A Brief History of Medicine in America
Medicine in America was largely unregulated until the late 19th and early 20th centuries. The medical scene consisted of herbal practitioners, naturopaths, lay healers, and regular doctors (now commonly referred to as allopathic doctors). Regular doctors were those who performed medical coursework and completed apprenticeships, whereas lay healers and herbal practitioners were unregulated. At the time, regular doctors’ training was more structured, however it was not well received by the public given the harshness of some of their treatments.
These doctors battled with other types of health practitioners who were their direct competition. As a result, regular doctors banded together and persuaded legislators to pass medical licensing laws that either restricted or prohibited the practice of medicine by “non-regular” doctors. The American Medical Association (AMA) in 1847. The AMA warned that in order for the profession to be lucrative, the number of individual practitioners needed to be limited.
During the same time period, medicine became an “industry,” largely in part to influential people such as Andrew Carnegie and John Rockefeller, who used their considerable wealth to shape American healthcare. In the early 20th century, Henry Pritchett of the Carnegie Foundation hired Abraham Flexner, a non-medical professional, to assess medical education in America. He visited every medical school in America and generated a report that significantly influenced and shaped medical education.
The report created huge disparities in care as many Black medical schools were forced to close due to a lack of funding. Any school outside of the German model of lab-based, research-based medicine was effectively sidelined due to insufficient financing. The Flexner report was also strategic in encouraging wealthy philanthropists to support certain medical programs.
While in many circles he is lauded as a visionary of medical reform, Abraham Flexner single-handedly contributed to the monopolization of medicine in this country.
Black Bodies in Medicine
“Where it was cheaper to use niggers than cats, because they were everywhere, and they were cheap experimental animals.” — Harry Bailey, Psychiatrist
Black folks in America have long been the experimental model. Medical history is replete with examples of Black people being used, dismissed, and abused. This includes but is not limited to Henrietta Lacks, the Tuskegee Syphilis Experiment, Dr. Albert Kligman’s abuse of black prisoners, Dr. Marion Sims’ use of black women for experimental gynecological procedures, the Mississippi appendectomies, Thomas Jefferson and the use of slaves for vaccine testing, and more recently, the black maternal mortality rate. This list is by no means exhaustive nor does it begin to cover the environmental assaults on Black folks at the hands of corporate and government groups in America.
Today’s current system of healthcare education was also built on the backs of Black people. Some universities are finally acknowledging this with Yale, Harvard, and Georgetown recently coming forth and admitting the use of enslaved people in the building of these institutions. Black bodies were also essential to American medical schools as their corpses were used as cadavers without consent — even in death, the enslaved weren’t free.
There are many foundational cracks in American medicine. Intelligence does not absolve racist biases held by many physicians that practice medicine on Black people. Medicine in America needs to be integrated in more ways than one. Understandably, there is a deep and appropriate mistrust held by Black folks towards the American healthcare system. Until racial biases in medicine are completely eliminated, we need more Black doctors seeing Black patients. We need doctors who understand the true racial history of American medicine and can fully empathize with their patients’ apprehension to buy into a system that has never given them a reason to trust it.
Asia Muhammad is a Naturopathic Doctor in St. Louis, MO. She values the power of lifestyle modifications to achieve optimal health. She has a special interest in gastroenterology, mind-body medicine, and stress management, as increasing research demonstrates the role of stress in disease. Asia received her Doctorate in Naturopathic Medicine from Southwest College of Naturopathic Medicine in 2014 and completed a three year independent residency at Arizona Digestive Health. She received her BS in Chemistry and Biology from Middle Tennessee State University in 2010. In her spare time, she enjoys connecting with her community to provide nutrition and exercise education.