THE RISE OF MEDICAL DOMINANCE

Despite the few benefits and many dangers inherent in allopathic medical care, by 1900 doctors had eliminated most of their competitors and gained control over health car. In this section, we will see how this change came about.

From its inception in 1847, the American Medical Association (AMA) had worked to restrain the practices of other health care occupations. State by state, the AMA fought to pass laws outlawing their competitors or restricting them to working only under allopathic supervision or performing only certain tech- niques such as spinal manipulation.

Most of these efforts met with little success initially because 19th-century Americans considered health care an uncomplicated domestic matter, unrelated to science, and requiring no special training. By the beginning of the 20th century, however, as improvements in public health and living conditions ended scourges such as cholera and typhoid and as Americans began reaping prac- tical dividends from scientific advances such as electric lights and streetcars, public faith in science swelled. Increasingly, Americans defined health care as a complex matter requiring expert intervention, assumed the superiority of “scientific” med- icine, and turned to allopathic doctors for care.

Like the public, homeopaths and botanic eclectics (allopathic doctors’ major competitors) also came to recognize the benefits of science and therefore realize that a lack of scientific foundation could doom their fields. However, they still received considerable popular support. Moreover, because, like allopaths, most were white men, homeopaths and botanic eclectics generally held social statuses similar to those of allopaths. Thus, homeopaths and botanic eclectics retained sufficient influence to pressure allopaths to accept them into medical schools and licensing programs, and their fields eventually faded away.

Other health care workers could bring far less power to their dealings with legislators and with allopathic doctors. Newly emerging occupations such as chi- ropractic lacked the long-standing history of popular support that had allowed homeopaths to push for incorporation with allopathy. Meanwhile, older occupations such as midwives and herbalists lacked the social status, power, and money needed to fight against doctors’ lobbying. Because most of these practitioners were women or minorities, they were assumed to be incompetent by both legislators and doctor.