Medical America in the Nineteenth Century: Readings from the Literature

The Actual Condition of the Medical Profession in This Country; with a Brief Account of Some of the Causes Which Tend to Impede Its Progress, and Interfere with Its Honors and Interests

F. CAMPBELL STEWART THE ACTUAL CONDITION OF THE MEDICAL PROFESSION IN THIS COUNTRY; WITH A BRIEF ACCOUNT OF SOME OF THE CAUSES WHICH TEND TO IMPEDE ITS PROGRESS, AND INTERFERE WITH ITS HONORS AND INTERESTS Editor's Note Ferdinand Campbell Stewart (1815-99) was one of the founders of the New York Academy of Medicine, in 1847, and a well-known New York teacher and clinician when he wrote the essay that follows. After completing his medical training at the University of Pennsylvania, in 1837, he spent several more years studying abroad, mainly in Edinburgh and Paris. In 1843 Stewart, who was eminently qualified to draw comparisons between the medical professions of Europe and America, published The Hospitals and Surgeons of Paris. Stewart wrote at a time when many members of the medical profession, especially in the Eastern states, were very much concerned with standards and position. As he noted in the opening paragraph of the following essay, the initial organizing meeting for what would be the American Medical Association was only a few months away. The A.M.A. took up the fight for better medical education, one of Stewart's main concerns, as a primary order of business. The social standing of the physician Stewart proudly declared, was highloftier , in fact, than in any other country. This elevated position was attracting perhaps too many to the ranks of medicine. But what then of the profession as a whole? Here the story was different, for, as he said, the profession was held in low esteem, often ridiculed. This was a common theme of a number of the authors already mentioned. It is of interest that today the argument still rages. On October 16, 1966, in an article in the New York Times Magazine entitled "The Doctor's Image Is Sickly," Walter Goodman observed many of the same things that agitated Stewart over a century ago. In the last half decade a spate of books critical of the medical profession have appeared. The problems they describe are not all new.1 New YorkJ. Med. 6 (1846): 151-71. ^ee for instance Martin L. Gross, The Doctors (New York: Random House, 1966); and Roul Tunley, The American Health Scandal (New York: Harper & Row, 1966). 62 F. CAMPBELL STEWART 63 AN ANNIVERSARY ADDRESS DELIVERED BEFORE THE NEW YORK MEDICAL AND SURGICAL SOCIETY, ON THE 3d OF JANUARY, 1846 Gentlemen of the Medical and Surgical Society: At a period when the attention of the profession has been called to the subject by a recommendation from our State Medical Society, that a convention of representatives from all the medical corporations throughout the country should assemble in this city in the month of May, for the purpose of considering its wants and endeavoring to remedy the evils by which our profession is surrounded, I conceive that I cannot better fulfil the duty with which you have honored me than by asking your attention to this matter, and endeavoring to lay before you an exposition of what I believe to be the actual condition of the medical profession in this country, and the causes which tend to impede its progress or interfere with its honors and interests. But before proceeding to discuss this subject, I wish distinctly to state, lest some of the remarks that I may have occasion to make may be misinterpreted, that it is not my aim nor my desire to attack individual associations. Occupying a strictly neutral position, bound by no alliance with cliques or parties, and feeling that I am influenced by none other than the purest motives, I shall, whilst disclaiming all feelings of prejudice or partiality, consider myself at liberty to discuss the question that I have raised in all its bearings-in a frank and free spirit, and without fear or hindrance. First, then, what is the actual condition of the profession in this country and what is its relative position here as compared with that which it occupies in other countries? In considering this subject we must draw a distinction between the social standing of the profession—the position which its members are allowed to occupy in society—and that which is accorded to it as a profession and in consideration of its claims and intrinsic merits. In its social relations to the community, I am proud to declare that the medical profession of the United States occupies a more elevated and lofty station than that enjoyed in any other country of the world. Here, owing to the...