HIST 249 Lecture Notes - Lecture 16: Jacksonian Democracy, Flexner Report, Abraham Flexner
17 Nov 2016
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Medical pluralism to medical monopoly: unify the profession. From many local occupations representing many social classes to single middle- class profession. Replace external patronage with collective solidarity and professional authority. Treat entire population or at least most of it rather than small segment. Internal segmentation (specialization); grows out of educational-research sphere then becomes dominant form of practice. (but divisions organized and remain part of single profession. ) Relationship to patient: changed from situation of dependence to one of authority, why, patronage disappears, nature of physician"s knowledge, nature of physicians social status, science as claim to cultural authority. Educational reform: homogenize, elevate status, reduce numbers (usually unsuccessful) Practice based on objective signs, images, analyses and measurements not patient"s account: a legally enforced monopoly (treat entire population) Earlier monopolies were fragmented and local and dependent on the patronage of the state. National or provincial monopolies based on credentials: increased social and economic status.
