Doctor of medicine profession (MD)

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Types of health care providers

Elizabeth Blackwell (1821-1920), upon graduating from Geneva College of Medicine in upstate New York, became the first woman granted an MD degree in the United States.

The Johns Hopkins University School of Medicine opened in 1893. It is cited as being the first medical school in America of "genuine university-type, with adequate endowment, well-equipped laboratories, modern teachers devoted to medical investigation and instruction, and its own hospital in which the training of physicians and healing of sick persons combined to the optimal advantage of both." Johns Hopkins Medical School served as a model for the reorganization of medical education. After this, many sub-standard medical schools closed.

By 1930, nearly all medical schools required a liberal arts degree for admission and provided a 3- to 4-year graded curriculum in medicine and surgery. In addition, many states also required candidates for medical licensure to have completed a 1-year internship in a hospital setting in addition to possessing a degree from a recognized medical school.

The emergence of specialization within American medicine did not take root until the middle of the 19th century. People who objected to specialization said that "specialties operated unfairly toward the general practitioner, implying that he is incompetent to properly treat certain classes of diseases" and that specialization tended "to degrade the general practitioner in the view of the public." However, as the base of knowledge within medicine continued to grow and many doctors chose to do more of what they were interested in and good at, specialization became inevitable.

Economics may have also played an important role as the specialists typically enjoyed higher incomes than did the generalist physicians. The debates between specialists and generalists continue and have recently been fueled by issues related to modern health care reform.

Medicine was the first of the professions to require licensure. State laws specific to the licensure of medicine outlined the activities of "diagnosis" and "treatment" of human conditions strictly within the domain of medicine. Any individual who professed to diagnose or treat as part of the profession could therefore be charged with "practicing medicine without a license." As a result of strict licensure laws that were issued by the various medical societies, conventional Western medicine was able to establish itself as a monopoly over the health care of the American populace.