On the first day of class, we discussed how modernization has brought the institution of medicine so far. Although the cost of modernization is seen as the “social germ”, modernization has also brought enormous improvement in health. Modern medicine defies all ancient reason. In primitive societies the division of labor was vague, no real specializing in anything, but over years of experimentation and development, the establishment of medicine was born. We now have overflowing systems of specialization and technological advancements, but this did not happen overnight.
Originally, religion had made medicine its own institution, despite Hypocrites suggestion to “take medicine out of religion and make it its own; health depends on other things…” Doctors, when they existed, were not always the powerful profession that they are today. They had far less prestige, and before 1900, were rather despised. But there has always been a need to care for the sick. This dependence eventually called on those in the professional medical field. Being dependent on doctors means that we must submit to their authority and recognize their power, something that took years to come to. The acceptance of this professional authority was a revolution. This revolution created a pyramid of power, defining authority of various groups in a hierarchical sense. But this authority was not readily accepted. The people of the 19th century did not accept doctors as authoritative. They had more “common sense” that that and weren’t ready to give up their own good judgment and submit to a physicians. But time, world events, and changes made the people more dependent. Self- reliance faded at the end of the 19th century, making folks more needy of specialized skill. People spread out geographically and couldn’t rely on their neighbors as much anymore, turning them to professional “strangers” for help. Technologies such as transportation, telephones and hospitals helped welcome the professional world. The sick no longer lay in bed at home, but went into the hospitals to confide in the physicians for healing. Science began to get respect, forcing the scientific world of medicine to be recognized as well. No longer was it up to the woman of the house to keep remedies for illnesses on hand and care for the sick of the house. Domestic medicine was fading out of the picture by the late nineteenth century and professional medicine was rearing its costly head. Professional medicine began to gain legitimacy. It began to convince the public of its value, a necessary component to becoming a dominant profession.
Physicians began to raise their standards and prestige through medical schools and licensing. Professional standards were established, although the cost of an education in medicine was low, making physicians popular and readily available. Unlike today, many physicians found in difficult to support themselves solely from medical practice. Although, there were still definite prestige inequalities among doctors. The wealthier families received help from the elite of the medical professionals the poor received from physicians of lower status and less training. The elite might have gone to Europe to study, expanding their knowledge, demanding more money from their patients. Despite the status of the physician, it was guaranteed that he still earns more money than the average factory worker. Physician’s incomes never increased as much as the early 20th century. The income and prestige of medical professionals grew immensely. Twice as many people were applying to medical schools as were being accepted and highly selective admissions had come about. The profession was developing high entry standards, another component necessary to achieving high status in the professional world.
The Civil War brought an enormous amount of experimentation for those in the medical field. Experience on wounded soldiers gave the medical profession “dummies” and the war created a laboratory. The physicians documented their work and much of what is known today is owed to that accident of history. This experience only brought the profession more authority, demanding more respect, power, and money. The war proved that the professionals were indeed skilled and they were starting to gain trust among the public.
The medical profession had become a monopoly. People no longer question whether or not they will go to a doctor when they’re sick. No one would think to depend on the woman of the house or the town minister to take care of them. Physicians have only become more recognized as powerful, necessary figures. They are ridiculously depended upon for every intricate detail of well-being, and have become so radically specialized that there is no way that one doctor can perform enough that you wouldn’t need another type of doctor for something on your body. This profession of medicine has become dominant and recognized as the most sovereign profession in the United States.