, if any, people, organizations or otherwise like someone else meddling in their personal affairs.
This is how the schools saw it. It was for these reasons that organized medicine decided to take a different approach, and that was through legislation.